Transcript Huseman - LIFE at UCF

RELATIONAL
INTELLIGENCE
A GREAT WAY TO LIVE…
AND LIVE LONGER
The SECRET to unleashing the power of your
conscious and subconscious mind to create
health and happiness.
PRESENTED BY:
RICHARD C. HUSEMAN, PH.D.
“Medicine is not a natural,
but a social science.”
HENRY SIGERIST, M.D.
(1946)
OVERVIEW
Part ONE:
THE CURRENT STATE OF HEALTHCARE
Part TWO:
THE POWER OF POSITIVE BELIEF
Part THREE: THE
POWER OF A POSITIVE APPROACH
TO LIFE
Part FOUR:
RX+ SCRIPTS
Part FIVE:
HOW YOU CAN LEVERAGE THE
POWER OF THE “BELIEF EFFECT?”
©2013 – Richard C. Huseman, Ph.D.
3
GENETIC CONDITIONING
• Many of us have been conditioned to believe
that our lives – and our health – are controlled
by our genes:
– “The men in my family have all died from heart
attacks before the age of 50.”
– “Cancer runs in my family.”
– “My father and my sister are both diabetics.”
• This belief has one powerful
consequence…
IT ALLOWS US TO SHIRK
INDIVIDUAL RESPONSIBILITY
FOR OUR HEALTH AND
WELL-BEING!
PERSONAL RESPONSIBILITY
• Preventable illness makes up approximately 80% of
all illness and 90% of all healthcare costs.
• Preventable illness account for eight of the nine
leading categories of death.
• 75% of all healthcare dollars are spend on patients
with one or more chronic conditions, many of which
can be prevented.
PEOPLE EXPECT THE HEALTHCARE SYSTEM TO
“FIX THEM” AND TAKE CARE OF THE PHYSICAL
AND EMOTIONAL PROBLEMS CAUSED BY
A LIFESTYLE THEY CHOOSE!
*
“In Brief, Health, United States, 2012,” U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, National Center for Health Statistics.
THE ILLNESS/WELLNESS CONTINUUM
PREMATURE
DEATH
WELLNESS &
LONGEVITY
DEGREE OF SELF ACCOUNTABILITY
THERE IS NO DOUBT THE
HEALTHCARE SYSTEM IS GOING TO
HAVE TO CHANGE,
BUT SO ARE THE PEOPLE
WHO RELY ON IT.
WHAT DO YOU REALLY WANT FROM HEALTHCARE?
• “I want healthcare that is safe and effective.”
• “I want healthcare that is affordable.”
• “I want my doctor to be able to spend time with
me, and not just be another face in the crowd of
too many patients.”
WHAT THE MAJORITY OF US WANT FROM
HEALTHCARE IS NOT TO NEED IT!
UNBALANCED COST/BENEFIT RATIO
• For all of the money we spend on healthcare,
we are not receiving any better care than
people in other development countries.
• The U.S. spends almost double the amount on
healthcare as Canada, France and Germany.
HEALTH EXPENDITURES/LIFE EXPECTANCY
COMPARISON TO U.S. TO SELECT OTHER COUNTRIES (2009/2010)
Country
Australia
Australia
Canada
Canada
China
China
France
France
Germany
Germany
Japan
Japan
Russia
Russia
Sweden
Sweden
United
United Kingdom
Kingdom
United States
Expenditure
per Capita
Expenditure
(% of GDP)
Life
Expectancy
at 60
Life
Expectancy
at birth
$3,441
$3,441
$4,404
$4,404
$379
$379
$4,021
$4,021
$4,332
$4,332
$3,204
$3,204
$998
$998
$3,757
$3,757
$3,480
$3,480
8.7%
8.7%
11.3%
11.3%
5.1%
5.1%
11.9%
11.9%
11.6%
11.6%
9.5%
9.5%
5.1%
5.1%
9.6%
9.6%
9.6%
9.6%
25
25
24
24
19
19
25
25
23
23
26
26
17
17
24
24
23
23
82
82
81
81
74
74
81
81
80
80
83
83
68
68
81
81
80
80
$8,362
17.9%
23
79
Data from World Health Organization’s Global Health Observatory
HEALTH EXPENDITURES/LIFE EXPECTANCY
AIRPLANE VS. HEALTHCARE SAFETY
• Captain Chesley “Sully” Sullenberger was the pilot
of the plane from the “Miracle on the Hudson”
incident.
