“…and greater works than these shall he do…”

Before getting into the main topic of this presentation, I will briefly pull together the main points of the first three presentations.  I started with a survey of the extensive scientific research findings confirming that positive and uplifting religious teachings tends to heal those involved with them.  Further, as many of the world’s most widely accepted spiritual traditions state or imply, the human mind is being shown to be much more powerful than we usually assume, and this is also well demonstrated by scientific research.    Strong support for this conclusion can be found in the research findings concerning the placebo effect and investigations into the commonalities found when cases of spontaneous remission of incurable diseases are studied and compared.  Research into the enduring effects of trauma and adverse experiences that damage our health and future well-being provide further evidence of this latent power within human conscious expectations and beliefs.  Until recently, this innate power has been almost entirely ignored by modern medical science. The work summarized in the first three presentations of this series shows us that we need to expand our concepts of the genesis of human chronic illness and disease as well as our understanding of how they might be healed. 

In this presentation, I will present several ways of making use of the insights from the first three presentations to help heal both ourselves and others who we care about. The information I am about to present is very practical.  The techniques involved can be used to begin to heal much of the negative emotional baggage most of us have accumulated in our lives and begin to free ourselves of its consequences.  These healing strategies do not necessarily require the help of a professional, but they can provide a foundation for programs which the members of a medical office might use to do a more effective job of preventing and healing serious illness.

Before I begin this exploration, though, I want to share a little of the impact that writing these first three presentations have had on me, personally.  First and foremost, I believe I am now less judgmental of certain of my patients after having carefully considered the research I presented.  It is much clearer to me that people who are involved with self-destructive behaviors like drug abuse and alcoholism are often responding to emotional injuries that they usually do not understand, and which they do not have conscious control over.  I find that I am more compassionate toward them, and I am confident that I will be a more effective healer as a result.  I am also feeling more enthusiasm and more motivation for my work as a physician. 

I will be following a similar format to the previous presentations.  I will explore several healing techniques, provide a summary of the research that support their efficacy, and provide biblical quotations that pre-date and support what has been found, but not necessarily in that order.  The citations of supporting research at the end will allow you to verify what I am saying here and give direction for your own exploration of topics that you might find interesting.

The self-healing power of helping others

When we think of the value of helping others, we usually think of the benefits in two ways.  The most obvious is the help and healing we provide for others.  But many of us also view altruism as following what we believe to be the commandments of our Creator.  From the Gospels, Matthew chapter 25, this is explicitly stated:

“Then shall the King sat unto them on his right hand, Come ye blessed if my Father; inherit the kingdom prepared for you from the foundation of the world: For I was hungered, and you gave me meat: I was thirsty and you gave me drink: I was a stranger, and you took me in: Naked, and ye clothed me: I was sick and you visited me: I was in prison, and you came unto me.”

Matthew 25:34-35

In the parable, it is also clearly stated why we should take these actions.  Here, again, from Matthew 25:40:

“And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye havedone it unto the least of these my breathern, ye have done it into me.:

The scientific research, though, indicates that there is another important benefit: helping others is also healing for those who do the helping.  The research that evaluates the health impacts of volunteering for various altruistic efforts shows that it results in improved health and lower mortality for the volunteers.  This research shows us that one of the most important ways we can help ourselves is through using our resources and abilities to improve the lives of others.

Here is one way this insight might be utilized.  At this point in time in the United States, there are a large number of elderly individuals living alone.  They are frequently lonely, often with their children living in other states.  For them to retain their independence while their memory, endurance and other resources decline as they age, they need more and more help with meals, handling medications and managing their homes.  There is also a large, underutilized resource that could be better mobilized to meet this need since there are more and more people entering their retirement years in good health, many of whom feeling they lost their purpose in life when they retired.

While there are some programs like Meals on Wheels that address some of these needs and make use of some of these potential volunteers, this concept could be expanded to coordinate motivated volunteers to greatly expand the help that is available to keep the elderly living in their homes safely more comfortably, for a longer period of time.

Next, I will begin to address research that shows how we can help people with a history of emotional traumas, as discussed in the previous presentation of this series, to begin to reverse their residual, damaging impacts.

The healing power of self-expression and sharing

The topic I just addressed, the healing power of helping others, is a general effect, much like the healing power of attending religious services discussed in the first presentation of this series.  Now, though, I will begin to present more specific healing effects that address the emotional scars discussed in the last presentation.  This topic has two closely related aspects: the healing power of group therapy, and the healing power of disclosing personal stories of emotional trauma to others who are sympathetic and concerned.

