Spirituality

Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

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Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

 

By John M. de Castro, Ph.D.

 

“Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.” – National Cancer Institute

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Not only the patient but also the caregivers have difficult issues to cope with. Providing care for cancer patients can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Caregiving comes at a cost to the caregiver. It exacts an economic toll in lost work hours, income, and even the opportunity to take a promotion or relocate for a better position. But, more significantly, it exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Obviously, there is a need to both care for the cancer patients and also for the caregivers. Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer and also for their caregivers. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens of cancer or on the quality of life of cancer patients and their caregivers. Hence, there is a need to study the effects of spiritual care on the cancer patient and their caregivers.

 

In today’s Research News article “Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/

Sankhe and colleagues recruited adult cancer patients undergoing surgery whose life expectancy exceeded 6 months and one of their caregivers. This was a pilot study without a control group in which all patients and caregivers were provided with spiritual care consisting of 90 minutes daily counseling, reading and chanting. They were measured at the baseline, discharge and 2, 4, and 6 months following the surgery, for spiritual well-being and quality of life, including physical well-being, social/family well-being, emotional well-being and functional well-being.

 

They found that both the cancer patients and their caregivers had large and significant improvements in spiritual well-being and in all quality of life domains. These improvements were maintained 6 months after discharge. These are impressive effects of spiritual care but, because of the lack of a control condition, any conclusions must be tempered with the understanding that there are a myriad of possible confounding factors. The results do though provide strong evidence for the conduct of a randomized controlled clinical trial of providing spiritual care for cancer patients and their caregivers.

 

So, improve cancer patient and caregiver well-being with spiritual care.

 

“Spirituality and religion can be important to the well-being of people who have cancer, enabling them to better cope with the disease. Spirituality and religion may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.” – National Comprehensive Cancer Network

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Sankhe, A., Dalal, K., Agarwal, V., & Sarve, P. (2017). Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study. Journal of Religion and Health, 56(2), 725–731. http://doi.org/10.1007/s10943-016-0324-6

 

Abstract

Spiritual care is still in infancy stage all over the globe including India. The present study was an original study evaluating the role of spiritual care in cancer patients and their primary caregivers regarding their spiritual and general well-being. The study was a prospective, non-randomized single-group study involving cancer patients undergoing surgery and their primary caregivers. Functional assessment of cancer therapy—general and functional assessment of chronic illness therapy-spiritual care was evaluated during the admission and at the time of discharge, two, four  and 6 months following discharge from the hospital. Descriptive statistics was used for demographic details and repeated measure ANOVA with Dunn’s test was used for analysis of changes in the scores. A total of 107 (63 males and 44 females) patients with a mean (SD) of age 51 (13) years were recruited in the study. Similarly, for each patient one of their primary caregivers was recruited with their mean (SD) age of 39.4 (12.7) years. A total of 11/107 (10.3%) patients died and nine out of 107 (8.4%) were lost to follow-up eventually during the study period. There was a statistically significant (P < 0.0001) increase in the scores at all the follow-up periods in both the patient and their relative groups. To conclude, we found out that spiritual care on the basis of MATCH guideline improved the level of not only spiritual well-being but general well-being also in both the patients and their primary caregivers. Control group could have improved scientific validity of study in accessing effect of spiritual care. Authors believe that more robust comparative study on each principle against all five MATCH principles in future will add scientific validity and clear the various ambiguities in spiritual care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/

 

Improve Psychological Well-Being in Gay Men with Spirituality

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Improve Psychological Well-Being in Gay Men with Spirituality

 

By John M. de Castro, Ph.D.

 

“spirituality can offer a vision of hope and meaning in a world that sometimes appears to be a hopeless miasma of pain and suffering. At its best, spirituality bestows vision and love of life. It widens our perspective. It sensitizes us to beauty and vitality–the very things at which gay men excel.” – Toby Johnson
Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. These are also all characteristics that the great psychologist Abraham Maslow labelled self-actualization.

 

These are lofty goals that only few truly accomplish completely. But, we can strive to improve at each. Religion and spirituality encourage such personal growth. Indeed, spirituality appears to be associated with more positive attitudes toward physical and psychological difficulties and improved overall psychological well-being. For gay men, there can be a conflict between their religion and their sexual identity as “many religious/spiritual institutions continue to hold conservative and/or hostile attitudes toward same-sex behaviors.” As a result, the relationship between religion/spirituality and psychological well-being can be complicated for gay men.

 

In today’s Research News article “Psychological well-being among religious and spiritual-identified young gay and bisexual men.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289650/

Meanley and colleagues study the relationship of religion and spirituality to psychological well-being in gay men. They recruited male gay men and transsexuals between the ages of 18 to 29 years to complete an on-line survey containing measures of religious commitment, participation, and coping, self-esteem, life purpose, internalize homophobia, and community stigma. Interestingly, 80% of the sample identified as religious and or spiritual.

 

As evidence that religion and spirituality can produce a conflict with sexual identity they found that participants who identified as religious/spiritual had significantly high internalized homophobia. Importantly, they also found that religiosity was associated with higher community stigma and internalized homophobia and lower purpose in life and self-esteem. But, on the other hand, spirituality was associated with higher purpose in life and self-esteem.

 

These results are interesting and suggest that for young gay men, adherence and commitment to a religion is associated with poorer psychological well-being while spirituality is associated with better psychological well-being. This makes sense as many traditional religions have teachings contrary to same sex sexual behaviors. But, the spiritual domain does not contain any particular dogma. By adhering to spirituality as opposed to religion gay men can bypass the conflict and reap the benefits of spirituality for psychological well-being.

 

So, improve psychological well-being in gay men with spirituality.

 

“many homosexuals naturally embody the traits of sensitivity and gentleness that religion is intended to teach. Gay men are often saints and moral exemplars. In spite of the contrary examples that can be offered, there is a goodness and virtue that runs through gay men’s lives, and a demonstration of real spirituality in how many of us resolve the problem of making sense of religion in the modern world.” – Toby Johnson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Meanley, S., Pingel, E. S., & Bauermeister, J. A. (2016). Psychological well-being among religious and spiritual-identified young gay and bisexual men. Sexuality Research & Social Policy : Journal of NSRC : SR & SP, 13(1), 35–45. http://doi.org/10.1007/s13178-015-0199-4

 

Abstract

Religiosity and spirituality are often integral facets of human development. Young gay and bisexual men (YGBM), however, may find themselves at odds when attempting to reconcile potentially conflicting identities like religion and their sexual orientation. We sought to explore how different components of religiosity (participation, commitment, spiritual coping) are linked to different markers of psychological well-being (life purpose, self-esteem, and internalized homophobia). Using data collected in Metro Detroit (N = 351 ages 18–29 years; 47% African American, 29% Non-Latino White, 8% Latino, 16% Other Race), we examined how components of religiosity/spirituality were associated with psychological well-being among religious/spiritual-identified participants. An overwhelming majority (79.5%) identified as religious/spiritual, with most YGBM (91.0%) reporting spirituality as a coping source. Over three quarters of our religious/spiritual sample (77.7%) reported attending a religious service in the past year. Religious participation and commitment were negatively associated with psychological well-being. Conversely, spiritual coping was positively associated with YGBM’s psychological well-being. Programs assisting YGBM navigate multiple/conflicting identities through sexuality-affirming resources may aid improve of their psychological well-being. We discuss the public health potential of increasing sensitivity to the religious/spiritual needs of YGBM across social service organizations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289650/

Spiritual Concerns Decrease Quality of Life in Cancer Patients

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Spiritual Concerns Decrease Quality of Life in Cancer Patients

 

By John M. de Castro, Ph.D.