• He co-authored an article for The Journal of Patient
Safety on “avoidable healthcare harm” making
comparisons between the aviation and healthcare
industries.
• Since retiring in 2010, Sullenberger has
become a spokesperson for airline safety…
AND FOR PATIENT SAFETY.
“The nature of the [healthcare] problem is systemic,
huge and immediate. The Institute of Medicine reports
medical errors and healthcare-associated conditions
lead to over 200,000 preventable deaths per year in
this country alone.
THAT’S THE EQUIVALENT OF 20 LARGE JET AIRLINERS
CRASHING EVERY WEEK WITH NO SURVIVORS.
If that were to happen in aviation, there would be a
nationwide ground stop, a presidential commission,
congressional hearings, and more…. No one would fly
until we'd solved the fundamental issues.”
CAPTAIN CHESLEY “SULLY” SULLENBERGER III
RETIRED U.S. AIRWAYS PILOT
Taken from “5 Questions: Capt. Chesley “Sully” Sullenberger on applying lessons on airline safety to healthcare practices,” Stanford School of Medicine “1:2:1” podcast with Paul Costello.
THERE MUST BE A BETTER WAY
• A critical aspect wellness is rarely leveraged to
promote wellness and/or treating disease or
illness.
• Medical professionals have known about it for
many centuries.
• Theologians, philosophers and spiritualists
have known about it far longer than that.
THE MOST ANCIENT OF HEALING PRACTICE IS STILL ONE
OF THE MOST IMPORTANT…
THE
POWER OF POSITIVE BELIEF
THE POWER OF
POSITIVE BELIEF
THE PLACEBO EFFECT
INTERNAL VS. EXTERNAL SENSORS
• The brain does more than just tell muscles how to
move via the sensory nerves.
• The brain can also instruct immune cells to change
their activity.
• As we learn more and more about how the brain
communicates with the body, it is becoming clear
that mental processes need not start with external
perception and end in external movement.
• Some mental processes originate and
terminate in events deep inside our body.
PLACEBO AND THE POWER OF THE MIND
• The infamous 1957 Krebiozen case
– Dr. Bruno Klopfer, in a last ditch and potentially
fruitless effort to save a terminally ill patient,
injected the cancer drug, Krebiozen.
– Ten days after the injection, the patient’s tumors
decreased in size to the point where they could no
longer be detected.
– The patient left the hospital
and returned to an almost
completely normal life.
Taken in part from The Placebo Effect: Mind over Matter in
Modern Medicine by Dylan Evans (2004).
PLACEBO AND THE POWER OF THE MIND (CONT.)
• Patient remained well for about two months… until
he read in the newspaper that Krebiozen was not as
effective as hoped.
• Almost immediately, the patient relapsed and the
tumors returned.
• In desperation, Dr. Klopfer told the patient he had
an IMPROVED VERSION of Krebiozen.
• IT WAS DISTILLED WATER.
• Again, the patient experienced
a full remission despite having
been given a placebo.
Taken in part from The Placebo Effect: Mind over Matter in
Modern Medicine by Dylan Evans (2004).
PLACEBO AND THE POWER OF THE MIND (CONT.)
• When the patient reads weeks later that the
American Medical Association declared
Krebiozen totally ineffectual.
THE PATIENT DIED TWO DAYS LATER!
• The Placebo Effect illustrates that BELIEF is the
strongest medicine we can ever access to heal
our bodies and live longer and healthier lives.
