Health Psych Week 5

Psychological Benefits of Laughter

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Professional Trends Toward Humor

-"Humor centers" in the living room of the William Stehlin Foundation for Cancer Research at St. Joseph's Hospital (Houston, TX) -"Humor room" at Schenectady's Sunnyview Hospital and Rehabilitation Center (Schenectady. NY), patients remined to take a "humor break" -"Lively Room" at General Hospital in Decatur, Georgia -Being hospitalized puts people at the highest level of stress- and humor is a natural remedy -Loss of control often places patients in fearful, compromising situations. Humor is an excellent diversionary took for keeping their minds off their pain -Most children's hospitals have roles like Dr. Hs Choo, Nurse Stefy Scope, and Dr. ICU Giggle -Has spread to long-term care facilities and even hospice care Innovative Programs: --Detroit medical center's childrens hospital of michigan, Clown-on-Call program --Clown Care Unit at Babies and Children's Hospital at Columbia-Presbyterian Medican Center in New York. Found that clowns helped decrease both the physical and psychological distress of patients who were undergoing medical procedures for heart ddisease and cancer, so they borught in specially trained clowns to work with the children. The joyful distraction provided by the clowns would increase patient cooperation, decrease parental anxiety, and decrease the need for sedation during anxious moments in the hospital -Trend toaward humor as a way of boostng both physical and mental health has spread to private practice. Physicians throughout the nation have begun using humor and laughter as a way of easing tension, promoting healing, and even boosting immunity among their patients. -More than 1000 nurses joined sorces to organize Nurses for Laughter (NFL), they boast the mottoe "Caution: Humor may be hazardous to your illness" -Humor is also being used successfully in long-term care facilities. At Regency Healthcare and Rehabilitation Center, staff members act out whodunit mysteries, and come together to put on their own Academy Awards show -Humor is even being used in hospice care, where people are assisted in the death process. Workers help patients focus on life- on living each day until they die. It's not unusaly to hear people describe uncontrollable laughter at times not usually thought of as funny, because humor s often a mechanism that frees them from emotional bondage -The benefits of laughter on physical and mental health are being noted even in the corporate world. Some of the nation's largest corporations have instituted humor programs to help develop a sense of humor in employees- and the results include an increased employee capacity to deal with stress and an overall improvement in job performance -Major companies like Safeway Stores, Manville Corporation, Southewestern Bell, IBM, and more use humor clinics or programs

The Healing Power of Forgiveness

Essential to a spiritual nature is forgiveness- the ability to release from the mind all the past hurts and failures, all sense of guilt and loss. -Forgiveness: a process of healing. The first step on the pathway of healing, it enables one to banish resentment -It is accepting the core of every human being as the same as yourself and giving them the gift of not judging them -Robin Casarjian: forgiveness is a relationship with life that frees the forgiver from the psychological bondage of chronic fear, hostility, anger, and unhealthy guilt. It's an attitude that implies that you are willing to accept responsibility for your perceptions, realizing that your perceptions are a choice and not an objective fact -Forgiveness removes whatever has blocked your creater mind from operating postiviely for you and for your good -Forgiveness is most difficult when we are asked to forgive ourselves. 7 out of 10 ppl carry throughout life a sense of guilt- a feeling of having committed a sin or mistake for which they have never been forgiven -Forgiveness is a decision to see beyond the limits of another's personality, and to gradually transform yourself from being a helpless victim of your circumstances to being a powerful and loving co-creator of your reality -Our own thoughts about what the offender has done are far more powerful in creating our reaction than is their act itself -Forgiveness is an essential key to reclaiming one's life, to feeling the sense of personal control that hs been so consistently linked to better health and medical outcomes -Forgiveness is taking back control of one's life, behavior, and personal actions. THis recovery of a sense of personal control is essential to wholeness and well-being (health). A low sense of personal control elads to all the negative emotions: anger, guilt, fear, anxiety, and frustration. A high sense of personal control (of one's self, not the world) leads to all of the positive emotions: confidence, inncer peace, hope, and loving kindness -The foremost way to get a high personal sense of control is to fully accept personal responsiblity for how one chooses to think about ad respons to the act of other (or fate). Take control back by refusing to to blame any longer what they have done for making you be other than what you want to be- by forgiving. -If we don't forgive, the hatred drives all the mechanisms causing poor health. With forgiveness, the anger and resentment dissolve. The body stops pouring high-voltage chemicals into the bloodstream, and healing begins -Best examples of the healing power of forgiveness can be found in nature -Dwight Wolter's "Tools of Forgiveness": 1. Begin by letting go of your unforgiving stance 2. Admit that the event and feelings you are stuggling with really happened 3. Admit that the past cannot be undone 4. Recognize that you no longer need to depend on tohers, including your parents, for approval. When you realize your independence, you assume your rightful power and you learn to be who you want to be regardless of the actions of others 4. Don't expect others to respond to your efforts to forgive 5. Release any unrealistic expectations of yourself 6. Accept others for who they are rather than who you want them to be 7. Be flexible about rules of conduct for yourslef and others 8. Talk about issues as they come up. Refuse any longer to blame -He also suggests fostering a forgiving attitude by praying, meditating, expressing gratitude, spending time in nature and allowing yourself to experience its wonder, serving others selflessly, and creating through any art form

Coping Interventions

Mindfulness Training -Refers to systematic training in meditation to enable people to self-regulare their reactions to stress and the negative emtoions that may result. MBSR may be effective inr educing stress, anxiety, and disress. Reported healthy and quality of life improved among participatns, suggesting the MBSR may have beneficial health effects as well as coping benefits -Neuroscience has identified that mindfulness engages the prefrontal crotical regions of the brain, which regulate affect and downregular activity in limbic areas related to anxiety and other negative emtions Expressive Writing -The more people are forced to inhibit their thoughts, emotions, and behavior, the more their physiological activity may increase -The ability to confide in others or to consciously confront one's feeling may eleminate the need to obsess about and inhibit the event, which, in turn, reduce the physiological activity associated with the event -Students who wrote about the most traumatic or stressful event in their lives were less likely to visit the student health center for illness during the following 6 months -When people talked about trumatic events, their skin conductance, heart rate, and systolic and disastolic blood pressure all decreased. Emotional disclosure cna also have beneficial long-term effects on immune functioning -One risk of writing interventions is that they sometimes increase distress on the short-term. Possible writing about perceived benefits from traumatic events may provide a less upsetting but nonetheless still effective way to benefit from writing interventions, rather than focusing directly on a traumatic experience itself -Interventions have employed expressive writing to encourage emotional approach coping. This has led to improved health among AIDS patients, breast cancer patients, people with asthma or arthritis, and headache patients, among other disorders -Writing may also help people cope with debilitating treatments. Guided writing led to a more beneficial postoperative course in surgery patients; tose who wrote about their experience, on average, left the hospital several days earlier and with lower psychological distress. Expressive writing does not affect all medical conditiongs, but its benefits suggest that it is a useful intervention for many patient groups -Many reasons why talking or writing about a stressful event or condifiding in others may be useful for coping. Talking with others allows one to gain informations about the event or about effective copingl it may also elicit positive reinforcement and emotional support from others. There may be beneficial cognitive effects associated with talking about or writing about a traumatic event, such as organizing one's thoughts and being able to find meaning in the experience. These interventions may lead people to change their focus of attention from negative to postivie aspects of this situation. Talking or writing about traumatic or stressful events provides an opportunity for emotional-approach coping and for affirming one's personal values -Alexithymia, which is difficulty identifying and expressing one's emotions, has been tied to health risks, and interventions such as expressive writing may reduce the risk Coping Effectiveness Training -Most of these interventions draw on cognitive-behavioral stress management -Coping effectiveness training typically begins by teaching people how to appraise stressful events in order to disaggregate the stressors into specific tasks. The person learns to distinguish those aspects of a global stressor that may be changeable from those that are not. Specfic coping strategies are then developed and practiced to deal with these more specific stressors. -Encouraging people to maintain their social support is also an important aspect of coping effectiveness training

Physiology of Religiosity/Spirituality

Studies demonstrate brain/central nervous system involvement in religious experience -Increased blood flow to some areas of brain -Increased serotonin reception (e.g., reduce experience of pain) -Meditation increases GABA, melatonin, and serotonin (similar to the effects of some psychedelic drugs) -Increases left hemisphere activity associated with positive emotion and elevated immune responses -Increases frontal lobe regulation which impact ability to cope with stress, empathy perspective-taking Increase in endocrine response -Affects dopamine neurons which influence other body systems (autonomic, endocrine) to deal with stress -Reduces activity of sympathetic nervous system

Social Support and Relationships

-"Statistically, this is one of the strongest areas under study. What isn't clear is how it works. How does a relationship get into the body and influence biological processes? All we know at this point is, something very important is happening." - Dr. Leonard Syme, professor of epidemiology at UC-Berkeley on the frustration of pinpointing WHY or HOW social support works -Parable of the hermit from Adlerian therapy -Alfred Adler was one of Sigmund Freud's first students, but he eventually broke away from Freudian theory (on very bad terms with his mentor Freud) as he had several problems with it. Adler's biggest contribution to psychology was his belief that humans are social creatures first and foremost, and that social connectedness is our number one need. Adlerians tell the following parable of the hermit to underscore how all of us exist in relationship to others: The Hermit Once long ago there lived outside a village in a cave an old man, the Hermit. One day the village and its inhabitants were totally destroyed by an erupting volcano. Sadly, the Hermit tied his belongings on his back and set out to find another cave outside another village.

The Tecumseh, MI Study

-10-year study of 3,000 adults in Michigan --Ruled out existing illness and assessed social relationships --# of friends, degree of closeness to relatives, participation in group activities, choice of activity -Socially isolated had 4x mortality rate of socially involved In a famous study, epidemiology researcher James House (no relation to Gregory) and his team conducted a prospective study of 2,754 residents of Tecumseh, Michigan, observing their social ties and group activities for ten years. This was a very rigorous study in that residents with any medical or psychiatric condition that could possibly interfere with their ability to be active in a social community were excluded. Over time it became clear that people with the greatest participation in a social support network or group were the healthiest. Those who initially had great support but who, because of various life circumstances, lost their connection to community were found to develop a variety of health problems. Those with the least social support were found to have four times the mortality rate of those with the most support.

Harris Poll, Spiritual Health

-1254 people about aches and pains -Age group that had the most pain: *young adults*. Pains were highly associated with the *"hassles of life"* -How did they rank their best relief? 1. Spiritual Counselors: 85% 2. Physicians: 73% 3. Non-MD practictioners: 60-75% helpful -Clearly, people are already integrating a more biopsychosocial approach to managing their daily hassles. -Spiritual practices were regarded as even more helpful than practitioners consulted for the treatment of chronic muscle pain of fibromyalgia -Religion/spirituality and medicine were interwined from the beginning of time. Disease was originally considered to be supernatural -Before the late 1800s, medicine, hospitals, and beliefs about health were intimately tied to religion and then need for dirivne help in healing. After the scientific revolution, medicine went in the opposite direction, think of healing processes along purely biological and psychological lines. "germs' and other offenders caused disease, and the way to treat to prevent disease was to kill or avoid the causative agent -"Host resistance" then evolved. Many factors play into that resistance: not only organic problem,s but social factors and such things as coping ability. All of these modulate the hemostasis and immune responses that make up the disease-resistant person -Now swinging back to rediscovering the role that spiritual issues play in the well-being (health) equaltion -Almost 1/3 of Americans say that their coping and overall approach to life are centrally grounded in their religious beliefs. Poll: 85% of Americans considered sprituality to be important in their davily lives, and 61% believe that spirituality or religion can answer most of life's perplexing problems. Surveys suggest that a very large majority (86%) believes that God, prayer, and spiritual practices are very important to them inhealing at a time of serious illness. Literature shows that both spiritual and religious factors play a significant role in both the prevention of illness and in health outcomes when people are recovering from physical or mental illness -Benefits of spiritual issues on health outcomes cross different religions, nationalities, age, genders, and types of medical practice Evidence suggests that increasing numbers of physicians today are taking the spirituality of their patients into account as part of patient care. These physicians are forming a "therapeutic alliance" with their patients that affirms the importance of their spirituality -"As physicians respectfully explore patient spirituality, a reciprocal enhancement in patient regard for physicians and a deepening of the alliance between patients and their physicians becomes possible, potentially resulting in more effective treatment" -Same type of spiritual involvment is being incorporated into mental health treatment and has been recognized as "a crucially important dimension" in acute mental care. Unfortunately, a patient's religious beliefs and values may be dfficult to discern and respond to in the contect of acute mental illness, which poses a signficiant challenge and requires extra effort -Patients are supporitve of a patient/physician relationship that takes spirituality into account. In a survey of the American public, 74% of sick patients feel a physician should introduce a discussion about an ill patient's spiritual needs, refer a patient to a spiritual advisor (rabbi, priest, minister, chaplain), or suggest prater -At the end of life, the number hoping for their physician to include spiritual considerations increases to 90 percent (but this is done only 24 percent of the time). A Gallup Poll indicates that 60 % of patients would like their physicians to pay with them. At the very least, new guidelines suggest that physicians should ask patients about their spiritual beliefs, practices, and values as a routine part of assessment, and should incorporate those into the patient's ongoing care -When the local culture of a community is taken into consideration, activities such as prayer, anointing, testimonials, and other worship practices can be explored as potential health resources. When this type of medicine is practiced, a patient is much more likely to enjoy both physical and spiritual health