 

“For some, a cancer diagnosis has the opposite effect on their sense of spirituality. It makes them doubt their beliefs or religious values, challenges their faith, and can cause spiritual distress. Some people become angry with God for allowing them to get cancer or wonder if they are being punished. Spiritual distress can make it harder for patients to cope with cancer and its treatment.” –  National Comprehensive Cancer Network

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer, when living with advanced cancer, and at end of life care. It is thought that people take comfort in the spiritual when facing their own mortality. There is very little information available, however, regarding the effectiveness of religion and spirituality in relieving the psychological burdens of cancer or on the quality of life of advance cancer patients. Additionally, the impact of spiritual concerns that the patient might have are not known. Concerns such as feelings of being abandoned by God or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort.

 

In today’s Research News article “The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Winkelman and colleagues study the relationship of patients’ spiritual concern to their quality of life with advanced cancer. They recruited terminal cancer patients who were undergoing palliative radiation treatments. They completed measures of religiousness, spirituality, spiritual concerns including spiritual struggles and spiritual seeking, and quality of life including physical and existential quality of life. The patients died on average of 180 days after completing the measures.

 

The majority of the patients experienced one or more forms of spiritual struggle (58%), and most (82%) experienced spiritual seeking. Their struggles included “wondering why God has allowed this to happen” and “wondering whether God has abandoned me.” The most common spiritual seekings were “seeking a closer connection to God” and “thinking about what gives meaning to life.”  They found that the greater the spiritual concerns, spiritual struggles, or spiritual concerns, the lower the patient’s quality of life. Virtually all of the patients indicated that spiritual care was important in their treatment.

 

These results are somewhat surprising in that religiousness and spirituality were not associated with comfort but with poorer quality of life in these terminal cancer patients. In particular, it appears that concerns about the spiritual meaning of their situation were very common and greatly troubled the patients leading to poorer quality of life. Being at peace with God is a very important goal of these patients and their concerns interfered with attaining that peace. Hence, it appears that in hospice and palliative care there should be greater attention paid to the religiousness and spirituality of the patients, particularly to their spiritual concerns, struggles, and seeking. This is important as spiritual concerns trouble them deeply and decrease the quality of life of terminal cancer patients.

 

 “When we took a closer look, we found that patients with stronger spiritual well-being, more benign images of God (such as perceptions of a benevolent rather than an angry or distant God), or stronger beliefs (such as convictions that a personal God can be called upon for assistance) reported better social health. In contrast, those who struggled with their faith fared more poorly.” – Allen Sherman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Winkelman, W. D., Lauderdale, K., Balboni, M. J., Phelps, A. C., Peteet, J. R., Block, S. D., … Balboni, T. A. (2011). The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings. Journal of Palliative Medicine, 14(9), 1022–1028. http://doi.org/10.1089/jpm.2010.0536

 

Abstract

Purpose

Religion and/or spirituality (R/S) have increasingly been recognized as key elements in patients’ experience of advanced illness. This study examines the relationship of spiritual concerns (SCs) to quality of life (QOL) in patients with advanced cancer.

Patients and Methods

Patients were recruited between March 3, 2006 and April 14, 2008 as part of a survey-based study of 69 cancer patients receiving palliative radiotherapy. Sixteen SCs were assessed, including 11 items assessing spiritual struggles (e.g., feeling abandoned by God) and 5 items assessing spiritual seeking (e.g., seeking forgiveness, thinking about what gives meaning in life). The relationship of SCs to patient QOL domains was examined using univariable and multivariable regression analysis.

Results

Most patients (86%) endorsed one or more SCs, with a median of 4 per patient. Younger age was associated with a greater burden of SCs (β = −0.01, p = 0.006). Total spiritual struggles, spiritual seeking, and SCs were each associated with worse psychological QOL (β = −1.11, p = 0.01; β = −1.67, p < 0.05; and β = −1.06, p < 0.001). One of the most common forms of spiritual seeking (endorsed by 54%)—thinking about what gives meaning to life—was associated with worse psychological and overall QOL (β = − 5.75, p = 0.02; β = −12.94, p = 0.02). Most patients (86%) believed it was important for health care professionals to consider patient SCs within the medical setting.

Conclusions

SCs are associated with poorer QOL among advanced cancer patients. Furthermore, most patients view attention to SCs as an important part of medical care. These findings underscore the important role of spiritual care in palliative cancer management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

What’s Wrong with Meditation III – Jargon

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What’s Wrong with Meditation III – Jargon

 

By John M. de Castro, Ph.D.

 

“Since clarity is beneficial and if Buddhism really is adaptable, then using one’s own language in its study should not be a big deal. I’m not trying to be Anglo-centric but it seems like we all lay it on thick some times.” – Brian Schell

 

As was discussed in the prior essay on What’s Wrong with Meditation I – Expectations  and What’s Wrong with Meditation II – Improper Instructions there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the focus of the present essay, the jargon used to describe the process, experiences, obstacles, and results are extreme, resulting in ideas and expectations that far exceed normal experience and miss the most powerful aspects of the teachings.

 

Words and phrases such as suffering, emptiness, impermanence, greed, quieting the mind, stopping thoughts, clinging, no-self, abandonment of desire, karma, etc. are in a sense accurate, but they present too extreme an image of what the process is, what actually occurs, and what are the desired outcomes. This can cause the practitioner to be looking for the wrong experiences and completely miss it when the experiences are moving in the right direction. In fact, a recent issue of a Buddhist magazine had three separate full articles each explaining what was meant by a particular term. No wonder the novice doesn’t have a clue what they mean.

 

Let’s start with “suffering.” We are told that the purpose of meditation is liberation from suffering. This term is often thought by the beginner, as was true for me, to mean very painful or highly damaging. I was taught that the way to liberation was through suffering. This gave me problems because I didn’t believe that I was suffering and this left me at sea as to how to proceed with meditation. But, the word that the Buddha used was dukkha which is often translated as “suffering” but this Pali word also can also be translated as unsatisfactoriness. Now that’s a completely different story. Looking at experience it can readily be seen that humans find most things in their live as not being satisfying. In fact, we wish that most of our experiences were different than they were. We want the news to be different, we want our meal to taste better, we want our route to be free of traffic, we want others to think like we do, etc. The truth is that unsatisfactoriness is everywhere all of the time in our lives. Once we see this we can begin to meditate on why we find things to be so unsatisfactory. We can begin to uncover the universality of the Buddha’s teachings. We can begin to see our egos refusing to accept things as they are, producing unsatisfactoriness. What a difference a translation of a word makes.