Taken in part from The Placebo Effect: Mind over Matter in
Modern Medicine by Dylan Evans (2004).
THE IPECAC EXAMPLE
• In the early 1950’s, pregnant women
suffering from severe morning
sickness were told they were given a
new medication to cure their nausea
and cramping.
• Ipecac is often used to induce
vomiting in patients who are
poisoned.
• To the astonishment of researchers, instead of
becoming more ill, the pregnant women ceased
vomiting all together.
• The women allowed their beliefs to override the
actual physical effects of the drug.
Taken in part from “Challenging Received Wisdom: Antidepressants and the Placebo Effect”
by Irving Kirsch, McGill Journal of Medicine, November 2008.
PLACEBOS AND THE BRAIN
• Studies have shown that placebos increase dopamine,
endorphins and other chemicals in the brain.
• Patients suffering from depression who have been given
placebos reveal changes in electrical and metabolic
activity in several different regions of the brain.
• It is the rituals and treatments that trigger our brains to
believe that we can heal that actually allows us to heal.
• People BELIEVE that everything done to/for them
in their doctor’s office, in their hospital room,
and in the operating room is designed to help
them heal.
• Two placebos pills are more powerful than just one
• Bigger pills are more powerful than smaller pills
• Injections are more “effective” than pills
THE PLACEBO EFFECT IS DEPENDENT NOT ON A
DRUG’S EFFECTIVES, BUT SOLELY ON THE
THERAPEUTIC INTENTION OR
BELIEF
ON THE PART OF THE PATIENT
“What we ‘placebo neuroscientists’ have learned is
that therapeutic rituals move a lot of molecules in
the patient’s brain, and THESE MOLECULES ARE THE VERY
SAME AS THOSE ACTIVATED BY THE DRUGS WE GIVE IN
ROUTINE CLINICAL PRACTICE…. In other words, rituals
and drugs use the very same biochemical pathways
to influence the patient’s brain.
It is very difficult to separate actual physical benefit
from the placebo effect when it comes to many
medical treatments.”
– Fabrizio Benedetti, M.D.
Author, The Patient’s Brain: The NeuroScience
Behind the Doctor-Patient Relationship (2011)
ANTIDEPRESSANTS VS. PLACEBOS
• Irving Kirsch, in his book, The Emperor's New
Drugs, has studied the placebo effect in regard
to antidepressant drugs.
• Patients given a placebo reported 75%
improvement as compared to those patients
who received the real medication.
• More surprisingly, was how small the difference
between the improvement response to the
drug and the placebo (called the
drug effect).
The Emperor’s New Drugs by Irving Kirsch, Ph.D. (2010)
ANTIDEPRESSANT TREATMENT STUDY RESULTS
Drug Effect
Improvement
1
(accounting for improvement
without treatment and placebo)
0.8
Placebo Effect
(accounting for improvement
0.6
reported without treatment)
0.4
0.2
0
Drug
Placebo
No Treatment
Taken in part from The Emperor’s New Drugs by Irving Kirsch, Ph.D. (2010)
ANTIDEPRESSANT TREATMENT STUDY RESULTS
Drug Effect
Improvement
1
SUPER
Placebo
Effect
0.8
0.6
0.4
0.2
0
Drug
Placebo
No Treatment
Taken in part from The Emperor’s New Drugs by Irving Kirsch, Ph.D. (2010)
DEPRESSING RESULTS
• Kirsch and Sapirstein found that when you
compare antidepressant drugs to “extrastrength” placebos…
“DIFFERENCES IN RATES OF IMPROVEMENT ARE
NO LONGER STATISTICALLY SIGNIFICANT.”
• There are was no difference between having a
patient take the placebo or the drug. The
results were the same.
• Yet, we spend $11 BILLION A YEAR on antidepressants.