The power of group therapy is well documented and sometimes its effectiveness can be quite remarkable.  A good example was published in Lancet in 1989, titled: Effect of psychosocial treatment on survival of patients with metastatic breast cancer.  In this randomized study, the treatment group participated in weekly supportive group therapy for a year.  Ten years after the study started, the mean survival time for the treatment group was over 36 months, compared to about 19 months for the control group.  Not only did the women in group therapy live longer, they also were more comfortable and had greater feelings of well-being than the women in the control group

Another example of the benefit of group therapy was a study by Dean Ornish MD, and others, titled: Intensive Lifestyle Changes for Reversal of Coronary Heart Disease, published in JAMA in 1998.  In this 5-year, randomized outcome study, the experimental group engaged in intensive life-style changes, including stress management and group psychosocial support for 5 years.  The experimental group showed continued regression of their coronary atherosclerosis while the standard-care control group, showed progression of disease in their arteries.

One of the most important aspects of group therapy is the ability for group members to express their feelings to other people who have experienced similar pain and discomfort.  We know that many traumatized individuals are ashamed of their experiences and suffer from a negative self-image as a result.  Beyond the healing value of group therapy, research has shown a second healing effect of sharing.   Even just writing about life traumas can begin a healing process.  If the experiences are then shared with others who are supportive and sympathetic, the improvement is further enhanced.

Research studies of the written or verbal disclosure of traumatic events have shown remarkably consistent benefits, particularly when those traumatic experiences were not previously disclosed.  These studies document improved mood, lowering of anxiety and greater feelings of well-being for months to years after their disclosure.  It is notable that after the disclosure of traumas, fibromyalgia pain, joint inflammation due to rheumatoid arthritis, and air flow measurements in people with asthma have shown improvement compared to controls who are treated with the usual standard of care.  These studies have also demonstrated that the stronger the emotional expression and release during the disclosure, and the more supportive the audience during the process of sharing, the greater improvement that results.

An organized approach to utilizing the research findings might involve the following steps:

          1. Screen people that are suffering from psychological problems like anxiety and/or depression for a history of past traumas.

          2. Form a discussion and support group for those with significant traumas, led by a knowledgeable and compassionate leader to guide the process. 

          3. Use trauma journals for people to write about their experiences and to share with the group, to the degree that they are comfortable.

          4. Follow the health and emotional well-being of group members to document the benefit that thegroup involvement and sharing have provided.

While the healing power of helping others and of sharing one’s own life traumas and discomfort with others have been shown to be remarkably effective in their healing, we have only scratched the surface of the strategies that have been shown to be worthwhile.  Next, let’s consider a brief summary of mindfulness-based strategies that have been clearly healing for those that participate.

The healing power of mindfulness strategies

Meditation is a practice that most of us associate with Eastern religious practices like Hinduism and Buddhism.  However, there are a number of passages in the New Testament where Jesus is reported to have spent long periods of time, alone in prayer.  Here are a couple examples:

“And in the morning, rising a great while before day, he went out, and depaterted into a solitary place, and there he prayed.”

Mark 1:35

“And it came to pass in those days, that he went out into a mountain to pray, and continued all night in prauyer to God.”

Luke 6:12

Periods of time in seclusion and focusing on a single topic, as described in these biblical passages, is, in its essence, what we call meditation.  There is an extensive body of scientific research demonstrating the healing power of meditation, and when the focus of meditation concerns spiritual topics which are already topics that are accepted by the person meditating, research shows that it is even more potent in its healing potential.

Jesus also gave us guidance to engage in a particular type of focus that is remarkably like what has been called mindfulness meditation:

“Take therefore no thought of tomorrow: for the morrow shall take thought of the things of itself. Sufficient unto the day is the evil thereof.”

Matthew 6:34

There are now many different kinds of what are often called “mindfulness-based interventions” that show the healing effects of various types of mindfulness meditation through randomized, controlled trials.  In these mindfulness approaches, the participants are given strategies to focus completely on the here and now, avoiding thoughts about the past and the future.  While the techniques did evolve out of Eastern religious practices, they do not require any commitment or belief in these spiritual doctrines to be of healing and preventive value.