 

We often hear the word greed as a desire that we should release. When I think of greed, I picture intense pursuit of money, like in the movie “Wall Street.” That being the case, it seemed that releasing greed is not a problem as I don’t think of myself as having that level of desire for money or things. But, again, the word is deceptive. What is actually meant by greed is wanting things, anything, even simple things, like a piece of candy, a new wallet, a significant other, the red light to change, win a point in tennis, for it to stop raining, etc. So, what we need to work on eliminating is not extreme avarice, but desiring things.

 

So, when we’re meditating should we release the desire to have anything. No, again that’s not the meaning. Desire for things is in human nature. There’s nothing wrong with it. In fact, it’s healthy. What needs to be released is insisting that you get the desired outcome. It is not needed that you meditate on releasing the desire, rather releasing the need for a particular outcome. This is even true for meditation. We need to release the desire to “make progress,” to “clear our minds,” to get into a new state of consciousness, etc. When it is said to eliminate greed, it simply means to eliminate the stake we might have in attaining the thing we desire. If we don’t get it or we get something we’re not expecting, it’s OK. We’re not married to the outcome. This is what is meant by another confusing term equanimity. It just doesn’t matter what happens, whether the desired outcome or something different happens. It’s perfectly OK either way.

 

One of the most confusing pieces of jargon is no self. We are instructed to practice and realize that there isn’t a self. This is sometimes termed losing the center. When I first heard of no-self, I envisioned it as being a state devoid of an experiencing entity. But, again that’s not the meaning. The mind produces a concept of self, based upon experience and conditioning, which is very useful in negotiating our world. But, it is a hypothetical construct. There is no thing that can be pointed to that is the self. It’s simply a term used to summarize a set of experiences. This construct is not permanent and unchanging but evolves and changes with experience. What the idea of no-self refers to is just that. There is no thing that is the self and there is nothing permanent called the self. Hence, there is no permanent self, or no self. Seeing this we can meditate on the self and become aware of its artificial and ever changing nature. We can begin to understand what is real and what is constructed reality.

 

When we meditate we are instructed that we should quiet the mind. When I first heard this I envisioned producing a state with no disturbance, no thoughts, feelings, interpretations, etc. But, once more that is not what is meant by quieting the mind. Thoughts, feelings, sensations, etc. arise in the mind spontaneously. There is nothing wrong with this. It’s the natural ongoing function of mind to do this. What’s referred to as quieting the mind simply means not to respond to these sensations. It simply means allow them to arise and to fall away without reaction, simply watching them. Thoughts will occur but in a “quieted mind” they are simply noted and let to dissipate without further processing. Likewise, sounds, sights, tactile sensations are only observed without further attention. Similarly, feelings arise, are observed, and allowed to simply dissipate without thought, or any attention at all. So, the “quieted mind” is not exactly quiet. Lots can be going on. But, whatever is happening is not reacted to, attended to, or thought about in any way. So, in meditation, we quiet the mind, not by turning things off, but by being a passive observer, letting them flow in and flow out, arise and fall away, come and go. This needed explanation because the term used can easily give a wrong impression and lead the meditator to try to control what can’t be controlled, leading to frustration and feelings of failure. Understanding what is really meant by the term produces peace and progress in meditation.

 

Meditation practice is often confusing and new practitioners often assume meditation is something other than it is because of the problematic and misleading terms used in its description and instruction. If you want to meditate it is important that proper instruction is provided in the early stages of practice so that it can develop appropriately. Without this instruction the meditator can move in wrong directions, become frustrated, and abandon the practice. With proper instruction, the meditator can understand the process, understand when its going in the right direction, be patient with its ups and downs, gradually improve the practice, and enjoy all of the wonderful benefits of a meditation practice.

 

“A seeker may be clever and may understand the exceedingly complicated principles of Buddhist philosophy, but is this really wisdom? These concepts have been born through excessive philosophizing in overly intellectual environments, where monks apparently had nothing better to do than analyze trivial things rather than find a clear path to enlightenment. To be intelligent is to aspire to gain the right knowledge: knowledge which is directly useful in the task of finding peace and realizing our true self.” – Anadi

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch.

What’s Wrong with Meditation II – Improper Instruction

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Image result for upset with meditation

What’s Wrong with Meditation II – Improper Instruction

 

By John M. de Castro, Ph.D.

 

“The next biggest danger is that no one thinks there are or can be any dangers to meditation, so there is almost no discussion and information-gathering on the subject. Everyone is just going blah blah about the benefits. As a consequence, meditators are constantly being blindsided and derailed by things that should be trivial hazards, easily dismissed or bypassed. If we compare meditation to a day at the beach, it is as if people are saying, “Oh, don’t worry, you can never get enough direct sunlight. Just soak it up. You don’t even need a hat. And swim out in the ocean as far as you want. It’s a lake. With dolphins that will love you.”” – Lorin Roche

 

As was discussed in the prior essay on What’s Wrong with Meditation I – Expectations there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, is the focus of the present essay, that immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

The Dalai Lama was brought on a tour of a major new meditation center in the United States. At the end of the tour, he simply asked “where’s the library?” He was astonished when he was told that there wasn’t one. He commented that before any of his new monks were allowed to meditate that had to spend at least a couple of years studying before they were allowed to meditate. He stressed that it is imperative that the practitioner have a proper background to understand the practical and theoretical basis for meditation before starting. This story exemplifies the difference between ancient Tibetan practice and meditation as it’s taught in the west where practitioners are launched into meditation practice with only minimal instruction. Hence people dive in without knowledge of obstacles and dangers hidden beneath the surface.

 

This western practice would be fine if meditation was straightforward and there weren’t any difficulties and traps that could ensnare the meditator. But, meditation practice is not simple and straightforward and without instruction in what to expect and how to recognize true progress, the practitioner is left to grope and stumble their way through the process. Beginners are generally not instructed, except in very general terms, as to what is the goal and how to recognize it if they attain it. They are frequently told to just follow and/or count the breath but receive no instruction as to what to do when their mind inevitably wanders. They are told simply return to following the breath. This was exactly how I was instructed when I began meditation practice.

