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The Wisdom of the HeartSocial Connectedness, Love, and Health

www.joanborysenko.com

Viktor Frankl

“For the first time in my life I saw the truth as it is set into song by so many poets, proclaimed as the final wisdom by so many thinkers. The truth ‐ that Love is the ultimate and highest goal to which man can aspire. Then I grasped the meaning of the greatest secret that human poetry and human thought and belief have to impart: The salvation of man is through love and in love.”

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“I have come to believe that it is through the establishment of a unique doctor-friend-patient relationship that most of the healing occurs, whether helped along by surgery, acupuncture, or regular doses of approved medicines.”

-Joseph Martin, MDFormer Dean of HMS

The Healing Presence

Empathy= Mindsight

The ability to mindfully connect to the inner life of another person. This activates the face, the vagus nerve, the mirror neurons. 

It also creates changes in the right hemisphere, the striatum,  and the medial and left prefrontal cortex.

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It’s Rewarding to be Seen

The frontostriatal pathway connects the medial PFC (self knowledge) with the ventral striatum (motivation and reward). When this pathway is weak psychiatric difficulties are increased. 

Multimodal frontostriatal connectivity underlies individual differences in self‐esteemRobert S. Chavez and Todd F. Heatherton, Soc Cogn Affect Neurosci (2014)Doi: 10.1093/scan/nsu063

Love is the Heart of Healing

TLC reduces IL-6 and cortisol levels, while increasing HGH levels. This is part of how loving support induces and sustains the self healing mechanisms of the body.

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Compassion and HealingShowing a film of Mother Theresa resulted in increased sIGA. After an hour levels fell to baseline, but rose again when the subjects were asked to contemplate a time when they experienced compassion and kindness.Hellman et al (old study (1980’s) reference unknown)

Empathy and Healing• Over 700 patients with common colds were assigned to one of 

3 groups1) no interaction with a practitioner; 2) a “standard” interaction that focused on history and examination, but offered little touch or eye contact; or 3) an “enhanced interaction” in which clinicians promoted “PEECE”: positive prognosis, empathy, empowerment, connection, and education.

• Those whose CARE score was high had reduced severity and duration of colds.

• High CARE scores were also associated better immune responses

Perception of empathy in the therapeutic encounter: Effects on the common cold. David Rakel et al, Patient Education and Counseling; vol 85: pp 390‐397; 2011

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Dogs are also good for your Heart

• Men who have heart attacks have a 5% chance of dying in the first year post MI

• If they have a dog the risk decreases to 1%

• Petting or playing with a dog releases oxytocin, dopamine, and endorphins

• Oxytocin decreases stress, lowers blood pressure, and lowers heart rate

Dogs, Rats, and Heart Attacks; Alex Korb, Ph.D.  Psychology Today, March 19, 2012

Love and Health

• Antagonist to stress• Stimulates pleasure system (increases

endorphins, endogenous cannabinoids, endogenous morphine, dopamine, oxytocin, vasopressin, nitric oxide)

• Decreases anxiety and depression• Enhances motivation and positive choice• Increases wellbeing• Decreases physical symptoms

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Negative Emotions and Proinflammatory Cytokines

• IL-6 overproduction results from both physical and emotional stress.

• Depression and anxiety increase IL-6 production.

• Inflammation is a commonality in heart disease, diabetes, osteoporosis, aging, some cancers and many chronic illnesses

We are Social Animalswho require the shelter of one another to thrive

In a 2013 study by Steve Cole at UCLA, lonely people had significantly higher levels of norepinephrine, an immunosuppressant hormone. 

“In a life‐threatening situation, norepinephrine cascades through the body and starts shutting down immune functions like viral defense, while ramping up the production of white blood cells called monocytes. ‘It's this surge in these pro‐inflammatory white blood cells that are highly adapted to defend against wounds, but at the expense of our defenses against viral diseases that come from close social contact with other people,’ Cole says.

At the same time, lonely people seem to be shutting down genes that would make their bodies sensitive to cortisol, which lowers inflammation. That ramps up the defensive inflammation response, Cole says.” 

The Pursuit of Happiness, Jo Marchant

Nature: Immunology, Volume 503, 27 Nov, 2013

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Cole Study 

“Out of the roughly 22,000 genes in the human genome, the researchers identified 209 that distinguished the lonely people from the sociable ones: they were either regulated up to produce more of an individual protein or regulated down to produce less. Any individual gene could easily look different by chance, but Cole was struck by the overall pattern. A particularly large proportion of the upregulatedgenes in the lonely group turned out to be involved in the inflammatory response, whereas many of the downregulated genes had antiviral roles. In sociable people, the reverse was true. It was a small study, but one of the first to link a psychological risk factor with a broad underlying change in gene expression. The researchers have since replicated that result in a group of 93 people5.” Ibid: previous slide

Poetry Break

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Last Night as I was Sleeping Antonio Machado

Last Night As I Was Sleeping

Last night as I was sleeping,

I dreamt—blessed illusion—

There was a fountain flowing

Deep within my heart.

I said: Along which secret aqueduct,

Oh water, are you coming to me,

water of a new life

that I have never drunk?