Genetic Bases of Social Support

-Genetic underpinnings in the ability either to construe social support as available or to establish supportive networks -During periods of high stress, genetic predispositions to draw on social networks may be activated, leading to the perception that support will be available to mute stress

The Healing Power of Humor and Laughter

-Laughter as medicine is probably as old as humankind -One of the earliest written accounts recognizing the healing power of humor is found in the Bible, in which king Solomon remarked that "a merry heart doeth good like a medicine" -Humor: the quality that appeals to a sense of the comical or absurdly incongruous. What we refer to as a "sense of humor" is the ability to bring happiness both to your own life as well as to the life of others. --Also "bad humor"- when you use it to hurt someone, lower their self-esteem, or bring tears of sadness) --"Good humor" is the ability to feel inner joy, peace, and harmony within yourself and your surroundings- to discover that we are all part of a divine comedy -Humor is a way of looking at things that helps to dissipate stress and accentuate the positive. Positive humor is not leveled at someone else's expense -American Indian tribes including the Zunis, Crees, Pueblos, and Hopis had ceremonial clowns whose sole purpose was to provide humor for their tribesmen -Ojibway Indian doctor-clowns (the Windigokan) used laughter to heal the sick -17th cenury physician Thomas Sydenham: "The arrival of a good clown exercises more beneficial influence upon the heath of a town than twenty asses laden with drugs" -13th century surgeon (Henri de Mondeville) told jokes to patients after operations -Humor has long been part of medical treatment across cultures, although it fell out of favor in our traditional medical model over the last two centuries. -One of the most renowned uses of laughter in our own day occurred when former Saturday Review editor Norman Cousins incorporated it in a program to treat ankylosing spondylitis, a debilitating connective tissue disease. 10 minutes of genuine belly laughter had an anesthetic effect and would give at least 2 hours of pain-free sleep. The response to incongruities is one of the highest manifestations of the cerebral process -C.W. Metcalf: "humor is a set of survival skills that relieve tension, keeping us fliud and flexible instead of allowing us to become rigid and breakable, in the face of relentless change -"If you wish to glimpse inside a human soul and get to know a man, watch him laught. If he laughs well, he' a good man...laughter is the most reliable gauge of human nature."

Psychological Benefits of Laughter

-Perhaps the most pronounced psychological benefits of laughter are its ability to relieve stress and its tendency to improve our perspective- on everything from pain to life itself Laughter as Stress Relief: -Some reasons that laughter is as good for stress relief as a massage or hot bath is because of the physical outcomes: the body doesn't produce stress hormones as efficiently during laughter, and laughter itself physically breaks up tension -Lawrence Peter considered laughter to be an important safety valve. When you laugh, you get rid of stress-related tension that can otherwise accumulate and damage health -The ability of laughter to dispel stress lasts long after the laugh- and can even help the person who laughts to build an actual immunity to stress Laughter as New Perspective: -Humor's most important psychological function is to jolt us out of our habitual frame of mind and promote new perspectives. One of the best measures of mental health is the ability to laugh at oneself in a gently mocking way -Rosemary and Dennis Cogan designed an experiment to see whether laughter would help change the perspective of pain. Randomly assigned students into one of four groups: one listened to a humorous audiotape, one listened to a relaxation tape, one listened to an informative narrative, and the fourth group did not hear a tape --Then fastened automatically inflating blood pressure cuffs around their arms and subjected them to highest level of discomfort that the cuffs could produce --The students who were able to withstand even the highest pressure without becoming distressed were those who had listened to the humorous tape. Laughter changes our perspective of discomfort or distress and enables us to withstand many time what we normally could -Gordan Allport: 4 decades ago: laughter provides new perspective on our place in society- much as climbing a mountain or activity in a religion does If you want to have more fun in your life, try doing these: -Make a pledge to laugh out loud or to make someone else laugh at least 10 times every day -Once a week, set aside time to call someone who always adds fun to your day -Read your favorite comics in the newspaper every day -Make regular dates with a friend or your spouse to do any recreation that you both enjoy -Do something silly at least once a week -Start a humor collection- go for jokes, clippings, cartoons, cards, mugs, books, or videos -Share funny items with others, and use stick-on notes that have humorous messages -Rent funny movies -Try to find the humor in every predicament -Keep a "fun first-aid kit"- cram it full of things like modeling clay, bubbles, puzzles, brain teasers, and other things you love to do -Finally, recall all the fun you had as a child -One of the best suggestions is to create a "humor survival kit" -Study showed sense of humor boosts self-esteem and optimism. Those scoring low on humor scale had higher rates of distress and depression -Other benefits --Correlated with greater creativity/problem solving --Maintains a sense of balance (ex. wakes and grieving) --Improves performance --Bestows a sense of power (ex. used by people in dire situations. You can gain a sense of power through laughter even when you can't control the event or outcome In addition to the physiological benefits we covered, it is not surprising that humor comes with psychological benefits as well. Most of these bullet points are self-explanatory, but I want to highlight the one on maintaining a sense of balance. When I was learning about approaches to grief counseling, I learned that children are excellent models for appropriate grieving. Think about the last funeral you attended. They are pretty sober affairs in our culture (so culture more so, some less so). Adults are often speaking in hushed tones, many are clearly expressing sadness, others appear neutral. There are very clear expectations about what is appropriate or not. But watch children under the age of 8. They most certainly express sadness as they are surrounded by it, but they are also off playing and joking around minutes later. Grief specialists argue that this is the natural way to grieve—to recognize that we come in and out of emotional states, and there is nothing wrong with laughter and joy even during periods of grief. This might explain why some cultures (like the Irish) have wakes as part of the grieving process that are often joyful celebrations of the deceased person's life.

Church Affiliation and Health

-Religion is basically a science in how to know God -People with active religious faith and people who are strongly affiliated with a particular church generally enjoy better health -Religion: the personal beliefs, values, and activities pertinent to that which is supernatural, mysterious, and awesome, which trancends immediate situations, and which pertains to questions of final causes and ultimate ends of man and the universe -2 basic orientations of religion: 1. Personal. Involves a person's values, beliefs, and attiudes. Spiritual experience is the cornterstone of religion. Can be either intrinsic or extrinsic. Intrinsic sense of religion participate in their chosen religion for spiritual reasons; the religion comes first and is a dominating force in their lives. Extrinsic sense of religion do not share the "zeal" or commitment of those with an intrinsic orie3ntation; religion for them is recondary and does not represent a primary need. They "belong" but they do not "live" their religion 2. Institutional. Adopt a church or religion bc of group-related benefits: they enjoy attendin church, participating in group activities or rituals, and receiving community support -Religion may enhance health and well-being in at least 4 ways: 1.Through socal integrations and support 2. through the establishment of a personal relationship with a divine other 3. Through the provision of systems of meaning and existential coherence 4. Through the pomotion of specific patterns of a more healthy personal life -High levels of religious involvment are associated with better health. Some show particular religions (such as Mormons or Adventists) as being protective health, others show that factors such as frequency of attendance and religious belief are aso important in protecting health -Studies that examined the rate of heart disease, high blood pressure, stroke, cancer, digestive disease, physical disbaility, self-rated health, and self-reported symptoms showed a strong relationship between religious participation and good health. Old ppl that attended church regularly were less depressed and physically healthier than those who did not attend church -Those patients who undergo open-heart surgery have a much greater chance of surviving if they gain comfort and strength from religious faith • Those who enjoy regular religious affiliation live longer, probably in part because regular church attendance promotes social support. • The elderly who regularly attend church have significantly better physical and mental health and lower death rates (one study, in fact, showed that some elderly people in New Haven, Connecticut, actually postponed the timing of their death until the conclusion of major religious holidays, such as Easter or Christmas). -Religion was important coping factor for men. 1 in 5 said religion is the "most important thing that keeps me going" Nearly half of the patients rated religion as very helpful to them in coping with the situation of being hospitalized. Developed peace and comfort from prayer, Bible study, faith in God, and the emotional support of a pastor or other church members -Those who were religious had high levels of social support, low levels of alcohol use, and significantly less clinical depression -High religious commitment is associated with the following: --Better physical health outcomes: 212 studies, 75 percent positive, 17% mixed, and 7% negative (including heart disease, cancer, survival, hypertension, general health, and overall functioning) --Better mental health outcomes: 18/19 studies: better adjustment and coping. 15/15 less drug abuse, 20/24 less alcohol abuse, 15/18 less psychiatric illness, 13/19 less depression --Better quality of life: 18/19 better life satisfaction, 10/10 better marriage adjustment, 20/22 better overall well-being, 14/21 less death anxiety -Harold Koenig and David Larson, 542 people aged over 60, those who atteneded church at least weekly were hospitalized 56% less. When hospitalized, those affiliated with any religion stayed less than half as long as those who claimed no religion -Their religious beliefs and involvement may counteract feelings of helplesness, provide meaning and order to challenging life experiences, and restore a sense of control -"Alternative" practices in mental health: --Spiritual/religious practices 50% --Mediation 43% --Massage 31% --Yoga 20% --Imagery 17% --Herbs 16% --Dietary Supplements 13% All provided the following enhanced benefits: increased calmness and stability, better cognitive function, improved relationships, greater sense of purpose, feeling spiritually nurtured, improved general functioning -Study of depressed eldery people, significantly better improvement in those who were religious came from much more than simply social support

Take Yourself Less Seriously

-View your life in context --While we might think taking weight of world on our shoulders is admirable, in long run it's unrealistic, unproductive, and unhealthy -Deal with your stress --Stress= Major impediment to humor and laughter -Laugh at yourself --Share your embarrasing moments and times when you took yourself too seriously -Pay attention to children and emulat ethem --They are the experts on playing, taking life lightly, and laughing -Red comic authors --Anything by David Sedaris, David Foster Wallace's A Supposedly Fun Thing I'll Never Do Again, Jon Stewart, Firoozeh Dumas Funny in Farsi

Support from Whom?