 

As a result of this lack of instruction, beginners deride themselves for mind wandering making the process unpleasant. They are not told that this is effectively punishing themselves for recognizing that their mind has wandered. This makes it less likely that the individual will recognize and return from mental discursions. With a little instruction, they can learn that minds do what minds do, and that’s OK. They’re going to wander. Get used to it! But, they also need to be instructed to celebrate their recognizing it and returning to the meditative focus. This instruction produces reward for recognizing that the mind has wandered making it more likely that it will be recognized again and sooner. If beginners were simply given this much simple instruction their meditation practice will be much more enjoyable and productive and they’ll be much less likely to give up the practice.

 

Beginning meditators are frequently told that they should quiet the mind but are never instructed as to exactly what that means. They often confuse a quiet mind with a total blank, believing that a quiet mind is one without content. If they are simply instructed that they are to quiet the internal chatter, not everything. There’ll still be sounds, sights, odors, touches, etc. But when the mind is quiet there is no verbal commentary accompanying them. They are simply observing these stimuli as they are without categorization, judgment, labelling, reflection on past stimuli, or projections as to the future course of the stimuli. That’s a quiet mind. But few beginners are taught this. A completely blank mind can and will happen later in practice, but only after the mind has been quieted, not stopped. If beginning meditators were simply provided instruction about what is their goal and what a quiet mind is actually like their meditation practice will be much more enjoyable and productive.

 

A very important instruction for beginners is to warn them about the troubling kinds of thoughts and memories that often spontaneously arise during meditation. People come with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But, often the thoughts or memories are overwhelming. Proper instruction is needed on how to work with issues gradually, avoiding delving too deeply too soon. At retreats, there are always boxes and boxes of tissues available for the inevitable copious tears shed by some of the participants as they are dealing with deeply troubling issues. Yes, in meditation you try to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The practitioner needs proper instruction beforehand of the likelihood of this happening and how to deal effectively with it. Knowing that this is normal, healthy, and part of the process, helps immeasurably to lessen the impact of these thoughts and memories on the individual and increases the likelihood that they can be effectively resolved. At times, professional therapeutic intervention may be needed. Once again, if this is understood ahead of time, the individual is more likely to seek assistance.

 

Meditation practice can also produce some troubling experiences beyond unmasking deep psychological issues. These are rarely presented or discussed with people before engaging in meditation. Not the least of these experiences are awakening experiences themselves. These can occur at any time and even to beginners. If they are not properly understood, they can lead to sometimes devastating consequences. These experiences are so powerful and unusual that they can be misinterpreted. Awakening experiences have been misdiagnosed as psychotic breaks and the individual placed on powerful drugs and/or institutionalized. There are no systematic studies of the extent of this problem, but a number of psychiatrists who meditate and understand awakening experiences have said that it is quiet extensive. At the very least, the individual may believe that they are losing their sanity or as one has said, “I just got used to the idea that occasionally I would have just one of those days.” This is one of the reasons why the Dalai Lama insists that beginners study first, so they can recognize what is happening to them if and when these experiences arise.

 

Meditation practice can sometimes produce energetic states that can vary in intensity, location, and duration. If and when these occur, they are usually quite surprising and unexpected. Many practitioners never experience these states or only experience very mild energy states. But, for those that do, if they have no prior instruction they can readily misinterpret them. They are sometimes called Kundalini energy states and involve energy focused in specific parts of the body or overall. They can feel like nervousness, tension, or almost like electrical currents flowing through the body and can produce spontaneous and undirected movements. These can be minor or overwhelmingly intense and can last from a few days to years. With these states sleep can be quite difficult and the individual may go days at a time without any sleep whatsoever. These energy states are usually found to be aversive and difficult to cope with. If the practitioner hasn’t been instructed about these states, they may seek out medical help. Unfortunately, the medical professions are not trained to recognize these states and often prescribe powerful anxiolytic drugs that can stupefy the individual but not affect the energies. Monasteries and major retreat centers are often equipped to recognize and treat these energies states. But, the vast majority of meditators and meditation instructions are completely devoid of an understanding of Kundalini energies. A little prior study and instruction can go a long way toward preventing misinterpretations and getting assistance from experienced teachers.

 

Another state that can be produced by awakening experiences has been termed as the “dark night of the soul.” After awakening there is, almost inevitably, a honeymoon period of happiness and bliss. But this is frequently followed by an aversive state that has been described as a spiritual desert. These have been reported by awakened individuals throughout the centuries, including the Christian and Sufi mystics and saints, Buddhist masters, and everyday practitioners. In these states the individual loses interest in life and seemingly has no motivation to do virtually anything. They feel emotionally dry and lament the loss of what they call the juice of life. Everything is flat and the individual often becomes deeply depressed. This dark night can last for months or years. To deal with dark nights the individual needs sophisticated instruction from accomplished teachers. No preparatory instruction will help to stop or prevent this from occurring. But, with proper instruction the individual can be better prepared to understand what is happening to them and what to expect in the future. This again can prevent misinterpretation and consequent maladaptive responses and harmful consequences.

 

At this point it should be clear why the Dalai Lama is so insistent upon extensive study and instruction prior to engaging in meditation. It can prevent potential negative reactions and consequences to some of the unexpected consequences of meditation. It has been my experience that the less instruction a person has prior to engaging in meditation the greater the likelihood that problems occur and the greater the likelihood of them being misinterpreted and counterproductive and even damaging responses occurring. So, study about meditation, work with an experienced teacher, and prepare yourself ahead of time before getting deeply involved in meditation practice. If you do, the rewards can be maximized and the pitfalls minimized, making practice productive and potentially profoundly altering.

 

The issues discussed above can seem off putting. You may be asking yourself if it makes any sense at all to engage in a meditation practice with all these potential problems. The answer is a resounding yes. The amazing benefits of meditation practice on your psychological, emotional, physical, and spiritual health make it well worth the effort. In fact, it has the potential to change you in profound ways for all of existence. The above caveats should be taken as indicators that study and guidance should be undertaken and that meditation should be practiced with understanding of what to expect both good and bad ahead of time. These warnings are important but should not be taken a stop signs, only caution signs. Know what you’re getting into, be prepared, and then reap the extraordinary benefits.

 

“It’s a kind of re-birth.  The dark night of the soul is a kind of death that you die.  What dies is the egoic sense of self.  Of course, death is always painful, but nothing real has actually died there – only an illusory identity.  Now it is probably the case that some people who’ve gone through this transformation realized that they had to go through that, in order to bring about a spiritual awakening.  Often it is part of the awakening process, the death of the old self and the birth of the true self.” – Eckhart Tolle
CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

What’s Wrong with Meditation 1 – Expectations

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What’s Wrong with Meditation 1 – Expectations

 

By John M. de Castro, Ph.D.

