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February 17, 2003

The Healing Power of Spirituality
Neil F. Neimark, MD

In the world of health, it is clear that a sense of spirituality is a critical factor in the healing equation. At a conference on faith and healing, Harold G. Koenig, M.D., psychiatrist and author of The Healing Power of Faith: Science Explores Medicine's Last Great Frontier, summed up the results of hundreds of scientific studies on religious involvement and health. What he found was that religious involvement was positively correlated with the following outcomes:

greater levels of well being, hope and optimism
greater sense of purpose and meaning
less depression and more rapid recovery from depression
decreased risk of suicide
decreased anxiety and fear
greater marital satisfaction and less risk of divorce
greater social support which confers known health benefits
decreased risk of substance abuse and
lower rates of juvenile delinquency
In these studies, religious involvement was defined as a combination of:
1) strong personal belief and faith and
2) involvement with that faith either by:
a) private religious activities (prayer and/or scripture reading)
b) use of religion to help cope with stress
c) attendance at religious services or
d) participation in congregational activities.

The key message, according to Dr. Koenig, is that "religious involvement is a protective factor that can be quantified like other health variables such as diet, exercise, smoking or alcohol use." In other words, the lack of a definitive sense of spirituality and/or religious involvement is a risk factor for your health, just like high blood pressure, high cholesterol or diabetes.

This fascinating finding begs the question, "How does spirituality intersect the physical, material world of cells and chemistry?"

The answer is found in the work of Herbert Benson M.D., a Harvard cardiologist and pioneer in field of mind/body medicine (sometimes called psychoneuroimmunology). In his book, Timeless Healing: The Power and Biology of Belief, Dr. Benson teaches us that every event in our life: every thought, feeling, action, attitude, belief and occurrence creates a pattern of nerve cell firing and chemical release called a neurosignature.

There are neurosignatures for love, for disappointment, for happiness, for joy, for frustration, for a sunset in Maui and for the first time you held a baby in your arms. These neurosignatures are physical, for they can be measured as nerve cell impulses and patterns of chemical release. The chemicals released are known as chemical messenger molecules (technically called ligands) and are composed of three basic groups you may have heard of
1) neurotransmitters (like serotonin, dopamine or epinephrine)
2) neuropeptides (like endorphins) and
3) steroid based hormone molecules (like estrogen, testosterone and cortisone).

With this understanding, we come to see that all our thoughts and feelings are chemical. And, just as chemicals can affect our body positively or negatively, so too, our thoughts and feelings can profoundly affect our body positively or negatively. But what is the relationship to spirituality? How does spirituality factor into the equation?

The spiritual masters teach us that all spirituality involves making the invisible, visible the impossible, possible. As such, true spirituality begins by understanding the nature of the invisible realm we call consciousness. Though many things happen to us in the real world that we live in, these things create their greatest impact on us in the "invisible" world of consciousness. In particular, it is the choices we make in response to these external things, the feelings we choose to attach to them and the meaning we choose to give them that influences us long after the external, visible event has passed.

In this way, the nature and quality of the thoughts we think, the feelings we experience and the meaning we attach to events in consciousness both influence and are influenced by our sense of spirituality.

What is spirituality? In terms of health, spirituality is most easily defined as a sense of wholeness, a connection to something greater than ourselves, often characterized as a higher power and a higher purpose in life.

What is a higher power? For most of us, it is belief in God as the creator and sustainer of the Cosmos. For others, it may represent a connection to something greater than ourselves, like nature, community or love.

What is a higher purpose? It is the realization that we are all given certain gifts with which to help make the world a kinder, more loving, just and beautiful world in which to live. When we do so, we instill life with a sense of purpose and meaning.

It is, in this way, that spirituality factors into the health equation. Virtually all of our thoughts and feelings in life, at some point, gravitate back to central spiritual questions concerning the meaning of life, our sense of belonging or abandonment, our sense of justice and fairness, our sense of what it takes to live a good life, our sense of entitlement and our sense of relationship to the world and others at large.

Because our beliefs about a higher power and a higher purpose, whether positive or negative, influence virtually every decision we make in life, our spirituality is a critical factor in determining our level of physical health. In fact, the attitudes and beliefs we hold about the meaning of life, our sense of belonging or entitlement, the things we love and fear in life and our connection to a higher power dramatically influence every molecule of our physical being.