Continued

Last night as I was sleeping,

I dreamt—blessed illusion—

I had a beehive

Deep within my heart.

And the golden bees

were making white combs

and sweet honey

from my old failures.

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Continued

Last night as I was sleeping,

I dreamt—blessed illusion!—

that a fiery sun was giving

light inside my heart.

It was fiery because I felt

warmth as from a hearth,

and sun because it gave light

and brought tears to my eyes.

Continued

Last night as I slept,

I dreamt—blessed illusion—

that it was God I had

here inside my heart.

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Spiritual Identity as our Birthright

Our birth is but a sleep and a forgetting, the soul that rises with us, our life’s star, hath elsewhere its setting and cometh from afar, not in entire forgetfulness and not in utter nakedness, but trailing clouds of glory do we come.

-Wordsworth

An Identity more Enduring thana Diagnosis

“Your identity is not equivalent to your biography. There is a place in you where you have never been wounded, where there’s a seamlessness in you, where there is a confidence and tranquility in you, and I think the intention of prayer and spirituality and love is now again to visit that inner kind of sanctuary.”

‐John O’Donahue

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A Compassionate Possibility 

What if the seeds of your soul’s becoming were hidden in the very stories of your life that cause you pain and limitation? What if telling your story from the perspective of the soul caused those sacred seeds to germinate?

We are spiritual beings having a human experience (Teilhard de Chardin)

Biography becomes Biology andyou are your own biographer

“…narrative medicine is creating a larger context for your story that lets you find the nobility within yourself and share it.”

‐Dan Siegel. MD

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Stories Create Identity

Jack Kornfield quotes from Time magazine: “After more than a century of looking for it, brain researchers have long since concluded that there’s no conceivable place for a self to be located in a physical brain.”

Commentary from Jack: “Self is quite malleable. There’s no fixed self, but we are constantly creating self with the stories we tell, the beliefs we have, and what we choose to identify with. “

In Praise of Healing Fiction (James Hillman)

Stories we tell ourselves that make sense of the world. True or not they make a positive difference in how we live our lives. 

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Ram Dass

• Fierce Grace: He writes about his stroke as the ultimate spiritual teacher

• “I am loving awareness”: entering the realm of the soul and letting go of the fixed identities attached to past and future

“Positive Emotions, Spirituality, and the Practice of Psychiatry”Mens Sana Monograph  2008; 6:48‐62

George Vaillant, M.D.

“… eight positive emotions: awe, love (attachment), trust (faith), compassion, gratitude, forgiveness, joy and hope constitute what we mean by spirituality. These emotions have been grossly ignored by psychiatry….Spirituality is not about ideas, sacred texts and theology; rather, spirituality is all about emotion and social connection… Our whole concept of psychotherapy might change if clinicians set about enhancing positive emotions rather than focusing only on negative emotions.”

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Study of Forgiveness after Emotional Abuse

Emotionally abused women often have PTSD and affective disorders after the relationship ends. 20 women were assigned to either forgiveness training or an alternative training in anger validation, assertiveness and interpersonal skill building.

Results

Women in the forgiveness intervention had significantly greater improvement in depression, trait anxiety, PTSD symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering.

The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse: Reed, GL et al Enright RD, J. Consult and ClinPsych, Oct 2006, 920-929.

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Forgiveness and Heart Wisdom

“What is the sign of someone who knows God?” a young woman asked the great 14th century poet Hafiz. He replied, “My dear, they have dropped the knife, they have dropped the cruel knife they so often use upon their tender self and others.”

-Daniel Ladinsky

Creating a New Story createsnew neural circuitry

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Cognitive Neuroscience

Feelings and thoughts work together so that you can integrate the brain. By creating new meanings for the events of your life and focusing on becoming present to its beauty you can calm down your worry circuits and build resilience circuits.

Challenging Old StoriesThe Magic of Attribution Theory

Suzanne Ouellette Kobasa

3 C’s of Stress Hardiness

•Challenge

•Control

•Commitment

“Stressful events challenge

me to change and grow.”

Martin E.P. Seligman

3 P’s of Pessimism/Helpless

•Personal•Pervasive•Permanent

“It’s my own fault, I mess up everything I do, and it’s the story of my life.”

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Training Heart WisdomThe Brain‐Heart‐Mind‐Spirit Axis

Getting Best Self Back Online

Strengthening the connection of the medial prefrontal cortex to the amygdala

• Mindfulness

• Meditation

• Mental training techniques (slogans, reframing, cognitive behavioral approaches)

• Exercise

• Breathing

• Music?? 

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Training Compassion

Longterm meditators: Tibetan Buddhist monks, versus controls studied with fMRI•Decreased stress•Increased empathy (rt brain structures)•Increased happiness setpoint (lft prefrontal)

Regulation of the Neural Circuitry of Emotion by Compassion Meditation, Lutz et al PLoS One 3 (3): e1897, 2008

The Emory-Tibet Science Initiative

Lovingkindness meditation and lojong

(control vs meditation groups in students):

•Decreases reactivity to stress

•Decreases inflammation

Raison, Pace, et al Psychoneuroendocrinology, 2008; doi: 10.1016/j.psyneuroendocrinology, 2008.08.011

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And when all else fails…Consult your local pet therapist