Spirituality My focus is on the spirit of a person. I am not exhaustive on the topic of spirituality. What is presented are significant facets of the Spirituality Diamond. Soul : What resides primarily inside you, such as your mind, will and emotions. as compared to.. Spirit: What is primarily coupled outside you, as in a connection to God, a Higher Power, a Calling, or other people. Facets of Spirituality: God / Transcendence Meaning / Purpose Community / Relationship Hope / Belief B.Judd 2014 Fair Use Applies Page 1
God / Transcendence God : Relational Side : prayer, interaction, dialog help, guidance, peace Tangible Side : observed answers to prayer timing miracles. Celebrate Recovery : Step 2 in the 12-step program of recovery is to admit that a power greater than ourselves is able to help us recover. In most recovery groups, you can claim anything you want as your higher power. At Celebrate Recovery, they believe there is only one true Higher Power, and that is Jesus Christ. Transcendence : completely outside of and beyond, lying beyond the ordinary, being above and independent AA : Has room for both generic Higher Power and a personal God, thus appeals to theists or atheists and all in-between. One atheist comments: I ve become aware that [AA] 12-step programs are home to people from every religion, denomination, sect, cult, political tilt, gender identity, sexual preference, economic strata, racial and ethnic background, believers in gun rights and abortion rights and the right to home schooling, drinkers of coffee and tea, whiskey and mouthwash, people who sleep on their sides or their stomachs or sidewalks. I believe that the most important spiritual principle of AA is humility. The recognition that we are flawed, that we can and must change and that our purpose not only in sobriety but in life is to be of service to others. Marya Hornbacher, a self-proclaimed atheist http://religion.blogs.cnn.com/2011/08/28/my-take-an-atheist-at-aa/ Victor Frankl : his calling by life to contribute beyond prison camp; a drawing to something outside and beyond his immediate surroundings. Everyone has his own specific vocation or mission in life; everyone must carry out a concrete assignment that demands fulfillment. Therein he cannot be replaced, nor can his life be repeated, thus, everyone's task is unique as his specific opportunity to implement it. B.Judd 2014 Fair Use Applies Page 2
Meaning / Purpose To what extent does a person s context effect their sense of meaning and purpose? Context, as in the context a word has in a sentence from which it derives some of its meaning. Does poor relational connection --- context if you will --- often lead to a poor sense of meaning? Equally compelling is the centering and spiritual renewal coming for the person who does the believing in another. Whether it is for our children, lover, pet or person in need of help, there is deep meaning for the person who can step outside their world to support another's. A client I had seen through many hospitalizations recently had a long period free of such episodes. She clearly had a new light in her eye. When I asked what had changed she said now that she was working as a provider she had a sense of meaning and purpose in her life. Helping others gave her sufficient meaning that she felt her life was worth living. --- Someone who believed in them helped them to recover By Daniel B. Fisher, M.D., Ph.D. being human always points, and is directed, to something, or someone, other than oneself-- be it a meaning to fulfill or another human being to encounter. The more one forgets himself--by giving himself to a cause to serve or another person to love--the more human he is and the more he actualizes himself. What is called self-actualization is not an attainable aim at all, for the simple reason that the more one would strive for it, the more he would miss it. In other words, self-actualization is possible only as a side-effect of selftranscendence. --- V. Frankl Delusions --- delusional thinking is like a runaway addiction an addiction of the ego for self-esteem and purpose. One is drunk on importance. A delusion : "A false belief that is based upon perception rather than truth." Truth is universal. Perception of truth is not. B.Judd 2014 Fair Use Applies Page 3
Community / Relationship Relationship provides context, which helps to provide meaning. Relationship with God, others People who have significantly recovered from mental illness frequently say they were greatly helped by someone who believed in them. the research of Carl Rogers into the nature of the helping relationships. He stated that "the safety of being liked and prized as a person seems a highly important element in a helping relationship." (On Becoming a Person, 1961). Martin Buber also describes the importance of having someone believe in you. He calls this characteristic "confirming the other...confirming means accepting the whole potentiality of the other. I can recognize in him the person he has been created to become." Rogers goes on to state that "if I accept the other person as something fixed, already diagnosed and classified...then I am doing my part to confirm this limited hypothesis. If I accept him as a process of becoming, then I am doing what I can to confirm or make real his potential. We who have been labeled with mental illness, remain just as human if not more so than others who are temporarily not labeled. Our needs are human needs of which the most basic is to enter into trusting, loving, and caring relationships. These relationships need to be nurtured and cultivated for us to find the compass of our true self to guide our recovery. Any system of care which disturbs or interferes with these relationships is preventing not promoting recovery. Someone who believed in them helped them to recover, By Daniel B. Fisher, M.D., Ph.D. Open Dialogue --- Over the past seventeen years [1993 to 2010], open-dialogue therapy has transformed the picture of the psychotic population in western Lapland. Since [a] 1992-93 study not a single first-episode psychotic patient has ended up chronically hospitalized. Spending on psychiatric services in the region dropped 33 percent from the 1980s to the 1990s, and today the district s per-capita spending on mental-health services is the lowest among all health districts in Finland. Anatomy of an Epidemic, by Robert Whitaker, pg. 343 B.Judd 2014 Fair Use Applies Page 4