-When social support is provided by the wrong person, support may be unhelpful or even rejected, as when a stranger tries to comfort a lost child -May also be ineffective if the type of support provided is not the kind that is needed. Emotional support is more important when it comes from intimate others whereas information and adivce may be more valuable coming from experts -Social influences may adversely affect some health habits, as when one's peer group smokes, drinks heavily, or takes drugs or when a lot of social contact is coupled with high levels of stress; under these circumstances, risk of minor illnesses such as colds or flus may actually increase. Social inluences affect health habits beneficially: -People with high levels of social support are more adherent to their medical regimens and they are more likely to use health services, especially when the support network is postively inclined toward those services

The Relaxation Response

-of 131 controlled experiments on prayer-based healing, more than half showed statistically significan benefits -20 years of research by Benson, professor of medicine at Harvard Medical School and chief of Section on Behavioral Medicine ---Relaxation response is the body's ability to enter a "scientifically definable state" of relaxation. During the relaxation response, changed occur in the mody: metabolism slows down, blood pressure drops, breathing slows, heart rate lowers, and even the brain waves are less active. ---Relaxation response has most often and effectively been elicited through forms of prayer --Why does prayer seem to work? It's the most common form of meditation in the Western world -Here's a new twist to the prayer research. When you have people in the studies pray themselves, then you start to get significant results for prayer and health outcomes. Dr. Benson and others have measured all of the physiological and neurological effects while someone is engaged in prayer, and he suggests that the benefits are a result of parasympathetic activity (i.e., the relaxation response). The findings are identical to those on meditation. And since prayer is the most common form of meditation in the Western world, that might help explain some of the positive health outcomes that have been coming out of the research. This is good news for both the religious and non-religious as it means everyone can benefit from interventions that activate the parasympathetic response! -Gives clue as to one reason why prater improves health: it helps us meditate, relieving stress. Prayer may be one of the most common kind of meditation in the Western World. When ppl pray they're focusing on their deepest values and drawing on spiritual power that develops a sense of connectedness and also develops hope, which had been known to effect medical outcomes -Most benefits from prayer come from what researchers call "meditative" prayer- being still, knowing that God is God. People who use only active prayer but don't get into meditative prayer "aren't as likely to find peace and serenity" through their prayers Poloma and Brian Pendleton found that different types of prayers affected people in different ways. Happiness seems to be predicted not by the frequency, but by its quality. -4 Main types of prayer that are performed away from church: 1. Meditative (feeling or quietly thinking about God). Closely associated with "existential well-being" and religious satisfaction 2. Colloquial (asking for guidance or forgiveness). Related to overall happiness 3. Petitonal (asking for explicit favors) 4. Ritual (reading specific prayers)

How could spiritual or religious beliefs and/or activites promote health, aid in healing, or prevent illness?

1. Religious participation encourages better health habits which pay off in long run -Many different religions have explicit and implicit rules about behavior. Some religions prohibit the consumption of alcohol and other intoxicants (Mormon, Islam, etc.). Others provide more general guidelines for healthy living. 2. Many religions teach "body as a temple" metaphor -Some religions teach that the human body is a temple to a higher power, and that we must take care of it. This can include health behaviors and the encouragement of lifelong learning (as in some orders of nuns). 3. Many religions have a strong social and fellowship component -Most religions have a very strong social component. People gather together for prayer, services, community service, celebrations, etc. It might be that very strong social ties provide a range of other health benefits.

Other Research

AIDS -Lower rates of depression; higher immune functioning Breast Cancer -37 months in group therapy vs. 19 months traditional medical treatments only Melanoma -60% reduction in mortality after 6 years for group with therapy Birth Complications -Having female companion in the delivery room reduced Caesarian rates from 18 to 8%; need for epidural from 55 to 8%; fewer premature births and infacnt complications Above are some other general health findings with links to social support.

The Health Benefits of Laughter

Because of the physiological changes that take place during laughter, it packs a punch in terms of physical benefits, pain relief, boosts in immunity, and psychological benefits -Story with the cancer veterans and the phone operator/coins

Health Benefits of Laughter

How might laughter provide health benefits? Physical 1. Muscle relaxation 2. Reduction of stress hormones (increase in immunity) 3 Cardiac exercise 4. Blood pressure 5. Respiration Psychological 1. Stress 2. Coping Researchers have known about the positive correlation between humor and healing, and we now have actual studies that show evidence of those benefits.

Special Case of Forgiveness

Impact of forgiveness on CV reactivity and recovery (Friedberg, Suchday, & Shelov, 2008) -Not related to CV reactivity, but higher levels predicted lower diastolic BP and faster DBP recovery -Findings suggest that forgiveness may be related to overall reductions in BP levels and aid in CV recovery from stress Lawler-Row, Karremans, Scott, Edlis-Matityahous, & Edwards, 2008 -Trait forgiveness significantly associated with fewer medication, less alcohol use, and lower BP -State forgiveness significantly associated with lower heart rate and fewer physical symptoms Forgiveness is another variable studied that is both rooted in religious thought but certainly not limited to it. To help you understand the studies above, I need to explain the difference between trait and state variables. In personality research, we usually refer to traits as those parts of our personality that are stable across time. State behaviors are much more driven by context, and short-lived. Anger can be a trait (someone is perpetually angry across many situations...they are just "an angry person"). It can also just be a state (someone is generally pretty even keeled, but might get angry only in certain situations like being stuck in traffic). One other definition you need to know: cardiac reactivity. It is increase in blood pressure and heart rate during times of stress. Evidence suggests that chronic cardiac reactivity contributes to coronary artery disease. Study 1: Friedberg et al measured participants' self-reported trait forgiveness and wanted to see how it impacted CV reactivity and recovery from cardiac stress. There were no differences between low and high forgiveness on CV reactivity; however, those scoring higher in forgiveness had better diastolic blood pressure profiles. Study 2: You can see from the slide that there appeared to be different health outcomes for trait vs. state forgiveness. This suggests that even if you aren't a generally forgiving person, practicing forgiveness can still result in some health benefits.

How Does Social Support Work?

No one knows for certain -May enhance health regardless of stress level through self-esteem, stability, and control over environment -Act as a buffer by protecting from stress-related diseases -Strong network and healthy social ties-> greater, more general sense of control -Confiding reduces internal physiological arousal and stress response Although we know social support is critical to our lives, there is no single unified theory as to how it works. Above is a summary of the major ideas about its effects on health.

Healing Power of Spirituality

Spirituality -Based on experience, not intellect -Provides purpose, meaning, strength, and guidance in shaping journey of life Religion -Way people practice or express spirituality -Organized practice of person's beliefs Faith -Experience of five senses that provides acceptance of beliefs not demonstrable through experimentation or reason There are no agreed upon definitions in the literature for spirituality, religion, or faith. However, we will work with these broad definitions to understand how they are similar and different. People can be spiritual but not participate in any organized religious practices (services, prayer, etc.), and there are certainly people who practice religions that aren't particularly spiritual.

Moderation of Stress By Social Support

The Direct Effects Hypothesis: maintains that osicla support is generally beneficial during nonstressful as well as stressful times -The Buffering Hypothetsis: maintains that the physical and mental health benefits of social support are chiefly evident during periods of high stress; when there is little stress, social support may offer few such benefits. Social support acts as a reserve and resource that blunts the effects of stress or enables the individual to cope with sress more effectively when it is at high levels -When researchers have looked at social support in social integration terms, such as the number of people one identifies as friends or the number or organizations one belongs to, direct effects of social support on helath have been found -When social support has been assessed more qualitively, such as the degree to which a person feels that tere are other people available who will provide help if it is needed, buffering effects of social support have been found

The Power of Prayer on Health

-76 year old Spanish-speaking man fron north of Santa Fe, New Mexico. -Your own prayers can make you feel better. Prayer signlas a commitment to a set of moral and ethical values. It is a signpost of our spirituality and is at the core of most spiritual experiences. During prayer we empty the mind, yet we receive some inner direction. Part of the magniticism of prayer comes from our own belief, our own faith- the powerful suggestion that prayer will work, that something will happen -Study of 4000 mostly Christian ppl over age 65 -Found that those who never or rarely prayed ran about a 50% greater risk of dying over a period of 6 years. THe authors postulate that the relaxation and meditative effects of prayer may play a role in the protection it provides, or ppl that pray tap into the power of hope and expectation that improves outcomes -Subtle peace and quiet effect of prayer that may be the most effective. -Study of spontaneous remission of cancer conducted at Kyushu Univerity School of Medicine in Japan -found that prayer preceded the cure in every case. It was a prayerful, prayerlife attitude of devoation and acceptance that did the trick, not aggressive prayer for specific outcomes -Dr. Larry Dossey: the state of mind that I call prayerfulness seems to involve certain fairly specific qualities, in partiuclar, empathy. The most successful prayer experiements have always linked outcomes to the empathy, love, and sense of involvment felt by the people doing the praying

Stress Management

-A program for dealing with stress in which people learn how they appraise stressful events, develop skills for coping with stress, and practice putting these skills into effect -Some people obtain help in stress management through private therapies in a one-in-one psychotherapeutic experience. More commonly, stress management is taught through workshops, sometimes in the workplace. -$68 billion lost in productivity each year bc stress leads to absences, claims agains companies, and increased health care costs -Basic techniques of stress management can also help people reduce their risk of illness ranging from tension headaches to heart disease Basic Techniques of Stress Management: -Stress management programs typically involve three phases: 1. Participants learn what stress is and how to identify the stressor in their own lives 2. They acquire and practice skills for coping with stress 3. They practice these stress management techniques in targeted stressful situations and monitor their effectiveness

Research on Health Benefits

-Analysis of 42 independent samples involving 126,000 people, McCullough et al. (2000): religious involvement-> higher odds of survival -Higher levels of religiousness-> lower levels of depression (Braam et al., 2001) -In longitudinal studies, religiousness has predicted facter remission from depression in community-based and hospitalized older individuals (Koenig et al., 1998) -Study of 100 geriatric patients found that those with little "religious activity" had much higher rates of cancer, chronic anxiety, depression, smoking, and alcohol use

Muscle Relaxation

-Biofeedback show quicker muscle relaxation after watching funny cartoons than beautiful scenery -Muscles not directly participating in act of laughter tend to relax while you're laughing --Why little kids fall down during fits of laughter --Why you seem to lose strength when laughing hard --When you stop laughing, those muscles also relax-> produces pattern of relaxation throughout body Using EMG biofeedback, researchers have hooked up sensors to scores of muscles in the body to see which ones are activated during laughter. Results show that people are able to experience muscle relaxation more efficiently through laughter than by traditional relaxation imagery (picturing yourself on a beach). And it's not just the muscles used directly in the laughter (rectus abdominis AKA abs)—the relaxation appears to spread throughout the body.

Laughter Yoga

-Brainchild of Dr. Madan Kataria, physician from Mumbai -Launched first Laughter Club in 1995- now more than 6000 Social Laughter Clubs in 60 countries -Combines unconditional laughter with yogic breathing (Pranayama) --Based on scientific "fact" that body cannot differentiate between fake and real laughter --Anyone can *laugh for no reason*, without relying on humor/jokes --Laughter simulated as a body exercise in a group-> eye contact and playfulness turns into real and contagious laughter -First started telling jokes but then ran out, so then combined yoga techniques and laughing -Body can't tell difference between laughing as a joke and simply laughing -So successful it's caught on to buisness community -First thing they have to do is their laughter class -You do this exercise and let go tension and your productivity improves -University of California and stress hormones in the blood. Wether laughter lowers stress hormones and boosting body's natural killer cells. Important bc those cells kill tumor cells -Sound of laughter is as infectious as looking at it. Used it with blind people. They linked it -Laughter doens't solve your problems, it can help you to dissolve your probems

Relationship to Church Teachings

-Churches promote healtheir lifestyles such as leating less meat, drinking less alcohol, etc. they also encourage to eat a diet of healthy, nutricious food, promotion of proper rest, life balance etc. -Encourage support in times of need, and they cutivate attitudes that may give individuals a helpful perspective with which to face stressful life situations (a belief in life after death makes it much less stressful to face the terminal illness of a loved one) -Not all religions act to perserve life and promote health. Some include the use of contaminated substances in rituals, burials, and other practicees; placing the dead in rivers; ritual suicide; religious warsl tortures and executions in the name of religion; and endogamous marriage customs that may engender and perpetuate genetic disorders. Some also prohibit members from seeking modern medical treatment or from practicing modern health principles -Churches may protect health may lie in attitude. Religious teachings of many churches help foster a more positive apprach to illness, pain, or disability -One theory regarding how churches protect the health of their members rests with the well-known fact that social support boosts and protects health. People who are active in church are not as likely to be lonely. Church members are like an extended family; they provide comfort, companionship, and even material assistance when needed -Lifestyle prescriptions are probably at least partly responsible for the better health of active church members. Support provided by the social netowrk may be the more important force in boosting the health of active church members -Not only physical healt that benefits, but mental and emotional health as well: --Religiously faithful have lower suicide rates, lower drug use and abuse, less juvenile delinquency, lower divorce rates, higher marital happiness, better overall well-being, and better recovery from mental illness --Regular participation seems to be a key. It is associated with increased life span and decreased mortality, even after controlling for age, sex, and various other risk factors

The Roseto, PA Study

-Close-knit Italian-American community with average exercise, smoking, obesity, high BP, and stress...but diets higher in fat, cholesterol and red meat -Men= 1/6 incidence of heart disease compared to random US samples --Women fared even better -Researchers found strong sense of community, social ties, and respect for elderly -Decades later mortality increased to US rates. Why? --Younger generation moved away, married "outsiders", and severed emotional ties to "old neighborhood"

Pain Reduction

-Dr. orman Cousins first to document that 10 minutes of belly laughtre (counting total laughing tie) provided two hours of pain-free sleep from his ankylosing spondylitis (1 in 500 chance of surviving) -Dr. James Walsh, an American physician, noted in his 1928 book Laughter and Health, that laughter often reduced level of pain experienced following surgery and appeared to promote wound healing -Norman Cousins has been regarded as one of the founders of our modern research into humor and healing. Modern medicine is now able to engage in research that wasn't necessarily available in 1928 when Dr. Walsh wrote his book

What Kinds of Support Are Most Effective?