 

“When you meditate, whether you know it or not, you unconsciously setup expectations or conditions. This starts off simple enough. You expect to relax, you expect to release tension from your muscles or core, you expect to find some relief from your day-to-day concerns etc. These expectations, although they may be subconscious and we aren’t aware of them, they are there and often feed the babbler. More so, they greatly limit the depth of meditation you will experience. For the novice, it can make the difference of finding yourself frustrated half way through your meditation because you are dissatisfied that you are not relaxing as much as you had hoped or expected. So by default your session has ended or ironically created more frustration and self-disappointment.” – Eric Pepin

 

How many time have I heard people say, “I tried meditation, but I can’t do it,” or “I tried meditation, but it scared me,” or “I stopped meditating since it didn’t seem to be going anywhere,” or “It’s against my religion to engage in a heathen practice.” These statements are reflective of the large numbers of people who could benefit from meditation but refuse to try it, abandon the practice, or feel that they failed at the practice and abandoned it. All of these statements reflect the prevailing misconceptions and misunderstandings about meditation.

 

I believe that there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

These three problems set up expectations about what the meditator is supposed do and what should be experienced. Unfortunately, that is simply not what actually occurs. As a result, new practitioners quickly give up the practice as they find that they can’t meditate like their image of what meditation should be, they get overwhelmed by the unexpected and powerful psychological issues that arise, sometime precipitating negative consequences, or they are thoroughly disappointed as they discover the promised benefits are subtler than they were led to believe. I’ll admit it, that I was a victim of inaccurate expectations and I’d be willing to bet that at the beginning of a meditation practice most westerners also have them.

 

The media, including print, video, books, and the internet have presented idealized images of meditation, including blissfully meditating people in serene settings. They are presented on the seashore, on mountain tops, at waterfalls, in gorgeous temples, in meditation groups populated by extremely attractive young people, and even floating in the clouds. Just do a google search on meditation pictures and this is what you’ll find. These can be wonderful settings, except perhaps clouds, but are not the usual or even common setting where meditation occurs. Meditation not only doesn’t require this it actually distorts reality. For example, the meditation hall in one of the first meditation centers in the U.S., the San Francisco Zen Center, is located at street level on a noisy, busy city street.

 

Establishing a relatively quiet place to meditate is helpful, but meditation can occur virtually anywhere. I frequently meditate while sitting at the gate at an airport waiting for my flight to board, while in flight, or in a car when I’m a passenger on a long trip. When the weathers nice I like to meditate in my back yard, with the breeze blowing, with noise from traffic barking dogs, and planes passing overhead prevalent. In fact, I find meditation in real-world settings to be particularly beneficial. After all, meditation is useful only to the extent that it transfers to the real world. If meditation only produced effects that only occurred in a quiet room, it wouldn’t be very useful. For meditation effects to transfer to real life, what psychologists call generalization, then the more similar the meditation environment is to the real world, the better. It can be difficult to meditate with all the hubbub and distraction of the real world, but you can learn more, practicing observing without judgment when there’s lots present that you normally judge.

 

The media also presents images of meditating people in perfect lotus posture, with serene, peaceful, and blissful expressions. But, meditation is rarely blissful. It’s wonderful when it is. But, this is the rare exception, not the rule. For that matter it’s rarely peaceful and serene. Once again, it’s great on the rare occasions when it is, but this is not the usual experience. Meditation is often chaotic, sometimes stressful, sometimes troubling, but, if you take an open attitude, it’s always beneficial. That is not to say that meditation does not bring serenity, happiness, and occasional bliss. It does. But, not at first and not with every meditation. These states grow over time. I had people commenting about how I’d changed before I even realized it myself. Be patient. It will happen.

 

Also, very few meditators can comfortably maintain a lotus position. Most find that they are better off sitting in a chair, kneeling with a bench, sitting with a back-jack, or with their feet up in a recliner. We’re taught that getting too comfortable promotes sleepiness and therefore erect sitting postures on a mat are preferred. What is not taught is how excruciating painful these postures can be and how pain is not conducive to meditation. The truth is, each individual needs to experiment to find what works best for them and discard the media’s image of what should be. Meditation is best when the individual is alert but comfortable. Every individual needs to find the position and posture that produces this state of alert comfort best for them.

 

One of the most frequent misunderstandings is that meditation produces a quiet mind. This is generally what is taught and expected with meditation. It’s true with continued practice the mind does settle down and occasionally becomes quiet. But, again, this is not the typical experience, particularly for new meditators. I have frequently asked groups of people who are not practiced meditators to simply try to close their eyes and count breaths while concentrating on their breathing for two minutes. They are often astounded to find that they can’t do this. Within a brief time after beginning their minds wander. I point out to them that they were unable to control their mind even for two minutes. It’s important that the beginning meditator should take note that they can’t control their mind and reflect upon the fact that their notions of control are delusions. They are not in control at all. This is eye opening. It is rarely taught to the beginning meditator, but is perhaps the most important teaching of all before entering into a meditation practice. You can learn from looking at what the mind does rather than trying to quiet it and getting frustrated. You can learn a great deal from the so called “monkey mind.” Fighting it is doomed to failure. Instead watch it and learn. Learn that you are not your mind!

 

It is important that we teach the realities of meditation rather than the ideal. Beginning meditators need to be instructed not to expect to be able to control their minds, but to relax, learn from the internal chaos, don’t fight it and don’t invite it in, just observe it. Don’t worry about perfect posture and position. Explore what works best that produces a state of sustainable alert comfort. Don’t only meditate in quiet comfortable surroundings. Rather, meditate where you are when reflective time is available. It doesn’t have to be for a fixed period of time. Again, experiment and find what works and don’t be afraid to change it. Think of meditation practice as an experiment with one participant. See how it goes, keep what works, and change what doesn’t. Finally, leave expectation at the door. See for yourself. Be open. Let it flow. The benefits will come but only when you stop trying to make them happen.

 

 “‘It is hard to have a balanced view when the media is full of articles attesting to the benefits of meditation and mindfulness. We need to be aware that reports of benefits are often inflated … whereas studies that do not discover significant benefits rarely pick up media interest, and negative effects are seldom talked about.” – Catherine Wikholm

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Where Can Permanence be Found?

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Where Can Permanence be Found?

 

By John M. de Castro

 

“We suffer from a hallucination, from a false and distorted sensation of our own existence as living organisms. It is almost banal to say so, yet it needs to be stressed continually: all is creation, all is change, all is flux, all is metamorphosis.” – Alan Watts

 

There is a prevalent delusion that there is permanence and stability in our existence. In fact, we so expect it that we are upset when things change. In truth, permanence is hard to find when one looks. Our immediate experience is constantly changing. As the Buddha taught, it’s impermanent. This is clear as sounds, sights, smells, tastes, and touches come and go constantly. They never stick around for long.

 

It’s a little harder to notice that our bodies are also constantly changing. It happens at a slower rate than immediate experience, but is constantly happening nonetheless. Over time every cell in our body degenerates and is replaced. We take in new molecules in the forms of air, water, and nutrients, using them to fuel the body and grow and replace tissues and excrete old and toxic molecules in the breath, sweat, and elimination processes. These ongoing processes mean that we are physically different than we were just a few minutes ago. This is most evident in the maturation process, growing, developing, maturing, and aging. Hence, not only our experience but also our physiology is impermanent and constantly changing.