The focus [of Open Dialogue] is primarily on promoting dialogue, and secondarily on promoting change in the patient or in the family. The dialogical conversation is seen as a forum where families and patients have the opportunity to increase their sense of agency in their own lives by discussing the patient s difficulties and problems. Open Dialogue Approach: Treatment Principles and Preliminary Results of a Two-year Follow-up on First Episode Schizophrenia The idea behind Open Dialogue is the provision of psychotherapeutic treatment for all patients within their own personal support systems. This is done by generating dialogical communication within the treatment system, and involves mobile crisis intervention teams, patients, and their social networks in joint meetings. Open Dialogue Approach: Treatment Principles and Preliminary Results of a Two-year Follow-up on First Episode Schizophrenia Treatment involves patient s social network Open Dialogue Approach: Treatment Principles and Preliminary Results of a Two-year Follow-up on First Episode Schizophrenia Hope / Belief Hope can be founded on belief in God who hears prayer and can intervene. Hope can also rest on belief in medicine and advances from research. Hope can spring from many places. Some people with high hope possess these "components of hope": Goals: They have long- and short-term meaningful goals. Ways to reach those goals: A plan or pathway to get there and the ability to seek alternative routes, if needed. Positive self-talk, similar to the little red engine from the children's book, telling themselves things like "I think I can." Researchers add that these three traits are related to each other and can be taught. http://www.webmd.com/depression/news/20080818/does-hope-therapy-help-depression B.Judd 2014 Fair Use Applies Page 5
"Abandon all hope ye who enter here." Dante Alighieri's inscription on the entrance to Hell. nthe entrance to the feared death camp of Auschwitz, author-psychoanalyst Viktor Frankl's home as prisoner of conscience of the Third Reich. An undated image shows the main gate of the Nazi concentration camp Auschwitz in Poland. Writing over the gate reads: Arbeit macht frei (Work Sets You Free). B.Judd 2014 Fair Use Applies Page 6
Viktor Frankl, M.D., Ph.D. was an Austrian neurologist and psychiatrist as well as a Holocaust survivor. His bestselling book Man's Search for Meaning chronicles his experiences as a concentration camp inmate, which led him to discover the importance of finding meaning in all forms of existence, even the most sordid ones, and thus, a reason to continue living. "When we are no longer able to change a situation - we are challenged to change ourselves." "The one thing you can't take away from me is the way I choose to respond to what you do to me. The last of one's freedoms is to choose one s attitude in any given circumstance." The prisoner who had lost faith in the future his future was doomed. With his loss of belief in the future, he also lost his spiritual hold; he let himself decline and became subject to mental and physical decay. B.Judd 2014 Fair Use Applies Page 7
My Hope : Why Faith in my Future Ephesians 2:10 For we are God s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do. (Bedrock : Ephesians 2:8-9) Philippians 4:4-9 Rejoice in the Lord always. I will say it again: Rejoice! Let your gentleness be evident to all. The Lord is near. Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable if anything is excellent or praiseworthy think about such things. Whatever you have learned or received or heard from me, or seen in me put it into practice. And the God of peace will be with you. I Thessalonians 4:13-14, 5:9-11 Brothers and sisters, we do not want you to be uninformed about those who sleep in death, so that you do not grieve like the rest of mankind, who have no hope. For we believe that Jesus died and rose again, and so we believe that God will bring with Jesus those who have fallen asleep in him. For God did not appoint us to suffer wrath but to receive salvation through our Lord Jesus Christ. He died for us so that, whether we are awake or asleep, we may live together with him. Therefore encourage one another and build each other up, just as in fact you are doing. Pessimism vs. Optimism Research has shown that optimism is correlated with many positive life outcomes including increased life expectancy, general health, better mental health, increased success in sports and work, greater recovery rates from heart operations and better coping strategies when faced with adversity. The optimists and the pessimists: I have been studying them for the past twenty-five years. The defining characteristic of pessimists is that they tend to believe bad events will last a long time, will undermine everything they do, and are their own fault. The optimists, who are confronted with the same hard knocks of this world, think about misfortune in the opposite way. They tend to believe defeat is just a temporary setback, that its causes are confined to this one case. The optimists believe defeat is not their fault: Circumstances, bad luck, or other people brought it about. Such people are unfazed by defeat. Confronted by a bad situation, they perceive it as a challenge and try harder. --- Martin Seligman B.Judd 2014 Fair Use Applies Page 8