The Emperor’s New Drugs by Irving Kirsch, Ph.D. (2010)
THE SURGICAL PLACEBO
• In the 1950’s, many thousands of people underwent
Internal Mammary Artery Ligation as a treatment
for angina.
• By blocking clogged arteries completely, surgeons
believed that blood could be forced to find
alternative routes by sprouting new channels
through the heart muscle.
• Early reports showed angina improvement
in up to 91% of cases and complete relief in
up to 64%.
Taken in part from “Placebos and placebo effects in medicine: historical overview,” A.J. de Craen, T.J.
Kaptchuk and J. Kleijnen, Journal of the Royal Society of Medicine, October 1999
THE SURGICAL PLACEBO (CONT.)
• In 1958, a skeptical surgeon tested the validity of
internal mammary artery ligation.
• He simply lassoed the artery and left the suture
ends loose outside the skin. By not tightening
the ligature, no blood was diverted.
• His patients reported great subjective
improvement to their angina, despite the fact
that NO REAL CHANGE was made to the blood
flow to their heart.
Taken in part from “Placebos and placebo effects in medicine: historical overview,” A.J. de Craen, T.J.
Kaptchuk and J. Kleijnen, Journal of the Royal Society of Medicine, October 1999
THE SURGICAL PLACEBO (CONT.)
• Further studies found that various “sham”
surgeries found that their was no difference in
patients receiving the actual surgery or the sham
surgery.
• The vast majority of patients found their
symptoms improved.
• After more than 10,000 internal mammary artery
ligation operations, this procedure was
ABANDONED in the 1960s.
Taken in part from “Placebos and placebo effects in medicine: historical overview,” A.J. de Craen, T.J.
Kaptchuk and J. Kleijnen, Journal of the Royal Society of Medicine, October 1999
TRUE VALUE OF PLACEBO EFFECT
• Many traditional health professionals tend to
dismiss the placebo effect. They wave it aside
as a non-phenomenon or nuisance.
• Indeed, the term “placebo effect” has taken on
a negative connotation even outside the
medical field.
• A better term may be – “The Belief Effect”
• The placebo merely triggers the
“The Belief Effect”
PROGRAM IN PLACEBO STUDIES & THE
THERAPEUTIC ENCOUNTER (PIPS)
BETH ISRAEL DEACONESS MEDICAL CENTER & HARVARD MEDICAL SCHOOL
PIPS IS STUDYING THE PLACEBO
TO CHANGE THE WAY WE THINK
ABOUT MEDICINE
THE MAGIC BEHIND “FAKE” MEDICINE
• Program in Placebo Studies and the Therapeutic
Encounter (PiPs)
– Harvard-affiliated multi-disciplinary institute
dedicated solely to placebo study led by Ted
Kaptchuck, who states:
“THE CHALLENGE NOW IS TO UNCOVER THE
MECHANISMS BEHIND THE PLACEBO RESPONSE –
WHAT IS HAPPENING IN OUR BODIES
AND IN OUR BRAINS.”
A LOOK INSIDE PLACEBOS
• Kaptchuck gathered 270 subjects with severe arm
pain (carpel tunnel, tendinitis, etc.). He divided
them into two equal groups:
– One group was given pain-relief medication.
– Second group was treated using acupuncture.
• Both groups were warned about potential side
effects:
– The pain-relief group was warned the medication
could make them drowsy and/or lethargic.
– The acupuncture group was warned that the
needles could cause redness and/or swelling
at the puncture site.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real ingredients of ‘fake’
medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
A LOOK INSIDE PLACEBOS (CONT.)
• Two weeks into the study, Kaptchuk was stunned
to find that nearly a third of the subjects in his
study reported severe side effects from their
treatment.
• In both groups, people reported side effect
symptoms.
– The pills made some subjects extremely sluggish.
– The needles caused inflammation that some
reported as overwhelmingly painful.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real ingredients of ‘fake’
medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
A LOOK INSIDE PLACEBOS (CONT.)