 

The mind seems reasonably constant. But, with a little study and reflection, it can be seen that it too is constantly changing. We learn and change as we grow, acquiring language and mathematics, fundamentally changing the mind, from purely experiential to conceptual, from present moment to future planning, and as we acquire memories, from present to past. Increasingly the mind moves away from raw present moment experience to memories of the past and images of the future. From moment to moment our thoughts and images are changing. Hence, not only our experience and physiology but also our mind is impermanent and constantly changing.

 

But, surely there is permanence in our world. The ground we stand on is solid and unmoving. It is apparently unchanging and permanent. But, this is an illusion produced by the limited time spans that we directly experience. Every aspect of the earth itself is also changing and impermanent. We recently spent a week exploring the National Parks in Utah. The rock formations and canyons teach lessons that are written in a time frame that extends, not days or years or decades, or even millennia, but in billions of years. It’s recorded in geological time. To see the impermanence, it is necessary to view the parks from the perspective of this time frame. When one does, it becomes clear that everything about the earth is in motion, including the very ground under our feet.

 

We learned that the sand under our feet in Utah was formed from eroding sandstone that itself was formed from the erosion of the Appalachian Mountains, being washed westward by erosion into the rivers, forming a shoreline that millions of years ago was located in what is now Utah. As the Colorado Plateau raised up these sands formed into sandstone. This sandstone has been in turn eroding and washing toward the west coast. In fact, it has already formed sandstone in California. Hence, it has moved and reformed only to have it eroded moved and reformed again. It has, is, and will be in constant motion. But, not in human time rather in geologic time.

 

I spent reflective time looking over the Sulphur Creek Canyon in Capitol Reef National Park. It was carved 800 feet into the Colorado Plateau by erosion from the movement of water in Sulphur Creek. It took over 6 million years to carve the canyon. Here were 280 million years of geological changes right in front of my eyes. The lowest layers near the current creek bed were formed over 280 million years ago when this was the edge of the Pacific Ocean and the layer is composed of ancient sand dunes which as stated above originated in the sandstone of the Appalachian Mountains. Looking carefully and contemplatively at the canyon walls, I could see the aliveness of the earth, its impermanence. To put this in perspective, what I was looking at was actually only a small part of the 4.5 billion years of geological changes that we call the Earth. Hence, not only our experience, physiology, and mind but also the earth itself is impermanent and constantly changing.

 

Again, not apparent in the human life timeframe, but the entire universe itself is impermanent. Throughout its 13.8 billion-year history it has been constantly changing. Starting with the “Big Bang” itself to the present moment, stars have been created, matured, aged, and died, sometimes spectacularly in supernova, sometimes forming nebula, and sometimes collapsing into black holes. During their lives they’ve been moving further apart from each other as the universe continues expanding. Around the stars, planets, comets, etc. have formed each of which constantly changes and their fates determined by their constantly changing stars. Eventually, they all will cease existence in their current forms and their matter and energy will be redistributed into other forms.

 

This is disconcerting. There doesn’t appear to be any permanence whatsoever, anywhere. Everything is in constant motion. In fact, one might think that the only thing that appears to be permanent is impermanence itself. But, wait a second, what a revelation! This is actually a helpful mindset. If impermanence is embraced, then the effort to keep everything the same ceases. Instead, impermanence is accepted. Once it is embraced, the beauty and grandeur of the constantly changing internal and external landscape becomes evident. Change is beautiful and wonderful when one ceases to fight it. Knowing that we are constantly changing means that there are always opportunities to reinvent ourselves, to move in new and exciting directions, to grow and develop, and to be happy with life. Knowing that others are constantly changing means that we can discard our stereotypes and expectations about them. They will be different tomorrow than they are today. They can reinvent themselves, grow, develop and learn to enjoy the ever changing life they’ve been given. Seeing the impermanence can make our mortality more evident, focusing us more on the present moment and what is most important in our lives. In other words, accepting, indeed relishing, impermanence can transform our lives, making them happier, richer, fuller, and with deeper meaning than ever before.

 

Adopting this, we are now positioned to observe the one thing that does appear to be permanent in our existence; our awareness. Not what we are aware of, as that’s constantly changing, but, that which is aware of that content. It never seems to change. The content changes but the awareness itself does not. It’s been the same from our earliest memories of being aware, to the present moment, unchanging and ever present. Because it doesn’t change, we have a hard time becoming aware of it. Our minds have evolved to detect change as changes are the most significant events in the environment. They can contribute to or threaten our very survival. So, they stand out. But, in the background, mostly unnoticed, is this mysterious, magical, spiritual thing, awareness.

 

Grasp it, enjoy it, observe the wonder of it. It was seeing this that led the Buddha to his enlightenment. This has also been true for countless sages, mystics, saints, and yogis. Clearing away the delusion of permanence of everything else opens the eyes to the primacy of awareness in all of existence. This revelation is itself a spiritual revelation, opening a path to ultimate understanding of existence.

 

So, find permanence by seeing impermanence.

 

“Nature’s first green is gold,
Her hardest hue to hold.
Her early leaf’s a flower;
But only so an hour.
Then leaf subsides to leaf.
So Eden sank to grief,
So dawn goes down to day.
Nothing gold can stay.”
― Robert Frost

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts arealso available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

 

Help Reduce Psychopathology with Severe Skin Conditions with Spirituality

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Help Reduce Psychopathology with Severe Skin Conditions with Spirituality

 

By John M. de Castro, Ph.D.

 

“Spiritual practices tend to improve coping skills and social support, foster feelings of optimism and hope, promote healthy behavior, reduce feelings of depression and anxiety, and encourage a sense of relaxation. By alleviating stressful feelings and promoting healing ones, spirituality can positively influence immune, cardiovascular (heart and blood vessels), hormonal, and nervous systems.” – University of Maryland Medical Center

 

Spirituality is often confused with being religious and attending services. Even though spiritual people often are religious, spirituality refers to a sense of connection to something bigger than ourselves, and it typically involves a search for meaning in life. It involves a subjective experience of a sacred dimension. People vary in their depth of spirituality. But It appears to be an almost universal human belief that there is something more to life than just the physical.

 

Even though spirituality refers to something metaphysical, it has consequences in the physical realm. In particular, spirituality has been found to be associated with better psychological and physical health. Spirituality has been shown to improve psychological well-being and mental health, particularly anxiety. Spirituality has been shown to be negatively associated with depression with the higher the level of spirituality the lower the level of depression. In addition, high levels of spirituality are associated with successful drug treatment for depression. This appears to lead to spirituality being negatively associated with suicidality with the higher the level of spirituality the lower the level of suicidality.