Optimism reacting to setbacks from a presumption of personal power: Bad events are temporary setbacks Isolated to particular circumstances Can be overcome by my effort and abilities Pessimism - reacting to setbacks from a presumption of personal helplessness: Optimism: Bad events will last a long time Will undermine everything I do Are my fault Inoculates against depression Improves health Combines with talent and desire to enable achievement http://www.shearonforschools.com/learned_optimism.htm Reframing Reframing --- Cognitive reframing consists of changing the way you see things and trying to find alternative ways of viewing ideas, events, situations, or concepts. It has to do with developing a new conceptual or emotional outlook relating to a situation, and putting it into another frame which follows the facts or evidence equally well, changing its whole meaning and impact. B.Judd 2014 Fair Use Applies Page 9
Post-traumatic growth Post-traumatic growth or benefit finding refers to positive psychological change experienced as a result of the struggle with highly challenging life circumstances. These sets of circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to individuals' way of understanding the world and their place in it. Posttraumatic growth is not simply a return to baseline from a period of suffering; instead it is an experience of improvement that for some persons is deeply meaningful. Results seen in people that have experienced posttraumatic growth include some of the following: greater appreciation of life, changed sense of priorities, warmer, more intimate relationships, greater sense of personal strength, and recognition of new possibilities or paths for one's life and spiritual development. http://en.wikipedia.org/wiki/posttraumatic_growth Post-traumatic growth refers to how adversity can often be a springboard to a new and more meaningful life in which people re-evaluate their priorities, deepen their relationships, and find new understandings of who they are. Post-traumatic growth is not simply about coping; it refers to changes that cut to the very core of our way of being in the world. Scientific studies have shown that post-traumatic growth is common in survivors not only of lifethreatening illnesses but also other various traumatic events, including disasters, accidents, and violence. Typically 30-70 percent of survivors say that they have experienced positive changes of one form or another. Post-traumatic growth is an important topic because it is changing how we think about trauma and how to treat it. It challenges the traditional psychiatric view of trauma and moves us away from only looking at its destructive effects to understand that it is in the struggle with suffering that growth may arise. [However,] three notes of caution, particularly for family and friends to remember. First, we ought not to burden each other with the expectation of post-traumatic growth. Second, the path to growth is not always smooth, nor short. The psychological journey following trauma can be a long and difficult one. Third, there is no promise of growth at the end of that journey. http://www.huffingtonpost.com/stephen-joseph/what-doesnt-kill-us-post_b_2862726.html Posttraumatic Growth Research Group Department of Psychology The University of North Carolina at Charlotte http://ptgi.uncc.edu/ B.Judd 2014 Fair Use Applies Page 10
The Anatomy of Hope: How People Prevail in the Face of Illness By Dr. Jerome Groopman "I understand hope as an emotion made up of two parts: a cognitive part and an affective part. When we hope for something, we employ, to some degree, our cognition, marshalling information and data relevant to a desired future event. If...you are suffering with a serious illness and you hope for improvement, even for a cure, you have to generate a different vision of your condition in your mind. That picture is painted in part by assimilating information about the disease and its potential treatments. "But hope also involves what I would call affective forecasting--that is, the comforting, energizing, elevating feeling that you experience when you project in your mind a positive future. This requires the brain to generate a different affective, or feeling, state than the one you are currently in. While it is a convenient construct to divide hope into a cognitive and an affective component, the two are tightly coupled. Feelings and emotions mold logical thinking and liberate decision making...true hope, then, is not initiated and sustained by completely erasing the emotions, like fear and anxiety, that are often its greatest obstacles. An equilibrium needs to be established, integrating the genuine threats and dangers that exist into the proposed strategies to subsume them. So when a person tells me that he doesn't want to know about the problems and risks, that he believes ignorance is necessary for bliss, I acknowledge that yes, unbridled fear can shatter a fragile sense of hope. But I assert that he still needs to know a minimum amount of information about his diagnosis and the course of his problem; otherwise his hope is false, and false hope is an insubstantial foundation upon which to stand and weather the vicissitudes of difficult circumstances. It is only true hope that carries its companions, courage and resilience, through. False hope causes them to ultimately fall by the wayside as reality intervenes and overpowers illusion. This is the vicious cycle. When we feel pain from our physical debility, that pain amplifies our sense of hopelessness; the less hopeful we feel, the fewer endorphins and enkephalins and the more CCK we release. The more pain we experience due to these neurochemicals, the less able we are to feel hope. Hope is the elevating feeling we experience when we see--in the mind's eye--a path to a better future. Hope gives us the courage to confront our circumstances and the capacity to surmount them. False hope can lead to intemperate choices and flawed decision making. True hope takes into account the real threats that exist and seeks to navigate the best path around them. Hope, then, is the ballast that keeps us steady, that recognizes where along the path are the dangers and pitfalls that can throw us off; hope tempers fear so we can recognize dangers and then bypass or endure them. B.Judd 2014 Fair Use Applies Page 11