• Despite the side effects, many subjects experienced
real relief from both the pills, and especially the
acupuncture.
• For the first time, Kaptchuk’s study provided
evidence that acupuncture provided more relief
than pain relief medication.
• The problem is Kaptchuk’s study was a DOUBLE SHAM!
– THE PILLS WERE MADE OF CORNSTARCH
– THE ACUPUNCTURE NEEDLES WERE RETRACTABLE
IMITATIONS THAT NEVER PIERCED THE SKIN.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real ingredients of ‘fake’
medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
SCHMALTZ & PLACEBOS
• In another study, Kaptchuk split 262 subjects into
three groups:
– First group was told they were on a waiting list for
treatment.
– Second group received the sham acupuncture treatment
with little interaction with the practitioner.
– Third group received the sham acupuncture treatment
with a great deal of attention from their practitioner.
• Very “schmaltzy” care including 20 minutes
of dialogue with the subject.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real ingredients of ‘fake’
medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
SCHMALTZ & PLACEBOS (CONT.)
• Phrases used included:
– “I’m so glad to meet you.”
– “I know how difficult [your
condition] is for you.”
– “This treatment has excellent
results.”
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real
ingredients of ‘fake’ medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
• There was no surprise that
people who received greater
attention reported the most
improvement, even though
the ACTUAL TREATMENT THEY
RECEIVED WAS FAKE.
• Example of a modern day
Hawthorne Effect.
THE OBVIOUS REVEALED
• The largest criticism for any placebo study is the
DELIBERATE DECEPTION of the subject as to the type
of treatment they were receiving.
• Kaptchuk simply took the ethical question out of
the equation.
– Group 1 received no treatment
– Group 2 were given drugs labeled “Placebo Pills.”
The only caveat was that
Group 2 subjects were told that
placebo drugs can often have a
healing effect on their symptoms.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real
ingredients of ‘fake’ medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
THE OBVIOUS REVEALED (CONT.)
Even patients who KNEW they were
taking placebos reported twice as much
symptom relief as the no-treatment group.
• A 50% improvement in symptom relief for a real
drug would be considered a highly favorable result
within the medical community.
• To have half of a study’s patients
report they felt improvement
from a pill that they KNEW to
be a placebo was staggering.
Taken in part from “The Placebo Phenomenon: An ingenious researcher finds the real
ingredients of ‘fake’ medicine,” by Cara Feinberg, Harvard Magazine, January-February 2013.
THE
BELIEF EFFECT
AND ITS IMPACT ON HEALTH,
LONGEVITY AND WELL-BEING
POSITIVE MINDSET & LONGEVITY
• A Yale University study of 660 elderly people found
that those who held positive attitudes lived an
AVERAGE OF 7.5 YEARS LONGER than those with
negative attitudes.
• A Mayo Clinic study conducted over a 30 period
found that on average optimistic people live 19%
LONGER than pessimistic people.
• That means if you life expectancy is 80, you
can expect to live an ADDITIONAL 15.2 YEARS.
1.
2.
“Longevity Increased by Positive Self-Perceptions of Aging” B.R. Levy and S. R. Kunkel, Journal of Personality
and Social Psychology, 2002, Vol. 83, No. 2, 261-270.
“Mayo Clinic Study Finds Optimistic People Live Longer, Medscape Today News, Feb. 16, 2000.
PLEASURE AND WELL-BEING
• A European study conducted by Dr. Ronald
Grossarth-Maticek staring in the 1970s, gave a
brief, paper and pencil test: The Pleasure &
Well-Being Test.
– The test basically assessed whether subjects had
positive or negative mindsets.
– The test was given to over 3,000 people in their
mid-fifties.
– Twenty-one years later, he followed up with
the same group to get an update of their
health status.
Taken in part from The Attitude Factor by Thomas R. Blakeslee (2005).