Numerous scientific studies conclusively demonstrate that these types of practices reverse chronic emotional discomfort.  Recall that in earlier presentations it was shown that these emotional scars lead to a cascade of damaging consequences.  Mindfulness practices have been shown to improve depression, anxiety, feelings of stress, and chronic pain conditions such as fibromyalgia.  These practices, once learned, can be used at home without professional support, and research studies demonstrate that the longer the practices are continued the more beneficial they are.

Recall also, from the previous discussions, that chronic emotional discomfort is associated with the likelihood of engaging in destructive addictive habits.  Since mindfulness interventions improve emotional discomfort, and emotional discomfort increases the likelihood of addictions, it would be expected that mindfulness techniques should also help eliminate these addictions.  This is exactly what the research shows for alcohol abuse, cigarette smoking and illicit drug addictions.

Taking this analysis even further, since it was shown that chronic emotional discomfort also leads to chronic physical disease, it would also be reasonable to expect that mindfulness techniques, if used long enough, would tend to reverse these otherwise relentlessly progressive disorders.  This is also what numerous research reports have shown.  Mindfulness techniques can improve or eliminate hypertension, diabetes, immune disorders, and blood lipid disorders, to name a few.  In many situations, medications can be avoided, decreased, or eliminated altogether.

For physicians and other medical professionals, developing a mindfulness-based program for patients as a complementary strategy for the usual care they provide is completely in line with their purpose.  Group treatments involving mindfulness interventions will also facilitate the healing effects of altruism that naturally arise between group members.  Furthermore, the healing benefits of disclosure, as discussed earlier, may also be easily incorporated within the group treatment program.  The benefits of all these strategies would be additive, promising significant improvements in the health and well-being of those involved.

In the next section of this presentation, I will discuss healing strategies that were completely unavailable back when the New Testament Gospels originated.  I will discuss some of the healing benefits that can be derived from the sophisticated use of electricity and magnetism, all well documented in high quality scientific research studies.

The healing power of modern technology

We are already familiar with many of the powerful technological methods of healing in use today.  MRI scans, genetic profiles, potent antibiotics, robotic surgical repairs, and numerous other ways to investigate and treat existing illnesses and disabilities are common knowledge.  But while these inventions are incredibly effective for acute illnesses and injuries, they are usually much less effective in their ability to reverse chronic, debilitating disease.  There are new healing technologies now emerging, though, that can prevent or reverse chronic disease.

One of the most promising is heart rate variability biofeedback.  It is based on the beat-to-beat changes in heart rate which can be easily measured and analyzed and compared to the presence or absence of disease.  We are most familiar with this kind of measurement as part of the output of an electrocardiogram.  In the usual EKG, though, only the average heart rate is reported, and it does not report much information about beat-to-beat changes in heart rate.  But, if you do longer measurements of the heart conduction patterns, and then do careful statistical analysis of the instantaneous beat-to-beat changes in heart rate that can be accumulated, you can then develop indices of heart rate variability (HRV) that are remarkably powerful in predicting the presence of disease as well as the likelihood that disease will develop in the future.

From investigations of the usefulness of these HRV measurements, we now know that a decrease in HRV is associated with many diseases.  We also know that HRV tends to decline with age, and the more chronic diseases a given individual is suffering from, the lower his HRV will be.  Furthermore, the lower the HRV, the higher the risk of chronic diseases developing in the future.  This technology is giving us a window to view the factors that are causing chronic disease and is beginning to guide us toward ways of intervening and stopping the disease process in its earliest stages, long before devastating illness results.

The autonomic nervous system (ANS) is the main determinant of HRV.  When we are threatened or stressed in some fashion, one component of the ANS, called the sympathetic pathways, accelerates our heart, and prepares our body’s organ systems to vigorously defend ourselves and continue do so despite any injuries we might suffer.  In contrast, the parasympathetic pathways within the ANS slow the heart and facilitate rest as well as the long-term repair of any damage to the body.  HRV is a product of the functioning of the ANS subsystems and gives us indicators of how well they are functioning. 

Research into the function of these neural systems is also showing that overwhelming trauma or prolonged uncomfortable experiences decrease heart rate variability.  If lowered HRV continues without being relieved or reversed in some way, chronic diseases begin to develop, the aging process accelerates, and our quality of life and well-being steadily decline.  The effectiveness of our immune system is also compromised, our susceptibility to acute disease increases, and our ability to repair injuries is impaired.  We are also finding that impaired heart rate variability is associated with specific changes in the structure of the human brain that mirror the defective functions of the damaged ANS.