-Having a confidance (such as a spuse or partner or close friend) may be the most effective social support. Social relationships that provide daily contact may be most effective -Marriage, especially a satisfying marriage, is one of the best protectors against stress -Men's health benefits substantially from marriage, whereas women's health benefits only slightly from marriage -The quality of the martial relationships is especially important, as marital satisfaction and support received account for its health benefits -Existing a marriage, being unmarried, or being in an unsatisfying marriage all bring health risks, especially for women -Marital strain, fighting, and separation and divorce have powerful adverse effects on health -Receiving social support from one's parents in early life as a child have long-term effects on coping and health. The Harvard men who perceived themselves to have had warm, close relationships with their parents in childhood were healthier 35 years later. The men who did not report a warm relationship with their parents in childhood were more likely to be diagnosed in midlife with coronary artery disease, hypertension, ulcers, and alcoholism --Experiencing a divorce of one's parents in childhood predicts premature death in midlife -One mechanism may be that active community participation increaes knowledge of resources. High social status in a community may enhance a person's control over their environment and may also influence how community ties affect health

Enhancing Social Support

-Health psychologists view social suport as an important resource in primary prevention. -Social isolation is a major risk factor for illness and death. Americans report that they have fewer close friends now than has ever been the case in the past. -Facebook, 500 million users, 50% log on at least once every day. -Social support groups and internet-based social support interventions show promise for enhancing access to socially supportive resources.

Respiration

-Laughter triggers peculiar pattern-> benefits people prone to certain respiratory problems --Residual air stays in lungs for long period-> oxygen content drops-> level of water vapor and carbon dioxide increases-> can lead to infection or pneumonia -Frequent belly laughter reduces risk by emptying lungs of more of the air that's taken in. Why? --You push air out of your lungs until you can't push out any more For those of you who work or volunteer in hospitals, you might know that pneumonia is a high-risk outcome after surgery. When people are under general anesthesia, their breath rate is significantly reduced, and that impairs their ability to clear out moist air from the lungs. Laughter has been shown to help reduce risk of lung infection and pneumonia because it is a highly effective way to produce the type of breathing that reduces such risk.

Self-Affirmation Theory

-Maintains that when people postively affirm values and other personal qualities that are important to them, they may experience beneifical physiological and physiological responses -Self-affirmation may be one of the reasons why writing about or otherwise disclosing one's stressors is beneficial to health. During the writing process people are bale to addirm their values and personal qualities, they may enhance the value of the writing intervention. -People are not using self-affirmation as an intervention to help people cope with stress

The Essence of Spirituality and Spiritual Well-Being

-Health: total wellbeing (physical, mental, social, and spiritual), not just th eabsence of disease. Others have defined health as the quality of existence in which oneis at peace within oneself (physically, mentally, and spiritually) and in good concord with the environment. -The mental (mind) elements that most powerfully affect physical health (body), at least 4 become very obvious: 1. A sense of empowerment and personal control- not necessarily over the environment, but rather over one's self and responses in that environment. This invovles being and acting in accord with one's deepest values in any situation- a type of spiritual integrity to deep wisdom 2. A sense of connectedness- to one's deeper self, to others, to the sources of one's empowerment, and even to the earth and universe, and all regarded as good 3. A sense of purpose and meaning- giving of one's self for a purpose of value and something believed in, thus having an altruistic sense of mssion about one's life. And also sensing purpose in the present here-and-now circumstances- whether difficult or joyful- honoring growth and having a vision of one's potential 4.Hope- not necessarily for a specific outcome, but for the wisdom and capability to deal well with whatever comes, and for something of value to come of it -All the "mental" elements (proven to improve physical and mental health) are at their core also very spiritual elements. Directin one's spiritual practices and religious motivations toward these principles has been shown to improve total health. Violating these principles, even with the best of intentions, is likely to cause problems -Knowing that we are going toward might guide one's approach to both religion and spirituality. Religion is a means to an end of spiritual well-being. Religion can be a very powerful measn to that end. But losing right of those end principles, relgion not done so well could cause difficulty -May be easiest to define spirituality by defining what it isnt. It is not the moral. Nor is it the ethical. It is also not the psychic, nor is it the religious. The spiritual is inclusive. It is the deepest sense of belonging and participation. We all participate in the spiritual at all times, whether we know it or not. There's not place to go to be separated from the spiritual... the most important thing in defining spirit is the recognition that spirit is an essential need of human nature. There is something in all of us that seeks the spiritual

Cardiac Exercise

-Heart races even after 15-20 seconds of laughter and remains elevated for 3-5 minutes -Cardiologists refer to it as "internal jogging" -Great workout for diaphragm, abdominal, respiratory, facial, leg, and back muscles (Stanford School of Medicine) --Massages abdominal organs, tones instestinal functioning, and strengthens muscles holding abdominal organs in place --Can benefit digestion and absorption functioning --20 min of hearty laughter= calories for 10 minutes on bike Although we know that exercise is a good thing, there are many reasons why a cardiac patient may not be able to engage in post-operative exercise. However, they can still get some cardiac benefits from laughter

Social Resources

-House and Kahn proposed 3 factors: 1. Social network (size, density, durability, intensity, frequency of contacts) 2. Social relationships (existence, number, and type of relationships) 3. Social Support (type, source, number, and quality) House (one of the researchers in the Tecumseh study) and Kahn suggest the three factors of social resources that matter in health: social networks, social relationships, and social support

The Physical Benefits of Humor

-Humor has been shown to have a positive effect on people with heart disease. -Study: 2 groups of ppl who had experienced heart attacks were followed throughout their cardiac rehabilitation; one group was allowed to view humorous videos or television programs for half an hour a day as part of their standard therapy. That group suffered fewer arrhythmias, had lower levels of harmful catecholamines in their blood and urine, required less medication, and had fewer heart attack recurrences -Study of relationship b/w humor and the Type A personality. 40% of people with coronary heart disease laughed less frequently and used humor less often during adversity. The people who laughed more were healthier -A sense of humor- a point of view that sees the comical in things, and an attitude of merriment- can actually promote good health by strengthening the immune system. Studies have shown that people who tend to have a humorous outlook have greater immunity against a variety of diseases as well as incrased ability to fight off infection -Study: group of men watch a 60 minute humorous video, then measured various immune indicators. After watching the video, the men ahd greater activity among their natural killer cells- the cells that ssist in immune surveillance- that lasted for at least 12 hours after watching the video. Bc effects lasted for 12 hours, daily expossure to humor could prolong the elevation of natural killer cells, adding powerful immune protection -Study: ppl randomly assigned to watch wither a humorous or a distracting video. Those who watched humorous video had greater stress reduction and elevated natural killer cell activity. The amount of mirthful laughter was the major contributing factor for the increased immune function seen in these subjects, rather than the reduced stress levels -Healthy people who watch a 60 minute humorous video have elevations in growth hormones and important decreases in stress hormones- including cortisol, dopamine, and epinephrine. The implication of these findings is that humor could reverse some of the classical physological changes that occur during stress

Effects of Stress on Support Providers

-If family members and friends are adversely affected by the stressful event, they may be less likely to provide social support to the person in greatest need. -Giving social support to others, at least at moderate levels, has beneficial effects on mental and physical health -Death significantly less likely for those people who reported providing instrumental support to friends, relatvies, and neighbors to those who reported providing emotional support to their spouses. Receiving support did not affect mortality. Giving support can promote health andretard illness progression -These findings especially important bc social support and helping have long been thought to benefits the recipient of the help while taxing the resources of those that provide it. The fact that helping, altruism, and support lead to physical and mental health benefits for both giver and receiver make social support that much more important

Primary Risk Factors for CV Disease

-Inactivity- RR 1.9 - Prevalence 59% -Hypertension- RR 2.1 - Prevalaence 10% -Cholesterol- RR 2.4 - Prevalence 10% -Smoking- RR 2.5 - Prevalence 18% -Social Isolation- RR 2.8 - ??% The impact of social support on our physical and mental health cannot be overstated. Recall the definition of relative risk (RR) earlier in the class. Epidemiological research shows that smokers have 2.5 times the risk of developing cardiovascular disease than non-smokers. What is remarkable is that social isolation is an even stronger risk factor!

Blood Pressure

-Increases during laughter (the more intense, the higher) --But...harmful if it was a lasting effect -Laughter stops-> BP drops below pre-laughter level --Short-lived, so not clear whether regular laughter helps keep blood pressure within manageable limits Blood pressure and laughter is a little more complex. Blood pressure raises during hearty laughter, which for some people could be risky if the effect was maintained over a long period of time. However, it does appear to return to normal or even lower after laughter. One theory is that laughter is one possible regulatory method for blood pressure variation.

A Stress Management Program (Combat Stress Now (CSN))

-Makes use of various phases of education, skill acquisition, and practice Identifying Stressors (first phase of CSN): -Participants learn what stres is and how it creates physical wear and tear -In sharing their personal experiences of stress, many students find reassurance in the fact that so many other students have experiences similar to their own. They learn that stress is a process of psychological appraisal rather than a factor inherent in events themselves. -College life is not inherently stressful but is a consequence of the individual's perceptions of it Monitoring Stress: -Students are trained to observe their own behavior closely and to record the circumstances that they find most stressful -They record their physical, emotional, and behavioral reactions to those stresses as they experience them -Also record their own maladaptive efforts to cope with these stressful events, including excessive sleeping or eathing, tv watching, and alcohol consumption Identifying Stress Antecedents: -Studetns learn to focus on what events happen just before they experience feelings of stress -By pinpointing exactly those circumstances that initiate feelings of stress, students can more precisely identify their own trouble spots Avoiding Negative Self-Talk: -Students are next trained to recognize and eliminate the negative self-talk they go through when they face stressful events -Negative self-talk can contribute to irrational feelings that perpetuate stress Completing Take-Home Assignments -Students keep a stress diary in which they record what events they find stressful and how they respond to them. As they become proficient in identifying stressful incidents, they are encouraged to record the negative self-statements or irrational thoughts that accompany the stressful experience Aquiring Skills: -Skill acquisition and practice. -Skills include cognitive-behavioral management techniques, time managment skills, and other stress-reducing interventions, such as exercise. -Some of these techniques are designed to eliminate the stressful event; others are geared toward reducing the experience of stress without necessarily modifying the event itself Setting New Goals: -Set goals, engage in positive self-talk, and using self-instruction -First sets several specific goals that he or she wants to meet to reduce the experience of college stress -Once the goals have been set, the next challenge is to identify specific behaviors that will meet those goals. In some cases, an appropriate response may be leaving the stressful event altogether -In other cases, students may have to put up with a stressful events but simply learn to manage it more effectively -Goal setting is important in effective stress management for 2 reasons: first, it forces the person to distinguish among stressful events to be avoided, tolerated, or overcome. Second, it forces her or him to be specific and concrete about what exactly which events need to be tackled and what is to be done Engaging in Positive Self-Talk and Self-Instruction: -Self-instruction and positive self-talk can help in achieveing goals. -Self-instruction involves reminding oneself of the specific steps that are required to achieve the goal -Positive self-talk involves providing the self with specific encouragement Using Other Cognitive-Behavioral Techiques: -Contingency contracting is enouraged sometimes -Summary: this program fro controlling stress involves a wide array of cognitive-behavior therapy techniques: the modification of internal dialogues, goal setting, homework assignments, positive self-talk, self-intruction, and contingency contracting. -Most stress management programs include a varied array of techniques so that people have a broad set of skolls from which to choose. People can discover the skills that work best for them. In these ways, people can "inoculate" themselves against stress, helping them to confront stressful events with a clear plan and an array of potentia measures that they can take before the stressful event becomes overwhelming

Social Support

-Information from others that one is loved and cared for, esteemed and valued, and part of a network of communication and mutual obligations -Comes from parents, a spouse or lover, other relatives, friends, social and community contacts (such as churches or clubs), or even a devoted pet -People with high levels of social support eperience less stress when they confront a stressful experience, and they cope with it more successfully -Social support takes several forms: tangible assistance, informational support, emotional support, and invisible support -Many of the benefits of social support may come from the *perception* that social support is available -Acutally receiving social support from another person can have several potential costs: 1. one may be monopolizing another's time and attention, which can produce a sense of guit 2. needing to draw on others can also threaten self-esteem because it suggests a dependence on tohers -These potental adversive costs of receiving social support can compromise the ability of support to ameliorate psychological distress Social Support Defined -The degree to which basic social needs are met through interaction with others --Being cared for and loved (shared intimacy) --Being esteemed and valued (self-worth) --Sharing compansionship, communication and mututal obligations (sense of belonging) --"Informational" support (access to information, appraisal, advice, and guidance) --Access to physical or material assistance There is much debate about how to capture and define social support in health research. Above are some of the different ways that researchers operationalize and measure social support.