Many people wonder, "What is the difference between religion and spirituality?" Entire books have been written on the subject, but in terms of a simple understanding, I believe that a greater sense of spirituality (i.e. a greater connection to God, or a higher power, and a greater connection to a higher purpose in life) is the goal of all religions. Religions utilize rules, rituals and practices designed to help create a greater sense of spirituality in life. For many people, these rules and rituals are meaningful, providing great comfort, guidance and a heightened connection to spirituality. For many others, they do not work, creating distance and separation from a meaningful spirituality. In terms of health and healing, what is most vital is not religious involvement, per se, but rather a heightened sense of spirituality.

The essence of spirituality lies in our ability to reach beyond our own self-centered ideas, concerns and desires in order to connect with something outside of our limited selves. We can recognize true spirituality because it leads to the fruit of greater love, meaning, belonging and connectedness.

Spirituality begins with the realization that, as human beings, we have limitations. John Bradshaw, author of Healing The Shame That Binds You, says that the very basis of our spirituality is the "permission to be human, to know that we will make mistakes, that we have limitations." In so doing, we are reminded that there is something greater than ourselves.

In summary, we see that our attitudes and beliefs about the meaning of life, a higher power and a higher purpose help create what is called our life story. What is our life story? It is not merely the things that happen to us, but rather the combination of these things and the meaning we attach to them.

We can better understand how the meaning we attach to events affects our physical health through an understanding of the placebo response. Most of us have heard about the placebo response, and understand it to be a sugar pill or inert element that is given to someone in order to test the efficacy of a new drug or in order to treat people who worry too much! Although this is not intentionally done in modern day practice, every effective healer utilizes the power of positive suggestion to help his or her patients heal. In fact, another name for the placebo response is the power of positive belief.

In his groundbreaking book, The Placebo Response, Howard Brody, M.D., Ph.D. defies the old definition of placebo as a simple pill or chemical and instead says that, "The placebo response is a change in the body that occurs as the result of the symbolic significance which one attributes to an event or object in the healing environment." This definition expands the scope of the placebo response beyond the sugar pill and explains how it is a change in the symbolic meaning of an event that creates the positive health benefits seen in the placebo response.

Though there are several proposed mechanisms for how the placebo response works, on of them explained by Dr. Brody is called the meaning model. This model states that any positive change in the meaning we assign to an event, treatment or illness creates positive health benefits. Positive changes in the meaning of events or illnesses occurs when
1) we feel listened to and receive clear and satisfactory explanations for our illness or situation
2) we feel the care and concern of those around us and
3) we feel an enhanced sense of mastery and control over our illness or situation in life.

The meaning model teaches us that our life story or narrative about our illness is a critical factor in our getting well. Consciously or unconsciously, we attach meaning to events and situations in our life by constructing a narrative or story about these events. Since many of the meanings attached to illness are filled with pain, negativity or hurt, when we have a chance to rewrite these narratives (though journaling, art, therapy or just talking things out), we can effect a positive change in meaning that has a positive influence on our health and healing.

We, in fact, are often unaware of many of the meanings we attach to events. In this way, we often suffer unnecessarily painful outcomes. When we begin to bring the invisible stories, and meanings, about the things that happen to us into the visible world of conscious awareness, we can begin to rewrite our stories and create a greater level of health, happiness and well-being.

Because, ultimately, all our life stories gravitate back to thoughts about spirituality (i.e. our sense of purpose, meaning or connection), these thoughts will affect our physical health. They do so because, as we already learned: our thoughts and feelings are chemical. Spiritual thoughts are no less so, and in fact, they form the very foundation of our patterns of belief: of positivity or negativity, of hope or despair, of comfort or challenge that create our very chemistry and physiology.

In fact, the very definition of mind/body/spirit medicine is that the unseen energies of thought, feeling, attitude, belief and imagination become manifest in the physical body, weaving the very fabric of our physiology and biochemistry.

Caroline Myss, author of Sacred Contracts, teaches it simply: "our biography becomes our biology." What is our biography? It is our life story: the sum total of the events that happen to us in life and our beliefs about and responses to these events. In this way, what we choose to believe about life and the meaning of our existence which is the very core theme of spirituality becomes an integral part of our biology and biochemistry. That is why, to achieve any level of lasting health or healing, it is so critical that we address the fundamental spiritual questions in our life. The answers we discover to these questions are not just of theoretical concern; theyin fact create the very essence of our biology and the resulting level of health, healing and happiness that we may achieve in life.

Neil F. Neimark, MD

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