2015 cancer survivorship conference - spiritual, physical & mental health
TRANSCRIPT
Moving Toward Wholeness:The Relationship Between
Spiritual, Physical, and Mental Health
Andrew Newberg, M.D.Director of Research
Myrna Brind Center of Integrative Medicine
Thomas Jefferson University and Hospital
What is Wholeness?Wholeness refers to the sense of unity or connectedness people can feel with other thingsWholeness can refer to a person’s physical health and well beingWholeness can refer to a person’s spiritual experience or spiritual well beingWholeness relates to certain brain structures and functions
The Brain and WholenessFirst we must understand how and where wholeness is experiencedUse phenomenological analysis to understand wholenessCorrelate wholeness with brain processesUse modern scientific methods to better understand biological correlates of wholeness Neurotheology as a framework for this discussion
When and Where Does Wholeness Occur?
Wholeness is central part of every religious and spiritual traditionCentral tenet is that we are separated from the source (i.e. something sacred or absolute)The goal is to reconnect and become whole with God or Absolute realityPrimary means for attaining wholeness is through various practices
Ritual, meditation, prayer
Wholeness in the BrainBinary function of the brain (inferior parietal lobe) Orientation area of the brain (superior parietal lobe)Rituals, meditation and prayer can alter activity in the parietal regionsBrain scan studies of meditation and prayer practicesThese practices also affect the body creating health and wholeness
Other Brain Areas Involved in Wholeness
Emotions related to limbic systemAmygdala and hippocampus
Frontal lobes associated with increased attention and willfulness
Modulates emotionSense of surrender
Thalamus regulates brain functions and consciousness
Orientation Area Orientation Area
Baseline Meditation
SPECT Images at Baseline and During Meditation
SuperiorParietal Lobe
SuperiorParietal Lobe
Baseline Scan Prayer Scan
Comparison of Baseline to Prayer
How Do Spiritual Practices Change Your Brain over time?
Combine imaging and other scientific measures with subjective and phenomenological evaluationLongitudinal findings
Comparison of long-term meditators with non-meditatorsDo spiritual practices affect the brain over time?Kirtan Kriya and memory study
Neuroemotional TechniqueNET is a program that utilizes several different concepts to provide a sense of wholeness and reduce stress and anxietyNET utilizes concepts from acupressure, biofeedback, and cognitive therapy NET has been particularly effective in helping patients with various health and psychologically related traumas
Cancer and StressStress can manifest in a variety of physical and psychological symptomsReferred to in the cancer literature as “Distressing Recollections”About 1/3 of cancer patients have distressing recollectionsThese distressing recollections cause as much morbidity as PTSDThe two primary psychological symptoms of distressing recollections are avoidance and intrusive thoughts
Avoidance
Avoidance is driven by strong unpleasant feelings (primarily fears) triggered by trauma-related thoughts, places (i.e. hospitals, doctor’s offices, etc.)Likely associated with increased amygdala activityAvoidance is manifested through staying away and escaping these provocative cues
Intrusive Thoughts
Involuntary, unwanted thoughts, memories or imagesIntrusive thoughts are usually upsetting and often indicate an ongoing coping and mental processing of an unresolved stressful event
Jefferson-NET Study
To assess the effect of the NET program on cancer patients with a history of distressing traumaTo evaluate the effect of the NET on brain functionPatients must have a history of cancer and a related distressing psychological traumaPatients are screened, evaluated for inclusion criteria, undergo psychological evaluation, and then scanned in the fMRIAfter the NET program patients again undergo psychological evaluation and fMRI
Study Design-SubjectsInclusion Criteria
Age ≥18 years of ageDistressing cancer-related recollection that causes physiological reactivity (i.e., increased heart rate >5% and/or increased skin conductance level >33%).Received a cancer diagnosis between 6 months and 3 years prior to participating in study
Exclusion Criteria Any current major psychiatric disorderHistory of depression before the cancer diagnosisCurrent diagnosis of substance abuse or dependenceUse of some psychotropic medications are allowed such as SSRIs and certain sleep aidsCurrently receiving chemotherapy or radiation
fMRI ProtocolStructural scan – required to provide anatomical informationResting functional connectivity scan (BOLD) (pre) – shows how different structures are connected to each otherDiffusion tensor imaging (DTI) scan – shows actual connecting tracts within the brainResting perfusion (Arterial Spin Labeling) scan (pre) – shows the brain’s activity at rest before the stressor taskNeutral perfusion (ASL) scan – shows the brain’s activity while listening to a control stimulusStressor perfusion (ASL) scan – shows the brain’s activity while listening to the stressor stimulusResting functional connectivity scan (BOLD) (post) – shows how different structures are connected to each other
Functional Connectivity Between the AmygdalasPre NET Treatment
Pre- Stressor Induction Post- Stressor Induction
LR R L
R=0.36 R=0.50
Functional Connectivity Between the AmygdalasFunctional Connectivity Between the AmygdalasPost NET TreatmentPost NET Treatment
LR R L
R=0.37 R=0.34
Pre- Stressor Induction Post- Stressor Induction
Diffusion Tensor Imaging (DTI)Diffusion Tensor Imaging (DTI)
After the NET program, the fiber density
increased between the frontal lobes and
amygdala by ~50%.
NET ConclusionsThe data show marked changes in the fMRI results between the pre and post NET scansThe amygdala is highly reactive pre-NET and actually decreases in reactivity post-NETThe frontal lobe appears to be able to modulate the amygdala’s reactivity post-NETThe NET program normalizes the brain’s reaction to trauma (stressor)We now await more data to confirm and augment these initial findings
Final Conclusions: Can we foster wholeness and well being?
We can turn to practices and beliefs that foster more compassion, wholeness and well beingFind practices that work best for you and are consistent with your belief systemSpecific practices such as meditation and prayer affect the wholeness areas of the brainPractices like NET lower stress response and anxietyWholeness can ultimately fill your brain, health, and life
The End
Andrew NewbergJefferson-Myrna Brind Center of
Integrative Medicine215-955-2221