Informational Support

-Information may help a person understand a stressful event better and determine what resources and coping strategies may be mustered to deal with it. -Ex. if an individual is facing an uncomfortable medical procedure, a friend who went throught the same thing could provide information about the exact steps involved, the potential discomfort involved, and how long it takes

Tangible Assistance

-Involes the provision of material support, such as services, financial assistance, or goods -Ex. the gifts of food that often arrive after a death in a family mean that the bereaved family members will not have to cook for themselves and visiting friends and family at a time when their energy and enthusiasm for such tasks is low

Pain Research

-Japanese Study --An hour of traditional comic stories (Rakugo) reduced pain level in rheumatoid arthritis patients --Important since symptoms worsen during negative emotions -Swedish Study --Six women with painful muscle disorders got significant relief through 13 week course in humor therapy --Patients who laughed most in group session showed greatest symptom reduction -Study of 35 patients in a rehabilitation hospital --74% agreed with statement, "sometimes laughing works as well as a pain pill" -Elderly who suffered chronic pain in long-term care facility --Watching 20-min comedy program 3 days/week for 6 weeks significantly reduced amount of pain medication requested during study -What ideas do you have to explain why laughter might help in pain management? --Distraction --Laughter causes production of endorphins (natural painkillers) --Partly due to reduction of muscle tension ---Many pain centers now use meditation and other relaxation techniques to reduce pain medication needed by patients ---Laughter is additional technique for achieving same effect

The Japanese

-Japanese smoke more cigarettes, have higher BP, live in polluted and crowded cities...but (historically) consistently enjoy longest life expectancy in the world. Why? -Dr. Pelletier of UC-San Francisco's School of Medicine hypothesizedd longevity tied directly to emphasis placed on community -"Social aspect of human companionship is one of the most important factors in health" apan is one of the most collectivist cultures in the world, and it places very high value on the family and community. In fact, residents of the island Okinawa have some of the longest life expectancies in the world as noted by the largest percentage of people living past 100 years old. In addition to their healthy diet, Okinawans are very socially connected.

Physical Benefits of Laughter

-Laughter also stimulates the sympathetic nervous system, the pituitary gland, the cardiovascular system, and the hormones that relieve pain and inflammation- making it a possible benefit in conditions like arthritis and gout. -Laughter has also been shown to reduce stress, hypertension, depression, heart attakcs, and stroke. Laughing is much like jogging as a physical exercise, and it's benefits are just as great -Tears you shed laughing and crying both are proven to carry away toxins and the hormones manufactured during stress

The Physiology of Laughter

-Laughter is a complex physical processs. It does the following: 1.Breathing: increases the breathing rate, increases the amount of oxygen circulated through the blood, and clears mucus from the lungs 2. Muscles: provides limited muscle conditioning, provides muscle relaxation, and breaks the pain/spasm cycle common to some muscle disorders 3. Cardiovascular System: temporarily increases the hreat rate and blood pressure, increases circulation, and increases the amount of oxygen delivered to all body cells -Laughter is valuable for strengthening the heart muscle, and just 20 seconds of laughter is the cardiovascular equivalent of three minutes of strenuous rowing -There occurs in laughter and more or less in smiling, clonic spasms of the diaphragm in number ordinarily about 18 perhaps, and contraction of most of the muscles of the face

Laughter as Exercise

-Laughter is one of the best exercises around -It's simple, requires no special training or equipment -Liken laughter to a form of physical exericse- it causes huffing and puffing, speeds up the heart, raises blood pressure, accerlerates breathing, increases oxygen consumption, gives the muscles of the stomach and face a workout, and relaxes the muscles that aren't used in laughting. 20 seconds of laughing can double the heart rate for 3 to 5 minutes -Laughter provides what some experts have called a total inner body workout -Something you see/hear/thing sets off a massive brain reaction: Nerve fibers in the involuntary nervous system trigger a snowballing cycle of discharges in the brain stem. Your enrual circruits revereate with the news: something is funny. Your humor is the converted into electrical and chemical impulses that wash through the frontal lobes of the brain, go over the motor centers of the brain, and land smack in the center of the cerebral cortex. The coretex than hands out an order to the body: laugh! -People in good spirits let loose with as many as 100 to 400 laughs a day -Once you're ready to laugh, the muscles in your face that control expression start to contort. Muscles throughout your body contract like fists. Your vocal cord muscles, designed for intelligble sound, cannot coordinate. Your glottis and larynx open, relaxed and ready to vibrate. Your diaphragm tenses up in anticipation of respiratory spasms. Air in your body billows until you feel pressure building in your lungs. Trying to hold in a lugh is no less than a violation against nature- rarely successful -Once laugh is in full gear, your breathing is interrupted for a station break. Your lower jaw vibrates. A blast of air gusts into your trachea, flinging mucus against the walls of your windpipe (some laughs come out at 170mph) -Once you're in full-blown laughter, your body bucks and fails and slaps. Your lacrimal glands squeeze out tears, you puff and rasp with symphonic regularity, you are wobbly in the knees -The complicated combination of physiological reactions makes laughing what some researchers have called "inner jogging". Your metabolism steps up, and calories are burned off. Your body temp increaes. Your entire system is showered with adrenaline, and the physical effects of laughter endure for up to two hours after you stop laughing -Laughter is essentially an act or repiration, and the lungs immediately fill with air. Air volume is dramatically increased, and your breathing rate goes up. Much more oxygen is delievered to the body than with normal breathing. You also breathe out more carbon monoxide and water vapor, which can encourage bacterial growth if it syas in the lungs. After laughing you cough, a reaction that finishes clearing out the lungs -Your heart rate increases during laughter, and the increase is in direct proportion to how long and hard you laugh. The entire cardiovascular system is stepped up, and the circulation increases; as a result, the entire cardiovascular system is tones. Fresh nutrients and oxygen go coursing through your arteries. Your blood pressure goes up. When you finish laughing, your heart rate and blood pressure drop to levels below those when you started laughing -Laughter improves your digestion and may even stimulate enzymes that acts as natural laxatives. It stimulate syour CNS. It first contracts then relaxes all the muscles in your body. When you begin to laugh, at least 5 major muscle groups begin a rhythmic movement: when you finish laughing, your muscles- especially of the abdomen, diaphragm, shoulders, neck, and face- are more relaxed than when you started laughing. Laughter not only improves muscle tone, but also enables total relaxation of all major muscle groups in your body.

The Impact of Humor on Health

-Laughter may be classed as aerobic activity bc physiological changes that occur are so effective -Stranded travelers with John-Roger. Luggage was destroyed, plane late, care rental agency didn't have reservations, taxis service on strike. Acted like it was a Woody Allen movie -Harvey Mindess- "humor at its best encourages a broad perspective on life. It provides a view of the ironies that abound, of the fact that nobody and nothing is as it seems. And recognizing life's zaniness encourages flexibility and adaptability, rather than rigidity and brittleness" -One of the most healing things about humor is that it acts as a bond between people

Reduction in Stress Hormones

-Laughter reduces four neuroendocrine hormones associated with stress response (epinephrine, cortisol, dopac, growth hormone) -Boots immunity --Studies show that as little as 30-60 minutes of comedy video increases both salivary and blood levels of IgA --Significant increase in *B cells* in blood following humor --Studies on HIV/AIDS show increase *killer T cell* count for people who score higher on humor measures

Supplementary Stress Management Skills

-Many stress management programs include training in time management and planing. CSN helps studnets set specific work goals for each day, establish priorities, avoid time wasters, and learn waht to ignore altogether -Many stress management programs emphasize good health habits and social skills as additional techniques for the control of stress. These include good eating habits, exercise assertiveness in social situations, and use of social support. By learning to control dietary habits effectively and by eating three balanced meals a day, the student can amerliorate physiological reactions to stress. Regular exercise reduces stress. At least 20-30 minutes of sustained exercise at least 3x per week is widely encouraged for all paticipants in the CSN program -Assertiveness training is sometimes incorporated into stress management. Often, people experience stress bc they are unable to confront the people who contribute to their stress -Stress Carriers: students who have identified other indivduals in their environment as causing them special stress. Ppl in CSN programs help one another practice dealing with these individuals -Students in CSN program are trained to recognize the important functions that social support can serve in helping them combat stress. They are urged to confide in close friends, to seek advice from people who can help them, and to use time with other people for relaxation and positive reinforcement after meeting their goals -In the final stage of the CSN program, stress management techniques are put into effect. If some techniques fail to work, the trainees are urged to figure out why. If initial efforts to cope with a stressful event are unsuccessful, the students may need to practice the technique or shift to a different technique -Stress management training imparts valuable skills for living in a world with many sources of stress, and it improves mental and physical health as well

Attendance and Afilliation

-More than 90% of Americans profess a belief in God, half belief life after death, almost 90% have some religious affiliation -Only about 40% of all Americans attend a place of worship weekly, and about 60% attend monthly -59% of churchgoers think churches spend too much time on organization issues, 32% believe organized religion is too restrictive in its moral teaching, and almost 1 in 4 of the respondents say they turned away from their church in search of "deeper spiritual meaning" -Research indicates that active participation in a church or synagogue boosts health, acts as a buffer against stress, and may even prolong life. Elderly people who are religiously active tend to be more optimistic and better able to cope with illness than people who are less religious -3000 retirement aged residents. Found religious involvement did enhance the well-being of the seniors. -Religious affiliation appears to protect the health of adolescents: those who have a strong religious affiliation are less likely to behave in ways that compromise their health, such as getting into fights, carrying weapons, smoking cigarettes, using marijuana, and driving under the influence of alcohol. They are also more likely to behave in ways that enhance their health, such as eating well, getting proper nutrition, getting regular exercise, and getting plenty of rest -Adolescents: 95% believe in God or a universal spirit, 94% believe that God loves them, 91% believe in heaven, 76% believe that God observes their actions and rewards or punishes them -Adolescent's health may even be protected by the fact that his or her mother regularly attends church. Those whose mothers attended religious services at least once a week had greater overall satisfaction with their lives, had more invovlement with their families, felt greater support from friends, and had better skills in solving health-related problems. The only factor that had a greater influence in the study was family income -People who attend church or synagogue on a regular basis have a much lower rate of diseases than those who attend less frequently or do not attend at all. Churchgoers have especially low rates of heart disease, lung disease, cirrhosis of the liver, and some kinds of cancer -Men who attend church infrequently or not at all are at almost teice the risk of dying of arteriosclerotic heart disease. They are more than 4x more likely to die of cirrhosis of the liver And women are more than 3x as likely to die of cancer of the cervix if they aren't frequent churchgoers -Religion improved health in eight different areas: cancer of the uterus and cervix, all other cancers, colitis and enteritis, cardiovascular disease, hypertension and stroke, general health, general longevity, and disease and death among the clergy