Studies that measure HRV and compare the results to the presence of disease find that both psychological and physical illnesses are associated with decreases in measures of HRV.  A low HRV is also predictive of disease developing in the future.  The psychological diseases shown to be associated with decreases in HRV include anxiety, depression, PTSD, schizophrenia, drug addictions, and many others.  Physical diseases include hypertension, diabetes, heart disease, stroke, chronic pain syndromes, arthritis, chronic immune disorders, to name just some of the important associations that have been found.

While emotional traumas and chronic distress cause a decline in HRV, and HRV usually stays impaired or gets worse over time, the process can be reversed.  Positive emotional states like joy, laughter and loving emotional relationships improve HRV.  In the past, we were not aware of these connections between our emotions and subsequent physical damage and disease, so we did not know how important our feelings of well-being or distress were to our health.  Now, however, we can use measurements like HRV to develop techniques to reverse the damage.  We can even measure our moment-to-moment changes in HRV with relatively inexpensive devices to monitor the state of our ANS and HRV.  This is a form of biofeedback and the processes being developed are usually called heart rate variability biofeedback (HRVBF).

HRVBF research has shown that these techniques result in improvements in feelings of well-being, less anxiety, better sleep, less fatigue, and less pain.  Along with these improvements in our mental state, we find lower blood pressure, lower blood sugar, lower levels of cortisol in our bloodstream, and lower cravings for addictive substances like drugs, nicotine, and alcohol.  Memory, ability to concentrate and reaction times also improve.

There is no reason why the group therapy and mindfulness-based interventions, discussed earlier in this presentation, could not be combined with HRVBF to form a treatment program that would provide significant benefits for those involved.  The research would indicate that people involved in this kind of program would feel better, and the longer they participated, the better they would feel.  Their health indicators would also improve, and it is likely that any existing diseases would be better controlled with less medications.  All these factors could be followed to demonstrate and prove the practical benefits of such a strategy.  As you might expect, this technique can be readily combined with other healing strategies, like group therapy and mindfulness-based interventions, discussed previously.

Conclusion

To end this presentation, I will provide a summary of the main points of the four presentations so far:

• It is the state of our consciousness (our thoughts, feelings, and intents), that is the most important determinant of our future emotional and physical health.

• Traumatic and distressing experiences create a hidden emotional injury that manifests as chronic emotional discomfort, physical disease, disability, and a shortened life span.

• Indicators that this emotional injury is present can be measured by using surveys to disclose ongoing emotional discomfort, HRV indices, and even brain scans to disclose brain changes typical of this injury.

• This chronic emotional damage can be reversed, and efforts to reverse it will improve our lives tremendously.

After presenting these techniques in some detail, I feel I need to share my belief that we do not actually need any of this technology to provide us with longer and more satisfying lives, but the technology makes it easier.  Since we have learned to believe so strongly in technological answers to our problems, devices like HRVBF can help us to eliminate any the misconception we might have about the power of our mind, making this healing potential much more accessible.  We have just scratched the surface of this power.  I will go further and deeper in a fifth presentation if enough people find what I have been saying so far to be useful.

As always, I have included references at the end of this presentation that support what I am saying.  The references are readily available on the internet and will provide a good starting point for anyone who wants to explore my conclusions in depth.

                                                                        References

Research reports showing better health and lower mortality in those who volunteer in helping others:

1. Harris AHS, Thoresen CE,  Volunteering is associated with delayed mortality in older people:  Analysis of the Longitudinal Study on Aging.   J Health Psychol 2005; 10:739-752

2. Oman D, Thoresen CE, et al.  Volunteerism and mortality among the community-dwelling elderly.  J Health Psychol 1999; 4:301-316

3. Luoh M-C, Herzog AR,  Individual consequences of volunteer and paid work in old age: health and mortality.  J Health Soc Behav 2002; 43:490-509

Here are the two research reports about group therapy mentioned in this presentation, one concerning cancer and another coronary heart disease:

4. Spiegel D, Bloom JR, et al.  Effect of psychosocial treatment on survival of patients withMetastatic breast cancer.  Lancet 1989; 334: 888-891

 5. Ornish D, Scherwitz LW, et al.  Intensive lifestyle changes for reversal of coronary heart disease.   JAMA 1998; 280:2001-2007

These reports are just a few of the many research studies demonstrating the healing effect of disclosing traumas:

 6.   Smyth JM,  Written emotional expression: effect sizes, outcome types, and moderating Variables.  J Consult Clin Psychol 1998; 66:174-184

 7.   Radcliffe AM, Lumley MA, et al.  Written emotional disclosure: testing whether social disclosurmatters.  J Soc Clin Psychol; 2010; 26:362-384

8.   Smyth JM, Stone AA, et al,   Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis.  JAMA 1999; 281:1304-1309

There are a huge number of research reports documenting the healing effects of engaging in mindfulness-based programs.  I will list a few of the best, here:

9.     Fjorback LO, Arendt M, et al.  Mindfulness-based stress reduction and mindfulness-based cognitive therapy – a systematic review of randomized controlled trials.  Acta Psychia Scand 2011: 124;102-119

10.  Gotink RA, Chu P, et al.   Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs.  PLoS ONE 2015: 10;1-17

11.  Li W, Howard MO, et al.  Mindfulness treatment for substance abuse: a systematic reviewAnd meta-analysis.  J Sub Abuse Treat 2017: 75;62-96

12.  Alamout MM, Rahmania  M, et al.  Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweightpeople.   Int J Nurs Sci 2020: 7;35-40

13.   Grossman P, Tiefenthaler-Gilmer U, et al.  Mindfulness training as an intervention for fibromyalgia: evidence of postintervention and 3-year follow-up in well-being.  Psychother Psychosom 2007: 76;226-233

14.   Carlson LE, Speca M, et al.  One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer patients.  Brain Behav Immun 2007: 21;1038-1049

15.  Hughes JW, Fresco DM, et al.  Randomized controlled trial of mindfulness-based stress reduction for prehypertension.  Psychosom Med 2013: 75;721-728

16.  Kian AA, Vahdani B, et al.  The impact of Mindfulness-based stress reduction on Emotional wellbeing and glycemic control of patients with type 2 diabetes mellitus.  J Diab Res 2018; 2018:1-6

For those who might be concerned about the compatibility of Christian worship and mindfulness-based interventions, here are a couple references concerning this issue:

17.  Hathaway W, Tan E,  Religiously oriented mindfulness-based cognitive therapy.  J  Clin Psyc 2009: 85;158-171

18.  Pearce MJ, Koenig HG, et al.  Religiously integrated cognitive behavioral therapy: a new method of treatment for major depression in patients with chronic medical illness. Psycotherapy 2015: 52;56-66

Here is a meta-analysis from 2013 demonstrating the effectiveness of HRVBF in a large number of both psychological and physical illnesses:

19. Gervitz R,  The promise of heart rate variability biofeedback: evidence-based applications.  Biofeedback 2013: 41;110-120

Here are good examples of research studies showing the effectiveness of HRVBF in treating anxiety, depression, and alcoholism:

20. Goessl VC, Curtiss JE, et al.  The effect of heart rate variability biofeedback training on stres and anxiety: a meta-analysis.  Psych Med 2017: 47;2578-2586

21. Karavidas MK, Lehrer PM, Preliminary results of an open label study of heart rate variability biofeedback for treatment of major depression.  Appl Psychophys Biofeedback 2007: 32;19-30

22. Penzlin AI, Siepmann T,  Heart rate variability biofeedback in patients with alcohol dependence.   A randomized controlled study.  Neuropsych Dis Treatment 2015: 11;2619-2627

Here are studies of the use of HRVBF in treating hypertension and dementia following a stroke:

23. McCraty R, Atkinson M, et al.  Impact of a workplace stress reduction program on blood pressure and emotional health in hypertensive employees.  J Alt Comp Med 2003: 9:355-369

24. Chang W, Lee J,  Effects of heart rate variability biofeedback in patients with acute ischemic stroke: a randomized controlled trial.  Bio Res Nurs 2019: 22;34-44

This is an excellent study using HRVBF to counteract the stress of being a correctional officer in a prison.  It showed that HRVBF in conjunction with stress management training lowered blood sugar, lowered blood pressure, decreased cholesterol levels, decreased anger, decreased stress, and improved fatigue:

25. McCraty R, Atkinson M et al.  New hope for correctional officers: An innovative program for reducing stress and health risks.  Appl Psychophys Biofeedback 2009: 34;251-272

Here is a meta-analysis of neuroimaging studies that show that impaired HRV is associated with characteristic changes in the brain:

26. Thayer JF, Ahs F, et al.  A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker for stress and health.  Neurosci Biobehav Rev 2012: 36;747-756