 

Spirituality appears to help the individual cope with adversity, with people who are high in spirituality less likely to be distressed following negative events. To some extent this results from the fact that spirituality appears to reduce the negative consequences of stress and thereby improve well-being. Individuals at the end of life with high levels of spirituality have significantly higher levels of well-being and are less likely to be depressed or suicidal. Spirituality has also been shown to be helpful in treatment for alcoholism and generally for substance abuse treatment and  relapse prevention. Spiritual meditation has also been shown to reduce the frequency of migraine headaches.

 

These findings lead to the conclusion that spirituality may help with the psychological responses to disease. In today’s Research News article “Spirituality and mood pathology in severe skin conditions: a prospective observational study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1476015799089008/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982877/

Unterrainer and colleagues studied the relationship of spirituality to the mental problems surrounding severe skin disease. They recruited patients with severe and potentially life threatening dermatological diseases of systemic sclerosis, lupus erythematosus, and early stages malignant melanoma. They measured spiritual well-being including hope immanent, forgiveness,  experiences of sense and meaning, religious well-being, general religiosity, connectedness, and hope transcendent. In addition, they measured a variety of psychiatric symptoms.

 

They found that hope for a better future, hope transcendent and forgiveness were the spirituality components that were most negatively associated with psychiatric symptoms, with high levels of hope and forgiveness associated with low levels of mental health issues. In general, the existential dimensions of spirituality were better predictors of low psychopathology than the religious dimensions of spirituality.

 

These results are interesting and suggest that spirituality is positively associated with the mental health of patients with severe dermatological diseases. Due to the fact that the study was correlational, it cannot be concluded that spirituality caused better mental health, or that better mental health caused spirituality, or some third factor was responsible for both. But, nevertheless, the findings clearly demonstrate that spirituality and mental health are positively related.

 

How might spirituality promote mental health. Obviously, it provides goals and meaning to life. In addition, virtually all spiritual practices and religious belief systems promote acceptance of one’s strengths and weaknesses, the need to maintain a principled life, and having harmonious relationships with others. All of these consequences of spirituality could contribute to mental health.

 

So, help reduce psychopathology with severe skin conditions with spirituality.

 

“Associations between spirituality and Eastern religious practices and lower blood pressure, lower levels of stress hormones and lower oxidative stress have been found. Moreover, associations between Judeo, Christian, and Islamic religious practices and lower blood pressure, protective effect against cardiovascular disease, increased immune function, lipid levels and protective effect against all-cause mortality were found.” –Iulia Basu-Zharku

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and Twitter @MindfulResearch

 

Study Summary

Unterrainer, H.-F., Lukanz, M., Pilch, M., Scharf, S., Glawischnig-Goschnik, M., Wutte, N., … Aberer, E. (2016). Spirituality and mood pathology in severe skin conditions: a prospective observational study. Archives of Dermatological Research, 308, 521–525. http://doi.org/10.1007/s00403-016-1672-5

 

Abstract

Although the association between spirituality and parameters of psychological health and disease has been investigated extensively, little evidence is available for its potential role in dermatology. In a single-centre observational prospective study, 149 outpatients (107 women) with systemic sclerosis (SSc; n = 44), lupus erythematosus (LE; n = 48), or early stage malignant melanoma (MM; n = 57) were investigated using the multidimensional inventory for religious/spiritual well-being together with the Brief Symptom Inventory for psychiatric symptoms (BSI-18). SSc patients reported the highest amount of Somatization in comparison with LE and MM patients (p < 0.05). Furthermore, in line with the previous research, spiritual dimensions, such as Hope for a better future (p < 0.01) or Hope for a better afterlife (p < 0.01), proved to be especially negatively predictive for the global amount of psychiatric symptom burden in these dermatological patient groups. Our findings suggest that greater attention should be given to spiritual issues, such as encouraging patients, imbuing them with optimism, and offering interventions that address spiritual well-being.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982877/

 

It’s the Awareness, Stupid!

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It’s the Awareness, Stupid

 

By John M. de Castro, Ph.D.

 

“The greatest human gift is to be aware, to be in touch with oneself, one’s body, mind, feelings, thoughts, sensations.”– Anthony de Mello

 

The vast majority of the human race is, and has always been, on a spiritual search, to find greater meaning in life and beyond. We expend time engaging in spiritual practices, going on retreat, visiting sacred sites, attending religious services, watching televangelists, etc. We expend resources supporting churches, temples, mosques, monasteries etc. supporting priests, ministers, evangelists, missionaries, gurus, rabbis, imams, spiritual teachers, and we may even tithe a considerable fraction of our wealth. And we expend cognitive and emotional resources philosophizing, studying sacred texts, ruminating about the health of the soul, listening to sermons, having conversations about spirituality/religion, etc.

 

Why do humans do this? Why do we feel such a strong pull toward spirituality? On a rational level we would do substantively better in our lives if we invested the time and resources on our careers, families, relationships, secular issues etc. rather than on spirituality. But there is something inside of us that demands attention and makes us feel that there is more to life than just the physical. Most people can’t identify what it is, but they feel strongly that there is a spiritual component of their existence. They sense something about themselves that is more than a biological machine, something enduring, something outside of the earthly realm.

 

The answer is actually right there and obvious, but they can’t see it. As Jesus said “The kingdom of heaven is spread upon the earth, but men do not see it.” They don’t understand that the one that’s doing the seeking is what they’re seeking. Sometimes I want to just scream out, “it’s the awareness, stupid.” It’s what’s seeing, hearing, feeling, smelling, tasting, and even what’s feeling that there’s something more. It’s the awareness they experience. It’s so obvious that most people miss it. It seems that they’re looking for something different than what is already present. So, they don’t see the most obvious, constant, and important experience of all; awareness.

 

It’s our awareness that’s responsible for all the spiritual seeking. But, we don’t seem to see that that’s what we’re seeking. Instead, we look everywhere else for something else. To some extent it’s the fault of spiritual teachings which often promise or portray a realm of existence that is far different from what is currently being experienced. The iconography portrays realized beings as altered and otherworldly, not as someone just like us. So, we constantly look for something different from what we’re experiencing and missing the oh so obvious. “It’s the awareness, stupid!”

 

Another reason why we miss it is that our nervous systems are programmed to detect change. That makes sense as they adapted to protect us from danger and a change in the environment may signal a threat that needs to be addressed as a priority and immediately, so we do. A change may also signal an opportunity, perhaps prey, and we need to react quickly to take advantage. Attention is grabbed by new things. In fact, we tend to ignore stable stimuli, like the constant hum of a ceiling fan, the feeling of our clothes on our bodies, or a persistent constant odor in the room. The retina of our eye only sends a signal to the brain when there’s a change. So, a constant image on a constant place on the retina disappears. Our awareness has been constant and unchanging throughout our existence. So, it’s no wonder we miss it, the entire nervous system is designed to ignore such things.