The Effect on Other People

-Nationwide poll asking doctors whether they believe patients benefit from prayer and whether they themselves pray for patients, the results favored prayer. Half said that they believe that prayer helps patients, 2/3 said that they pray for their patients -Study of 393 patients of a coronary care unit to either be prayed for or not. --Neither the patients nor the physicians knew who was in each group --Those praying knew names and diagnoses --Those who were prayed for did significantly better on standard measures of outcome such as time in the hospital, complication rates, medications needed, and new symptoms. -Similar study at Mayo Clinic was unable to replicate this effect when patients were unaware of prayer --Back in the late 1980s, a very famous study was published by Byrd that was the first of its kind to empirically test the effects of prayer. Cardiac patients were split into a control group and experimental group. Patient names and diagnoses were given to an order of nuns who then engaged in daily prayer. Byrd reported that those in the experimental group had better outcomes than those in the control group. However...and this is a big however...this finding has not been replicated to the same degree. Mayo Clinic was understandably interested in the results, and replicated the study. The one thing they changed was not telling any of the patients that they were in a study on prayer. There were no results. Critics of the original study suspect that there may have been a placebo effect with participants when they knew they were in a study on prayer. A more likely explanation from a research methods perspective is that it was just normal variation found in studies, which is why we have to replicate, replicate, replicate. -Prayer, as an expression of spirituality, can work in concert with medical treatment to bring about physiologcial changes and recoveries

Laughter & Stress

-Numerous studies show three characteristics that help people withstand extreme stress 1. Altruism 2. Social Support 3. Gain control of situations using humor -Study 1: Write a 3-minute comedy routine using an old tennis shoe, drinking glass, and aspirin bottle. -"Funniest" routines experiences less tension, fatigue, depression, stress, and anger -Study 2: Watch (unfunny) film of industrial accident -Group asked to write comical dialogue during film showed reduced stress response

Immunity-Enhancing Benefits of Laughter

-One of laughter's most important benefits: it apparently enhances the immune system -Due to two separate aspects of laughter: 1. it boosts the production of immune enhancers 2. it suppresses the production of stress hormones that weaken immunity -Dr. Lee Berk Study: those who watched funny videos compared with those who didn't had the highest concentrations of lymphocytes, greater natural killer cell activity, and significantly better measures of overall immune system activity -Other way laughter may improve immunity is by reducing the stress hormones secreted in the body, which generally suppress the immune system. -Berk Study on effects of laughter on stress hormones: 5 men watched an hour-long comedy video, then he took blood tests and compared them to test results from 5 men who did not watch the video -Results: the 5 who watched the funny film had lower levels of the stress hormone epinephrine. They also had significantly lower levels of DOPAC (which indicates dopamine activity) and the stress hormone cortisol, which can shut down the body's production of the immune substance interleukin -Concluded from the studies that laughing definitely has beneficial effects on the immune system, and may even help combat certain diseases

Matching Support to the Stressor

-The Matching Hypothesis: the hypothesis that social support has beneficial effects when there is a match between what one needs and what one receives from others in one's social network -Ex. if a person has someone he or she can talk to about problems but actually need only to borrow a car, the presence of a confidant is useless. But if a person is upset about how a relationship is going and needs to talk it through with a friends, then the abailability of a confidant is a very helpful resource. -Support that is repsonsive to a person's needs is most beneficial

Key to spirituality and spiritual health: relationships with others and experiences we share

-One of the keys to spirituality and spiritual health lies in our relationship with otjers and the experiences we share. Those experiences are of prime importance -The greatest benefits of spirituality are rooted in experience, not just belief. Those who "believe" but do not experience miss out on the psychological and physical benefits of spirituality -The notion of spirituality implies that we are able to give as well as to recieve- that we can recieve love and joy and peace and fulfillment, but that, through our experiences, we can give those things as well -Through the spiritual dimension, we emphasize our "connectedness" to other members of the human family. Bc of that connectedness, we have a responsiblity to help others experience spiritual growth. As we affect the spirituality of others, we receive help and support as well -In this results-oriented society in which we live, we need to realize that spirituality and spiritual health are a process or a journey, not an end point. It is a lifestyle, not a prescribed set of activities to accomplish on a onetime basis. There is no standard recipe to follow to achieve spirituality or spiritual health; spirituality and spiritual health involve intentional choices made over an entire lifetime. They involve living a series of experiences that define and fulfill out prupose in life and lead us to feelings of joy, peace, and love -Wholesness has to do with the acceptance of both darkness and light, so that the work of healing and transformation can begin. Healing is a state of authenticity that allows freedom of creativity and is marked by peace, joy, compassion, and acceptance of the wide range of emotions that carry the information required to continue learning

Pain Relief Benefits of Laughter

-One of the most well-known example of laughter as an anesthetic is provided by Norman Cousins. He got diagnosed with a potentially life-threatening collagen disease that affected all the connective tissues of the body. His physician told him that recovery was not probable -He didn't just want to accept his fate, so he designed a program of positive thinking, nutritious food- and as a painkiller, laughter -He found that laughter was the most effective painkiller he could find. 10 minutes of hearty laughter provided 2 hours of pain-free sleep. He found that inflammation in the tissues was reduced after each laughter session -Laughter probably relieves pain for several reasons. One of the reasons has to do wth muscle relaxation. Pain often invovles muscle tension, and when you laugh, the tension dissipates and the spasms relax. -Laughter also stimulates the brain to release endorphins. These potent naturla chemicals have painkilling power estimated to be 200 times that of morphine; they also reduce inflammation and can stimulate the immune system. These are the chemicals responsible for the framed "runner's high" and researchers believe there may e a very real and similar "laugher's high" that results when these chemicals leave laughers feeling relaxed and good all over -Laughter can relieve emotional pain, too. By providing a new perspective and lightening the emotional tension of a situation, laughing can relieve emotional stress and ease psychological pain -One study showed great promise for the role of "humor therapy" in relieving pain. -Study of 6 women with extremely painful muscle-bone disorder. Physicians administered psychological tests to the women before the beginning the experiment to determine general psychological well-being -Women given "humor therapy" for 13 weeks. Asked to regularly record on separate scales how amused they were and how much pain relief they had -Results: Women enjoyed "significant relief" from their painful symptoms, and those with the greatest degrees of amusement were also the ones who had the greatest pain relief. Tests adminstered at the end of the 13 week period also showed that the women had a greater overall sense of well-being -Their confidence increased, they coped more ably with their symptoms, and allowed themselves to be happy and enjoy life regardless of their medical problems. Pain relief was greater during the last 7 weeks than during the first 6 weeks, indicating that laughter had the greatest benefits

Emotional Support

-People go through stress and experience bouts of depression, sadness, anxiety, and low self-esteem -Reassuring the person that he or she is a valuable individual who is cared for. The warmth and nurturance provided by other people can enable a person under stress to approach it with greater assistance

Crisis as a Growth Experience

-Ppl with deep sense of spirituality have a purpose, enjoy a sense of meaning in life, and have a broader perspective. Spirituality buffers stress; not defeated by crisis. Able to relax their minds, elicit the relaxation response, and heal more quickly and completely -Those who achnowledge lifes' purposes, and even enjoy rising to the challenge, become more resilient -Spirituality heps people interpret crisis in a growth-producing way, and as a result they are able to use illness as a means of spiritual growth -In an effort to "heal a life" siegel says we need to figure out "what is the self trying to get me as a patient to learn about myself?" When you take on life's afflictions and challenges, you are a winner. He hopes ppl understand that there can be a gift in the disease and you can help heal everyone around you -People who are busy lviing, who are trying to make changes in their lives, experience great growth even in the face of serious illness. Ppl with this attitude define their disease as a gift, a challenge, a wake-up call, a new beginning, and abeauty mark. They are not necessarily saying theyre cured, but they accept their mortality. They take the fact that they're going to die and take it as an opporunity to live until they die -"Spiritual Flat Tire": There are many things in life that redirect our lives. So I don't judge things as good, bad, right or wrong. Just sit back and say "We'll see". -In using illness as an opportunity for spiritual growth, Siegel say that we neeed to accept the illness (not resign to it), view it as a source of growth, and view it as a porsitive redirection in life. Most important is to infuse your situation with spirituality and love -THe only way you can live forever is to love somebody; than you can really leave a gift behind -Spiritual healing is not a complicated system of diagnoses and remedies but seems to work on the level of unselfish love and compassion. Not an emotional love which is bound up with one's own needs, but a caring, unconditional, detached love with no beginning and no end

Specific Illnesses

-Regular church attendance has an impact on cardiovascular disease. The more active a peron is in a religion, the less chance he or she has of incurring myocardial infarction. The same holds true with people born of a religiously homogeneous marriage. People who attend church regularly are at lower risk for myocardial degeneration, chronic endocarditis, arteriosclerotic heart disease, and degenerative heart disease -Spiritual practices and attitudes that have been proven to be associated with enhanced physical health include the following: -Hope -Forgiveness -Giving up hostility -Altruism -Loving, supportive relationships- community -Prayer -Meditation -Feeling close to God

Relaxation Training and Stress Management

-Relaxation training affects the physiological experience of stress by reducing arousal -Relaxation training therapies include progressive muscle relaxation training, guided imagery, trancendental medication, and other forms of meditation, including yoga and hypnosis -Benefits: can reduce heart rate, muscle tension, blood pressure, inflammatory processes, lipid levels, self-reports of anxiety, and tension among other physical and psychological benefits -Most stress management interventions include relaxation therapy: 1. people learn how to control their breathing, taking no more than 6 to 8 breaths per minute. They learn to relax muscles in each part of the body progressively, until they experience no tension (progressive muscle relaxation). They learn to identify the particular sports that tense up during times of stress, such as a jaw that clamps shut or fists that tighten up. By becoming aware of these reactions, they can relax these parts of the body as well -Yoga may also have health benefits. Yoga may amerliorate the burden that stress places on an individual. Even joyful music can be a stress buster

What is Spirituality and Spiritual Health?

-Religion: derives from the Latin rool religio, which signifies a bond between humanity and some greater-than-human power. In ancient times, the experience of interacting with that power, and the rituals involved were central to religion. Religion has seemed to become less a personal experience with that power adn more identified with a fixed system (denomination, theologies, etc.). Religion and its beliefs provide ways to interpret the deeper purposed of life, to give life and its events meaning and structure, and to organize one's actions in keeping with those recepts. Religious communities provide a means to explore and share spiritual ideals and experience, and potentially to receive caring support. -Motivations used in religious groups to encourage "proper" behaviorcan vary: either using unconditional love and support, or else perhaps motivating with conditional guilt, shame, and fear. The health and well-being effects of religion can thus vary with which approach is taken. *Intrinsic religious experience improved health*, but *extrinsic religious commitment showed little benefit* Health and well-being effects vary with approach: -Intrinsic religions refers to being motivated by core, internalized beliefs that reflect deeply who a person is and that for which he or she most hopes. Deeply God-centered and not subjected as much to social pressures and conformity. Usedd by religious groups to encourage "proper" behavior through unconditional love and support -Extrinsic religious commitment usually involves using religion for other ends, such as security, social acceptance, or self-justification. Often driven by social pressure sand conformity, and tends to be more self-centered. *Intrinsic relgiion is healthy, but extrinsic religiosity is not* Used by religious groups to encourage "proper" behavior through conditional guilt, shame, or fear -In general, there are robust findings that suggest various positive health outcomes as a result of spiritual and/or religious beliefs, practices, etc. But there is more to the story. There is a difference in outcomes between intrinsic and extrinsic religious experiences. When people engage in religious practices out of core beliefs or unconditional support and love from family and friends, they tend to experience positive health outcomes. This is consistent with the data on social support. In contrast, when people use religion to shame or guilt others into behaving in certain ways, those health benefits disappear. Again, this makes sense if that fear and guilt are activating the sympathetic response. -Spirituality dervies from the Latin spiritus meaning breath or life. Ancient biblical people used breathing meditiatve techniques to "breathe in" and tus experience spiritual power. Shamanic healing ceremonies among native Americans and Polynesians invoke similar rituals of drawing healing spiritual power within one who needs it. *The experience of oneness with the sources of spiritual power and life seems central to spirituality*. Those same energies are sensed as sources of healing. -Recent years, the rise of secularism and the yearning for such experience with the transcendent has led to many nonreligious approaches to seeking spirituality, such as the New Age Movement and nonreligious mediation -Religion is usually associated with the institutional and ritual-practice elements, while spirituality refers more to personal experience with the trascendent -The mind/body connection appears increasingly to be a mind/body/spirit triad Healing: the words heal and health originally referred to being made whole, and are associated with "holy". The biblical Greek word soteria is translated as either "health" or "salvation". Thus, to ancient religious people, salvation, the end goal of religious and spiritual practice, meant total well0being (health): spiritual, mental, physical, and social -To heal also has to do with bringing separted things back together. Has to do with creating oneness; not only reestablishing homeostasis of physical system,s but also mentally and socially becoming "at one"- no longer ton or aliented form oneslef, from others, or from the sources of one's spiritual strength -Healing tends to make people feel more fully alive and mmore grateful for life. Gratitude for all that life is may be one of the best markers for spiritual well-being. Usually means more than simply a return to the former condition. Invovles enlarging the circle of our being to include more that is loved and understood -Spirituality is not the same as organized religion, although spiritual experience is the cornerstone of religion. And spiritual health is not the same thing as physical health: A person can enjoy optimum spiritual health while battling the ravages of terminal cancer. -Healing does not always result in a physical cure, but the quest for wholeness is never in vain, no matter what the outcome Spirit: the life principle, especially in humans, and the feelings and motivating part of our lives...while the mind alone can be used to influecne the physical state, is is used most effectively when it is aware of spirit