PLEASURE & WELL-BEING (CONT.)
• The findings from the Pleasure and Well-Being
Test were incredible:
– Of those who had high pleasure and well-being
scores (i.e., positive mindsets) – 75% WERE ALIVE AND
WELL!
– Of those who had low pleasure and well-being scores
(i.e., negative mindsets) – ONLY 2.5% WERE STILL ALIVE!
• A subset of 300 subjects who had high scores
on the test, but who also led very unhealthy
lifestyles still outlived those with healthy
lifestyles and low scores by 8.5 YEARS.
Taken in part from The Attitude Factor by Thomas R. Blakeslee (2005).
PRESCRIPTION POSITIVE
CAPTURING THE BENEFITS OF
THE “BELIEF EFFECT”
SCRIPT
Self
HaveAccountability
Faith
21
Be accountable for your life,
especially your health
choices. Take positive steps
every day to secure a healthy
and fully active life.
THE BELIEF:
I AM ACTIVELY TAKING CARE OF
MY MIND, BODY AND SPIRIT.
SCRIPT
Manage
Your Stress
Have Faith
22
Consciously and actively
manage the stress in your life.
Do what you can to reduce
stressors and leverage the stress
you have to your advantage.
THE BELIEF:
I AM MORE THAN CAPABLE OF
HANDLING ALL ASPECTS OF MY
LIFE EASILY AND POSITIVELY.
2
3
Focus
on Positive Relationships
Have Faith
SCRIPT
Build and maintain positive
relationships in your life with
others, and especially yourself.
THE BELIEF:
I PLACE A PRIORITY ON MY
RELATIONSHIP WITH MYSELF. I
HAVE STRONG POSITIVE
RELATIONSHIPS WITH OTHERS.
SCRIPT
Cultivate
Happiness
Have Faith
24
Actively seek happiness in your
life. Recognize that happiness is
a choice dependent not on
circumstances, but on belief.
THE BELIEF:
I CHOOSE TO BE HAPPY TODAY
AND EVERYDAY.
SCRIPT
Have
Have Faith
Faith
25
Practice your faith every day.
Allow your belief in God to
fill you with the joy of life.
THE BELIEF:
I AM LIVING EACH DAY IN THE
FULLEST AWARENESS OF GOD IN
MY LIFE.
SCRIPT
An
Attitude
Have
Faith of Gratitude
26
Practice an “attitude of
gratitude” every day to
consciously feed positivity in
your life.
THE BELIEF:
I AM TRULY THANKFUL FOR
EVERYTHING AND EVERYONE IN
MY LIFE.
HOW YOU CAN LEVERAGE
THE POWER OF
THE “BELIEF EFFECT?”
BELIEF AND HEALING
• The “Belief Effect” happens when the conditions
are right for people to believe in their own
healing, and when that belief gets triggered by a
ritualized interaction with a physician or other
healthcare professional.
• The doctor-patient relationship is one of the
primary factors that influences a patient’s belief
that a given therapy will function.
• When doctors are caring, when they believe in
the work they are doing, and when they take
interest in a patient, they are creating the
conditions for a patient’s belief to promote
their healing process.
BELIEF AND HEALING (CONT.)
• If patients feel strongly that they are receiving the
treatment they need, then they will consciously
and/or unconsciously enhance the healing process.
• It is imperative that we continue to study the
dynamics and rituals of the doctor-patient
relationship, so that we can ensure doctors are
providing patients with the intangible experience they
need to get all the benefits of positive belief alongside
their clinical treatment.
• Such treatment could mean the difference
between an inspiring healing experience and
one that requires unneeded suffering!
FOOD FOR THOUGHT
HOW CAN YOU LEVERAGE
PRESCRIPTION POSITIVE AND THE
POWER OF BELIEF IN PROMOTING
YOUR HEALTH AND WELLNESS?
HOW POSITIVE ARE YOU?
BULLETS & BUCKS STORY