To hope under the most extreme circumstances is an act of defiance that permits a person to live his life on his own terms. It is part of the human spirit to endure and give a miracle a chance to happen. Despite education and knowledge and experience, when you are the patient--suffering, confused, and despairing--it is very, very hard to take matters into your own hands. I was not able to stand alone and challenge the prevailing assumptions. I needed an external voice, strong and determined, to guide me. http://www.strategies-for-managing-change.com/kubler-ross.html Dreams by Langston Hughes Hold fast to dreams For if dreams die Life is a broken-winged bird that cannot fly. Hold fast to dreams For when dreams go Life is a barren field Frozen with snow. Hope.Belief.to dare to dream again. B.Judd 2014 Fair Use Applies Page 12
The 10 Fundamental Elements of Recovery Following is a summary of The National Consensus Statement on Mental Health and Recovery created by an expert panel convened by the Substance Abuse and Mental Health Services Administration. The panel worked to define the key elements of recovery in mental health. They are: 1. Self-direction: Essentially, a person with a mental health condition leads the process of recovery by defining life goals and then designing a unique path toward those goals. 2. Individualized and person-centered: The pathway to mental health recovery is based on a person s unique strengths, needs, preferences, experience, and cultural background. 3. Empowerment: People with a mental health condition have the authority to choose from a range of options and to participate in all decisions that will affect their lives. They also have the ability to join with others to speak as advocates for their needs, wants, and desires. Through empowerment, they control their own destiny. 4. Holistic: Mental health recovery comprises mind, body, spirit, and community. It encompasses all aspects of a person s life such as employment, education, mental health, addiction treatment, spirituality, creativity, social network, and family support. 5. Nonlinear: Mental health recovery is an organic process that is based on growth, occasional setbacks, and learning from experience. The initial stage of recovery is awareness that positive change is possible, and from there, being able to take an active role in the recovery journey. 6. Strengths-based: The mental health recovery journey builds on a person s strengths and talents, and moves forward through interactions with others in supportive, trust-based relationships. 7. Peer Support: Mutual support plays a key role in recovery. People with mental health conditions can encourage each other, share experiences, and provide each other with a sense of belonging and community. 8. Respect: Acceptance and appreciation of people living with mental health conditions including protecting their personal rights and eliminating discrimination and stigma. Selfacceptance and self-confidence also are vital. 9. Responsibility: Individuals have a personal responsibility for self-care, and their recovery journey. Working toward goals can require great courage. Identifying coping strategies and healing processes can promote wellness. 10. Hope: Recovery is a message of hope and understanding that people do overcome the barriers and obstacles that confront them. Peers, friends, and family can help to foster that hope. Hope is what can get the recovery process started. B.Judd 2014 Fair Use Applies Page 13
Through BRSS TACS, Ohio developed a working definition for recovery from mental health and substance use disorders. ODMH and ODADAS worked in partnership with stakeholders, advocacy groups and peers to develop the definition. This process involved a half day facilitated discussion, input through both departmental websites, and dissemination for public review. The resulting Ohio definition of recovery is not to be taken in isolation. It is intended to be accompanied by SAMHSA s 10 Guiding Principles of Recovery. "Recovery is the personal process of change in which Ohio residents strive to improve their health and wellness, resiliency, and reach their full potential through self-directed actions." Guiding Principles of Recovery Recovery emerges from hope: The belief that recovery is real provides the essential and motivating message of a better future that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Recovery is person-driven: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s). Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds? including trauma experiences? that affect and determine their pathway(s) to recovery. Abstinence is the safest approach for those with substance use disorders. Recovery is holistic: Recovery encompasses an individual s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated. Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery Recovery is supported through relationship and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change. Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations, including values, traditions, and beliefs, are keys in determining a person s journey and unique pathway to recovery. Recovery is supported by addressing trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration. Recovery involves individual, family, and community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery. Recovery is based on respect: Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems including protecting their rights and eliminating discrimination are crucial in achieving recovery. For further detailed information about the Guiding Principles of Recovery please visit: http://www.samhsa.gov/recovery/ http://mha.ohio.gov/default.aspx?tabid=440 B.Judd 2014 Fair Use Applies Page 14