The Psychological Benefits of Humor

-Sense of humor has tremendous psychological benefits as well, and correlated postively to quality of life -Study: humor was shown to boost a number of factors that are related to psychological health, such as optimisn and self-esteem. The same study found that those who did not score well on a scientific scale that measures humor were much more likely to show signs of psychological distress, such as depression -In addition to enhancing self-esteem, a humorous outlook on life can have farther reaching benefits, including promoting creativity, improving negotiating and decision-making skills, maintaining a sense of balance, improving performance, bestowing a sense of power, relieving stress, and improving coping abilitites: -Promoting Creativity: Ppl with good sense of humor are generally more creative and tend to have much more creativity int eh way they approach life's problems. Edward de Bono, the world's leading authority on reativity, says that humor and the creative process are actually one and the same thing. With both, the brain recognizes the value of the absurd dor the creative idea only in hindsight, bc before that, both seem "crazy". The hallmark of creative thinker are the willingness to play with ideas and to risk foolishness without fear -Improving Negotiating and Decision-Making Skills: Roleplaying situation where volunteers were given a rang eof alternative and were told to achieve the highest profit (the sellers) or the best deal (the buyers). The pairs who read funny cartoons did best. They were less anxious, had fewer contentions, and were better able to reach a solution that pleased both the "buyer" and the "seller" -Maintaining a Sense of Balance: A person without a sense of humor is like a wagon without springs- jolted by every pebble int he road. Sense of humor helps us achieve and maintain that delicate balance that puts life in perspective. Bad times viewed through a sense of humor makes it all seem okay. We are able to coast through situations that would otherwise tip us precariously off balance -Improving Performance: Humor helps to improve both group and individual performance. The greatest beneifts occur when the humor is directly related to the task at hand -Bestowing a Sense of Power: laughter helps us transcend our predicaments. Ex. Anatoly Sharansky, Russian human rights adovate who was confined for 9 years in Soviet prisons. Prison sentences included 16 months of solitary confinement and the constant threat of the death pentality. He managed to win against fear through humor. He started to actually joke about the firing squad and talking about it on a daily basis. Humor can turn any situation around, and cangive us a feeling of power over our circumstances -Relieving Stress: Ppl who withstand even tremendous stress without becoming brittle, bitter, and broke have several traits in common: theh are altruistic (they actively care about the welfare of others), they get plenty of support from friends and the community, and they gain control over difficult situations with humor. --Study: showed a good sense of humor doesn't get as stressed to begin with. Funniest routines= least likely to become tense, depressed, angry, fatigued, or confused when stress occurred in their lives. Study: 101 volunteers, gathered research on stress/anxiety/coping/appreciation; scored revealed tht the ones with the greated appreciation for humor were also the ones who were most effective in coping with stress. The ones who were least effective in coping with stress were also the ones who had a very dismal outlook when it came to humor. Study: 56 volunteers, a good sense of humor reieved stress and moderated the volunteers' physical responses to stressors --Study: shown a film about an industrial accident, half volunteers asked to come up with a comical dialogue during the film, the other half were asked to give a straightforward report about the film afterwards. Results in far less stress in the bodies of those who came up with the comical dialogue, even among those researchers characteristically would have categorized as "not funny" --Results show that humor not only helps relieve stress, but also that it can be learned, even by those who may not consider themselves to have a great sense of humor. Study suggests that the way we perceive ourselves may not necessarily reflect how capable we are of suing humor to cope. Challenges the notion that using coping humor is an unchangeable trait rather than an acquired skill. Results show that you can rethink the situation to decide if it's really a big deal or if you can handle it. And it may help you distance yourself enough from a situation to calm down --Study: split volunteeers in half. One watched hour long funny vid, other participated in neutral activity, both groups knew ahead of time which group they were being assigned to. Several stress hormones were significantly lower in the group that watched the humorous video. Surprisingly, those who anticipated watching a humorous video had lower levels of stress hormones even before they actually started watching the video. Those who anticipaed the neutral activity didn't --Humor has repeatedly shown to be a tool that helps relieve the stress of illness, terminal disease, and hospitalization. --Humor neutralizes emotionally charged stress and is especially helpful for people who are facing serious or terminal illness. Humor accomplishes one very essential purpose; it tends to block deep feelings of apprehension and even painc that all too frequently accompany serious illness, and it also frees concentration on the body and enables healing to begin -Improving Coping Abilities: Humor is the way we cope with living in an imperfect woul with imperfect selves. When we cant win, the best thing to do is laugh about it. Humor is a great coping mechanism --At the turn of the 20th century, Signmund Freud used humor as one of the only socially acceptable ways to release pent-up frustration and anger, and he hailed it as a way to perserve the emotional energy that would normally be required to cope with a stressful situation. Humor spares oneself the effects to which the situation would naturally give rise and overrides with a jest the possibility of such an emotional display --Humor increaes coping capacity in a number of ways: 1. Humor helps us avoid feeling sthat are too frightening to face, this is known as "gallows humor", which was first noted among prisoners in Nazi concentration camps who were about to face death. Humor had "normalizing" effects, helps reduce the severity of tense situations, and can actually reduce nervous tension to help us cope 2. Humor can help people cope even in the most harrowing situations. Used humor to calm down a rapidly deteriorating heart patient, and it was successful bc they attributed his survival to the staff's ability to squelch his sense of panic Freud suggested humor was one of few adaptive ways to release pent-up frustration and anger: --Study among patients waiting for medical treatment showed that a good sense of humor could, indeed, relieve tension and reduce anxiety, helping the patients to better cope. 75 patients who were waiting for medical procedures at a hospital; 1/3 saw a nonhumorous film, 1/3 saw a funny film, and 1/3 did not see a film. ---Those who saw the funny film were the least anxious and best able to cope with the upcoming medical treatment --Famous "funny people" who used humor to cope with deep psychological pain

Special Case of Confiding

-Slew of recent research based on Pennebasker's theories on confiding in tohers -Trends: -Women tend to confide in both men and women -Men overwhelmingly report intimate relationships with women and significantly less than with other men -Two decades of research suggest meaningful interactions with trusted confidants have greatest impact on health -Ex. Expressive writing paradigm for traumatic vs. non-traumatic experiences -Dr. James Pennebaker at The University of Texas at Austin is one of the world's top researchers on trauma, disclosure, and health. He has conducted scores on studies on what is called the "expressive writing paradigm." He believes one of the keys to the health outcomes of social support have to do with confiding in others and/or the expression of internal stress through writing. Without going into too much detail about his experiments, they are basically set up like this: Two groups of participants (who have been victims of trauma) complete a series of questionnaires that include measures on stress, health, etc.. One group spends 15 minutes each day for two weeks writing about the traumatic experience, their feelings, thoughts, etc. The control group is given neutral topics to write about for 15 minutes each day. At the end of these studies, the experimental group ends up scoring lower on stress and negative health behaviors.

Effects of Social Support on Illness and Health Habits

-Social support can lower the likelihood of illness, speed recovery from illness or treatment, and reduce the risk of mortality due to serious disease -People who have a high quanitity and sometimes a high quality og social relationships have lower mortality rates -Social isolation is a major risk factor for death for both humans and animals. Evidence linking social support to a reduced risk for mortality is substantial -Social support may achieve health benefits by affecting inflammation. People with larger social networks were less likely to develop colds, and those who did had less severe colds. Social support appears to help people hold off or minimize complications from more serious medical conditions and disorders as well -People with good social support have fewer complications during pregnancy and childbirth, report less pain, have a reduced risk of stroke, are less susceptible to herpes attacks, have fewer new brain lesions if they have multiple sclerosis, are less likely to show age-related cognitive decline, are less likely to show ealy symptoms of cardiovascular disease, and show better adjustment to coronary artery disease. -They are less likely to develop diabetes, lung disease, cardiac disease, arthritis, and cancer -Cumulative effect of postive social experiences reduces risks for many chronic illnesses later in life

Biopsychosocial Pathways

-Social support has beneficial effects on the cardiovascular, endocrine, and immune systems -Social support can reduce physiological and neuroendocrine responses to stress. Psychologists often study these effects using the acute stress paradigm- that is, by taking people into the laboratory, putting them through stressful tasts (such as counting backwards quickly by 13s), and then measuring their sympathetic and HPA axis response. Fairly consistently, these biological responses to stress are more subdued when a supportive companion is present than when no companion is present. One reason may be that warm social contact can release oxytocin, which has been tied to lower stress responses -Social support is associated with reduced cortisol responses to stress, which can have beneficial effects on a broad array of diseases, including heart disease and cancer. Social support is associated with better immune functioning and with a reduced likelihood of responses prognostic for heart disease -These biopsychosocial pathways, then, provide the links between illness and social support. These links are important bc they play critical roles int he leading causes of death- namely, cardiovascular disease, cancer, and respiratory illness

Extracting Support

-Some people are better than others at extracting the support they need -Assessed incoming college freshmen as to their social competence, social anxiety, and self-disclosure. Wanted to see if these skills influenced whether the students were able to develop and use social support effectively and whether the same skills could account for the positive effects of social support in combating stress -The students with greater social competence, lower social anxiety, and better self0discolsure skills did develop more effective social support networks, especially emotional support, and were more likely to form friendships -The findings lend credence to the idea that the use of social support as a coping technique reflects, in part, a difference in personality, social skills, or competence, rather than an external resource

Humor in Hospitals

-Story of Patch Adamss --Patch Adams in Kabul: "We wanted to make medicine human. Where are we most human? In friendship". -SMILE "Subjective Multidimensional Interactive Laughter Evaluation" for patients --Survey on emotional state, stress levels, support systen judgment of coping, and attitudes toward humor --Obtains info on favorite cartoons, comedians, sitcomes, etc. --Computer provides written summary of the information, includding recommendations preferred humor and humorists --Volunteer personnel provide resources which match each patient's unique sense of humor -Ex. Elderly patient's stay in children's ward Some hospitals now use SMILE carts. It is just a formal way to assess patients' sense of humor, preferences, etc. to help customize any available media (magazines, books, movies, etc.). I want to share a famous story in the humor and healing literature about an elderly cancer patient. He was receiving the standard cancer treatments (chemotherapy, radiation therapy) in the oncology ward of a large hospital. It was a slow cancer that required frequent visits to the hospital. Upon checking in to the oncology unit during a visit, he found out that all of the beds were full. The hospital staff decided to put him in the children's oncology ward for that particular visit. He was shocked by the difference in the environments, and reported a much better treatment experience in the children's ward. He asked to be relocated to the children's ward for future treatment!

