840: 334 HEALING: SACRED AND SECULAR    

back to home page

840: 334 HEALING: SACRED AND SECULAR
Fall 2002
Dr. James W. Jones
Office: Loree 132
Office Hours: M 11:00-1200, W 10:00-12:00 , & by appointment
Ph.: 732-932-9623 [Please use this phone number and not email to contact Dr. Jones]

Purpose. This course will cover the latest research on the relationship between religion and health and will explore how different concepts of health and healing develop from different models of human nature.

Readings. The following books are at New Jersey Books on college avenue.
E. Sternberg, The Balance Within
L. Dossey, Healing Words
M. McGuire, Ritual Healing in Suburban America.
A packet of required articles is also available at New Jersey Books

Requirements. Each class period will be devoted to both lecture and discussion. Students are expected to have done the reading and come to class prepared with questions and comments for discussion. This is one of the reasons the class is being kept small. Class participation will be part of the final grade. There will be three brief (6-8 pages) essays due, as marked on the syllabus. The topic for the final essay will be given out the last day of class. No extensions will be given on any assignments.

Essays. One of the purposes of this course to help students learn to evaluate the research literature on religion and health. The essays will require students to critically evaluate and discuss this research. Each of the three required essays must contain at least three components: (1)reference to the specifics of the studies or texts that you have chosen to evaluate, and not a just report of general conclusions; (2)discussion of the strengths and weaknesses of these studies or texts; and (3)discussion of the implications of these studies for the specific topic of the essay and, where appropriate for such issues as the nature of health, for our understanding of religion, medicine, and human nature. No readings or references beyond the course material should be consulted. Students are required to do their own analysis and evaluation of the material. Violations of the university policy on academic integrity will be dealt with severely. The University Policy can be found at http://TeachX.rutgers.edu/integrity/index.himl.

COURSE OUTLINE

9/4/ Introduction - Religion and healing

Part One: Mind-Body Medicine

9/9, 9/11 Mind-Body Medicine: Psychoneuroimmunology
E. Sternberg The Balance Within (to be read throughout part one)

9/16/ Mind-Body Medicine: placebo effect
T. Hurley, "Placebos and Healing"

9/18/Mind-Body Medicine: biofeedback
Green, "Psychophysiology and health" and Green, "Science and
psychophysiology"

9/23; 9/25 Mind-Body Medicine: hypnosis
Madrid & Barnes, "Hypnotic Protocol for Eliciting Physical Changes"

9/30, 10/2; 10/7; 10/9 The scientific basis of mind-body medicine.
This section will be a combination of class lectures and video taped lectures from
a recent NIH Conference on Mind-Body medicined

10/14 Summary Mind-Body Medicine: Psychoneuroimmunology. First essay due at the start of class today: to what extent do the scientific findings presented in class, in Sternberg's book or the various lectures, explain the effects of mind-body medicine. No extensions will be given.

Part Two: Religion and Health

10/16; 10/21; 10/23; 10/28 Research: religion and health
Payne, Bergin, et.al., "Review of religion and mental health," and Levin &
Vanderpool, "Religious Factors in physical health," from Pargament, Maton,
Hess , Religion and Prevention in Mental Health; "Patient spirituality in clinical
care," Primary Care Reports, Oct. 16, 2000. McCullough, Larson, et. al,
"Religious involvement and mortality"; Scientific Research on Spirituality and
Health (National Institute for Healthcare Research), "Physical Health." (all to be
read throughout this section).

10/30; 11/4; 11/6 Research: religion, stress & coping
Hathaway & Pargament, "The religious dimensions of coping" from Pargament,
Maton, Hess , Religion and Prevention in Mental Health

11/11 Summary: Religion, mortality and health. Second essay due at the start of class today: critical review of the research on religion and health (you should choose two or three specific studies to discuss) - what do you see as the major implications of this research? No extensions will be given.