 

Our attention is also attracted by strong stimuli, loud noises, bright lights, strong odors, etc.  Awareness is totally quiet, deeply silent, always in the background, never in the foreground. It doesn’t produce anything. It just registers what is. So, there is nothing to bring attention to awareness. How would we ever recognize its significance when it is mostly not on the radar screen?

 

If awareness is like this, what leads to the conclusion that it is what we’re seeking in our spiritual search? What evidence do we have that it is our true nature? After all, how can something so low key and unassuming be the spiritual key to understanding birth, life, death, and the nature of reality? To answer this question, it is important to look at what would be the characteristics of something that was indeed our true nature. Firstly, the truth doesn’t change or fluctuate. If it’s really the truth, it will always be the same. Secondly, it will always be there. Our true nature can’t come and go. It must be forever present. And lastly, our true nature could not be affected by temporary conditions. It must withstand all nature of changes in our environment, our physiology, and our psychological processes, remaining steadfast, constant, unaltered.

 

The idea we have of our self doesn’t live up to these criteria. The idea of self has been in constant change from the earliest moments of life to the present moment. It comes and goes depending upon what we’re doing and thinking about. And it is very much affected by our experiences. In fact, it is to a large extent built upon them. So, the self cannot be our true nature. Is our immortal soul, as taught by many religions, our true nature? Well, we can’t tell if it changes, but religion teaches that it does, as it’s blemished by sin. This also suggests that it’s affected by experience. In addition, we can’t detect if it comes and goes as no matter how hard we look, it can’t be found or observed. So, how could an immortal soul that we cannot find or observe be our true nature?

 

Awareness, on the other hand, has never changed. We are never more or less aware. The content of awareness is forever changing. The sensory stimuli in the environment are in a constant flux as are the contents of our ever changing minds, sometimes in the present moment, sometimes lost in memory or fantasy, sometime planning for the future. But the awareness of these changing mental states and sensory experiences is always the same. It always just silently registers whatever is transpiring. Awareness has always been there, never coming or going. It was there at birth, throughout development, and right now and has always been the same. Finally, awareness, isn’t affected by the external or internal environments. It’s the same when we’re ill as when we’re health, when we’re upset as when we’re calm, when we’re bombarded by intense stimulation like at a rock concert as when we’re in silence, when our minds affected by drugs as when totally sober. It’s always present and never changing regardless of circumstances. So, our awareness fits all of the criteria of being our true nature.

 

Even with this being true, how can we be sure that it actually is our true nature? Many religious and spiritual teachers and realized beings tell it is. But, if it’s the truth we need not take someone else’s word about it. We should be able to see for our self. Indeed, that is what the Buddha taught, “Do not believe anything, even my teachings, go and see for yourself.” He even told us how to, by meditation and deep contemplation, looking inside, not outside for the key to understanding our existence. It is here that we can clearly see that at the center, the core, of all experience is an unchanging, immortal awareness.

 

When you go see for yourself, you will see “it’s the awareness, stupid.”

 

“Spirituality means waking up. Most people, even though they don’t know it, are asleep. They’re born asleep, they live asleep, they marry in their sleep, they breed children in their sleep, they die in their sleep without ever waking up. They never understand the loveliness and the beauty of this thing that we call human existence.” – Anthony de Mello

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Improve Heart Failure Patient Longevity with Spirituality

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Improve Heart Failure Patient Longevity with Spirituality

 

By John M. de Castro, Ph.D.

 

“Although difficult to study, spirituality has been evaluated and deemed to have a beneficial effect on multiple measures including global quality of life, depression and medical compliance in the treatment of patients with heart failure.” – J Naqhi

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” – Centers for Disease Control. Congestive heart failure (CHF) is a major type of cardiovascular disease. “CHF is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently” (Healthline).

 

Congestive heart failure (CHF) is a very serious life-threatening condition. About 5.7 million adults in the United States have congestive heart failure. One in 9 deaths include heart failure as a contributing cause. The seriousness of CHF is underscored by the fact that about half of people who develop CHF die within 5 years of diagnosis. Hence, effective treatment is very important. There is a myriad of treatments that have been developed to treat CHF including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses.

 

Spirituality, a sense of inner peace and harmony, and religiosity are known to help with a wide range of physical and psychological problems. So, it would make sense to investigate the relationship of spirituality and religiosity to the treatment of congestive heart failure. In today’s Research News article “Spiritual Peace Predicts 5-Year Mortality in Congestive Heart Failure Patient.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1458465060844082/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4760860/.

Park and colleagues recruited a large sample of patients who had experienced congestive heart failure (CHF) of at least moderate severity. They were 64% male and averaged 69 years of age. The researchers measured severity of CHF, other health conditions, smoking, alcohol consumption, engagement in health behaviors, depression, social support, attendance at religious services, and spiritual peace. The patients were followed over a five year period to establish mortality rates.

 

At the five-year follow-up, almost a third (32%) of the patients had died. They found that age, other health conditions, and depression contributed to mortality. Controlling for these variables they found that smoking nearly tripled the risk of death, while alcohol consumption mildly reduced the risk. Adhering to a healthy lifestyle cut the risk in half and spirituality and engagement in religious practice was associated with greater engagement in healthy lifestyles. Controlling for all of these variables they found that spirituality was associated with a 20% reduction in mortality.

 

These results suggest that controlling lifestyle is critical for survival after CHF. This includes reducing smoking and increasing healthy lifestyle behaviors. But, in addition to these important factors, spirituality, but not engagement in religious practices, improves longevity. Although spirituality is associated with lifestyle, the analysis suggests that spirituality’s association with improved longevity occurs independently of lifestyle factors. These results have to be interpreted with caution since they are correlative and cannot prove causation. But, the fact that spirituality predicts longevity over a 5-year period after measurement, is compatible with an interpretation that spirituality causally contributes to longevity.

 

These results suggest that just being religious is not enough. One must be spiritual in order to obtain the longevity benefits. So, it is not enough to just believe in a greater power or attend religious services. Rather, a sense of spiritual peace and harmony is required. To some extent, this makes sense as this would reduce stress which is known to exacerbate disease processes. In addition, spirituality has been shown to improve adherence to treatment regimens for heart failure and this by itself could account for improved longevity. Regardless, the results make it clear that being spiritual can help extend the lives of patients with congestive heart failure (CHF).

 

So, improve heart failure patient longevity with spirituality.

 

“We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health,” – Paul J. Mills

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Park, C. L., George, L., Aldwin, C. M., Choun, S., Suresh, D. P., & Bliss, D. (2016). Spiritual Peace Predicts 5-Year Mortality in Congestive Heart Failure Patients. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 35(3), 203–210. http://doi.org/10.1037/hea0000271

 

Abstract

Objective: Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness.

Method: Participants were 191 CHF patients (64% male; Mage = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for five years.

Results: Nearly one third of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, while alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. While both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors.

Conclusions: Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4760860/