Threats to Social Support

-Stressful events can interfere with the ability to use potential social support effectively. People who are under extreme stress may continually express distress to others and drive those others away, thus making a bad situation even worse -Negative interactions may have a more adverse effect on well-being than positive social interaction may have on improving it -Too much or overly intrusive social contact may actually make stress worse. When social support is controlling or directive, it may have some benefits for health behaviors but produce psychological distress. People who belong to "dense" social networks (friendship or family groups that are highly interactive and in which everyone knows everyone else) may find themselves besieged by advice and interference in times of stress

Invisible Support

-Support received from another person that is outside the recipient's awareness -When one receives help from another but is unaware of it, that help is most likely to benefit the recipient

Effects of Social Support on Psychological Distress

-The elderly, the recently widowed, and victims of sudden, severe, uncontrollable life events may need support but have difficulty getting it. -People who have difficulty with social relationships, such as those who are chronically shy or who anticipate rejection by others are at risk for isolating themselves socially, with the result that they experience more psychological distress and are at greater risk for health problems -Loneliness leads to health risks in large part bc lonely people appear to have more trouble sleeping and show more cardiovascular activiation -Simply believing that support is available or contemplating the source of support one typically has in life can yield these beneficial effects. Even a supportive video playing in the background can have beneficial effects -Calming effects are greater when support comes from a friend than from a strnager. People benefit more when the suppor provider is *female*. When women perform stressful tasks in the presence of a male partner, they sometimes are more stressed than when they complete such tasks alone, unless their partner is actively supportive -Going through a stressful event sin the presence of a pet can keep heart rate and blood pressure lower. Dogs are somewhat better at providing social support than other pets -Even a short encournter with a friendly dog has been found to increase opioid functioning and to decreae levels of stress-related hormones such as cortisol; interestingly, the dogs experience many of these benefits as well -Interactions with pets typically lead to beneficial effects for both mental and physical health

Influences on Health

-The impact of spirituality on health may be due in part to the fact that attitudes of faith, hope, and commitment imply an internal locus of control, and following an ethical apth that involves fulfillment, purpose, and meaning may lead to enhanced self-esteem and a sense of connectedness with self and others -University of California, Los Angeles, a personal sense of control was shown to significantly increase serotonin function (much like an antidepressant medication would). And deeply loving relationships and vivid spiritual experience raise dopamine levels. Also, getting "turned on" with purpose to a project that is believed in can raise central norepinephrine levels. Meditation can raise GABA function, a neurotransmitter that calms the overresponsive nervous system characteristic of many common illnesses such as headache, irritable bowel, or chronic pain. Each of these neurochemical effects improves nervous system suppression of pain. All this may explain why a person with pain who falls in love and experiences joy will at times find their pain subsiding -Paul Pearsall: women who exemplified spiritual health when she shoud have been bitter, sick, and depression. Attributes her health, strength, and resilience to a deep sense of spiritual strength. Her spirituality enabled her to find meaning and purpose in life- even in the midst of crisis -Victor Frankl: Jewish Nazi camp survivor, the key to such resilience as a sense of purpose and meaning -Kenneth Pelletier: investigating the link between spirituality and health. Investigated the lives of top buisness executives and other prominent people who have achieved what most consider to be "success". Findings: 1. most of the professionally successful men and women participating in the study had strong spiritual values and beliefs. 2. almost all of them had suffered a major psychological or physical trauma early in life 3 Despite these traumas, more bc of them, ppl now have a more effective style of coping with life crises (spiritual people weather crisis better- partially bc the are able to find purpose and meaning in life despite the crisis and even from the crisis) -Correlation between good spritual health and good physical health: --People with a deep sense of spirituality reported less use of medical services, less minor illness, and more complete recovery from minor illness than the national average. --Similar findings were reported from a study of 300 terminally ill and nonterminally ill hospitalized adults. Those with the greatest spirituality, even though their illnesses were terminal, showed resilient emotionalhealth. Spirituality was significantly related to "low death fear, low discomfort, decreased loneliness, emotional adjustment, and positive dealth perspectives among terminal cancer and other seriously ill patients -Study of 100 geriatric patients. Found that those who had little religious activity ahd much higher rates of cancer, chronic anxiety, depression, cigarette smoking, and alcohol use. Patients with high levels of relgious activity enjoyed better overall physical and mental health -Some of the improvement in overall health may relate to the benefits of spiritual practice on mental health and reduction of feeling stressed. Evidence showed that spirituality can reduce anxiety, foster better intimacy, enhance a sense of purpose and meaning for life, and foster personal growth and control -Spirituality and religiousness were in particular related to greater subjective well-being, life satisfaction, and marital satisfaction, and less depression symptoms, delinquency, and drug and alcohol abuse -Seeking reassurance from God and seeking support within one'e religious community is more helpful than praying for a miracle -Some forms of religiousness had deleterious mental efects (e.g., beliefs in a punitive God, extrinsic religiosity, conflict with or feeling judged by clergy, and hyperrigid religiousness) -Mindful meditative practice reduces anxiety in the long term. This has been shown to reduce physical problems considerably, as do other treatments for anxiety. For example, transcendental meditation, by reducing stress hormones, can lead to regression of carotid artery thickening (compared to progressive thickening in control groups) and improved coronary disease outcomes -Gerald Epstein and the Ten Commandments: --10 commandents are a prescription for healthful living, the first five outline the proper relationship of human beings to GOd, the last 5 the proper relationships of humans to human society; all of them are finely and intricately related to each other --Determination on the part of the patient, not the physician, is what makes healing and joy possible. Combo of faith and determination a "sense of trust"- a trus in the spirit of God within each of us as the source of all joy -Disease-bearing organisms as simply one coponent of a process involving God and human beings, human beings and ethics, and human beings in relatinonship to each other. These relationships are an essential part of spirituality and spiritual health, this aspect of spirituality emphasizes what is positive about relationships -Choosing to care well for oneself is another aspect of spirituality. Requires a good sense of self-acceptance

Spirituality and Chronic Pain

-Wachholtz and Pargament, 2005 (acute pain) --Richer spiritual life-> greater pain tolerance --Higher spiritual interactions between self and others-> greater pain tolerance --Pain *perception* not altered by spiritual meditation, but Spiritual Mediation group able to endure pain 2x as long -Rippentrip et al., 2005 (chronic pain) --Poorer mental health related to negative religious coping (e.g., feeling punished/abandoned by God for sins) --Intensity of chronic pain lower for those who reported more forgiveness of self, others, and by God --Lack of forgiveness-> more daily pain interference One additional well-researched area is the links between spirituality/religiosity and pain management. This was particularly important to the patients I worked with at the pain clinic. They asked me and another psychologist to spend a full Saturday morning group workshop exploring the links between the two, and we invited the hospital chaplain to participate in the discussion. Wachholtz & Pargament: Participants completed a survey asking about a range of spiritual practices from meditation, prayer, attending services, etc. To induce acute pain, they performed the cold pressor task where they submerged their arm in below-freezing water and removed it when they could no longer bear the pain. They also reported the degree of pain/discomfort. The researchers broke the participants into two groups (high and low spirituality) to see how they differed. Both groups reported the same degree of pain/discomfort; however, the high spirituality group was able to tolerate the pain longer. Another phase of the project included having an experimental group perform a meditation activity, and that group went twice as long in the task compared to a control group. Rippentrop et al: Researchers at the University of Iowa surveyed chronic pain patients and had them report on a range of religious activities, beliefs, etc. Those who engaged in what is called negative religious coping (e.g., believing that their pain or injurious are a result of earlier sins) had significantly poorer mental health (more depression). In contrast, those who reported higher levels of forgiveness had lower intensity of chronic pain. Forgiveness was one of the strongest predictors of pain interference, with low forgiveness scorers reporting more daily interference due to pain.

Caveats

-Your sense of humor is not a magic bullet, which will cure cancer or other illnesses...it creates internal conditions which support body's basic healing and health-maintaining mechanisms -Not suggesting laughing off trauma- humor most often works in areas we perceive some level of control

Special Case of Touch

1. German emporer Frederick II and experiment to find "natural language of God" in 1211 -20 infants, basic needs met (fed, clothed, diapers, NO interactions/talking/cuddling/etc.) -It was a dismal failure. All of the infants were dead within several weeks. 2. Harlow and Harlow's research on monkeys -Those who grew up without physical touch prone to self-mutilation, aggression, and some killed own babies 3. Study on victims of child abuse -#1 predictor not that abuser had been abused, but if s/he had been deprived of touch -Many of you have probably heard in school or via the news that adults who abuse children often were abused themselves as children. While the two are correlated, an even stronger predictor is social deprivation and neglect. Someone raised in relative isolation and without healthy touch are at risk for failing to develop empathy, which makes it more likely they could commit abuse later in life. 4. Massage therapy w/ preemies -Leave ICU earlier, better weight gain, and fewer physical problems -Several decades ago premature infants were kept isolated from human touch because of the fear that they would be exposed to infection in their sensitive state. However, some researchers studied how they would respond to physical touch (e.g., gentle massage, stroking by their parent(s), etc.) and found that it significantly improved their health outcomes. This radically changed how preemies are treated, and contact is now a regular part of neonatal care. 5. Massage therapy with in-patient children and adolescents -Daily massage therapy reduced ANX/DEP -Another study looked at how children and adolescents in a residential mental health treatment facility (AKA psych ward) responded to daily massage therapy. It helped improve parasympathetic activity and reduce symptoms of anxiety and depression.

R. Banks Definition of Spirituality: 8 Different Ideas

1. Something that gives meaning or purpose to life 2. A set of princples or ethics to live by 3. The sense of selfesssness and a feeling for others- a willingness to do more for others than for yourself 4. Commitment to God, and an ultimate concern 5. Perception of what causes the universe to work the way it does 6. Something for which there is no rational explanation- recognition of powers beyond the natural and rational 7. Something perceived as being known to hazily known- something for which there is no easy explanation, and so it becomes a matter of faith 8. The most pleasure-producing quality of humans

Banks' 4 Aspects of Spiritual Health

1. The spiritual dimension of health acts as a unifying force that integrates the other dimensions of health: physical, mental, emotional, and social. The spiritual dimension unites the other dimensions of health, brining them into a while 2. The spiritual dimension of health creates or brings into focus a meaning in life. The exact components of that meaning vary from one individual to another. For one, it may be centered on family relationships, whereas for another it may be focused on humanitarian efforts or the result of professional effort. Regardless of the source of the meaning, it can serve as a powerful inner drive for personal accomplishment. And regardless of its source, it is vital. Without some meaning in life, the will to live is lost. 3. Because the spiritual dimension of health transcends the individual, it has the capacity to be a common bond between individuals. It rises above the individual and goes beyond the limits of the individual. With this common bond, we are enabled to share love warmth, and compassion with other people- and we are able to do unselfish and compassionate things for others, things that go beyond ourselves. We are able to put someone else's life, safety, security, and interest before our own. This common bond also enables us to follow a set of ethial principles- and to make a commitment to God (or some other source of spiritual power) 4. The spiritual dimension of health is based on individual perceptions and faith. We acknowledge that there is some power at work, a power other than the natural and the rational. We acknowledge and perceive that such a power is the cause behind the natural workings of the universe. Our perceptions and our faith bring us pleasure and convince us of our ability to survive. Indications of spirituality include prayer, a sense of meaning in life, reading and contemplation, a sense of cloesness to a higher being, interactions with otjers, and other experiences that reflect spiritual interaction or awareness -the wide range of decisions that have spiritual overtones include the degree of sexual intimacy engaged in, the decision to donate organs, the movies seen, the literature read, the music sung or listeneq to, smoking, drinking alcohol, taking drugs, etc.

Special Case of Gratitude

10 week, gratitude-based intervention (McCullough, Emmons & Tsand, 2002) for hypertension in mostly low-income, inner-city, African American patients -1/2 listed things for which they were grateful on a "gratitude hotline" via telephone -1/2 only received treatment as usual Patients in gratitude condition -Satistically significant decreases in systolic BP -Increased gratitude scores and positive health behaviors -Significant inverse correlation between gratitude and hostility -Correlations with quitting smoking and weight loss The field of positive psychology has grown substantially in the past 14 years after it was "introduced" in 2000. Gratitude is one of the variables from positive psy with a lot of research behind it. You can see a sample study above where the experimental group simply called a hotline and reported three things that they were thankful for each day, no matter how large or small. People in that gratitude condition reported lower levels of hostility, decreased in blood pressure, and increases in other positive lifestyle changes. Gratitude is something encouraged in a lot of religious traditions, but also available to anyone regardless of belief systems.

Another researcher's definition of spiritual health

Optimum spiritual health, he says, is the ability to develop our spiritual nature to its fullestpotential. Part and parcel of that is the ability to discover and articulate our own basic purpose in life. It's the ability to learn how to experience love, joy, peace, and fulfillment. And it's the experience of helping ourselves and others achieve full potential