Part Three: Beyond Conventional Medicine

11/13; 11/18; 11/20 Transpersonal healing
L. Dossey, Healing Words, chapters 1, 2, 7-12, appendices 1-4.
E. Targ, "Evaluating distant healing," and "Distant healing and prayer -
Evidence and new directions"; Sicher, Targ, et. al., "A randomized double blind
study of the effects of distant healing …"; Harris, et.al., "A randomized,
controlled trial of the effects of remote, intercessory prayer."
11/25/no class
11/27/Thanksgiving vacation

12/2/; 12/6/; 12/9 Cultural context of Unconventional Medicine
M. McGuire, Ritual Healing in Suburban America, chapters 1, 6-10

12/11/ Conclusion.
Final essay topic handed out. Due back in one week

12/18 Final essays due by noon. No extensions will be given.

 

Psychoneuroimmunology Lecture Outline

1. Introduction: An integrated immune response: How is communication possible?

2. Research on neural immune communication

3. Behavioral Research: Personality factors and disease

4. Behavioral Research: Stress and disease

5. Conclusion: Is this really mind-body medicine?

I. The  Immune System

Lymphocytes: produced by lymphatic system, main IS cells destroy microbes, cancer cells

Macrophages – first on the scene, non-specific immune response, release cytokines

T-cells (thymus derived)

B-cells (bone marrow derived)

Phagocytes -

Natural killer cells (NK)

Cytokines – interleukins (IL1, IL2, etc). Proteins that signal between immune cells and between immune system and brain, produce coordinated immune response.

Corticosteroids, glucocorticoids (CORT), eg. Cortisol, hormones made in the adrenal glands, released during stress, have anti-inflammatory effects, suppress specific immune response and keep it from going out of control, modulates stress response after stress.

Immune system balance: compromised immune system – infection, cancer versus overactive immune system - allergy, autoimmune/inflammatory diseases (rheumatoid arthritis, lupus, MS, firbomyalgia, etc).  The stress response shifts the immune response, mainly reducing it, and so is anti-inflammatory. If  hormonal system connected to the stress response is compromised, the immune system does not down-regulate and inflammatory/autoimmune diseases are likely. A low level of glucocorticoids suggests that there is not enough to turn down the immune system and autoimmune/inflammatory disease can result. A high level of CORT, say because of stress, suggests the immune system may be severely reduced and so the person is more susceptible to infections and perhaps cancer. So there must be a balance: the immune system must function powerfully enough to guard against infection and perhaps cancer and yet not become out on control and cause autoimmune and inflammatory diseases. Corticosteroids appear to have a major role in maintaining this balance.

II. Central Nervous System

Neurotransmitters: chemicals which transmit messages between nerve cells. Neuropeptides (endorphins, enkephalins): neurotransmitters, natural pain killers, natural opiates, also regulate IS.

Limbic System (Pituitary, hypothalamus): main emotional center and major source of neuropeptides.

Hypothalamic-pituitary-adrenal axis: together produce the stress response thru release of gluococorticoids and norepinephrine

III. Stress

Holmes-Rahe Stress Scale

Norepinepherine: neurotransmitter of sympathetic nervous system, regulates IS. Fight/flight response: activation of sympathetic nervous system.

                 STUDY GUIDE FOR THE FOUR VIDEOTAPES

While I am away for four class periods you will be watching four videotapes from a recent National Institutes of Health conference on the scientific status of Mind-Body Medicine. At the end of this you will be asked to write an essay on the extent to which you think these scientific findings account for the clinical material (hypnosis, biofeedback placebo effect, etc) that we have been talking about the last few weeks. Specific reference to the relevant conference talks is expected on this essay. This conference represents the current state of what Larry Dossey calls Era II medicine. Much of the focus is on the relationship between emotions and health. Remember two things. First, this conference was four full days and so I have selected a few of the talks for you to see. Mainly I removed talks that were repetitious or very, very technical. So some of the speakers will be referring back to lectures you have not heard. Second, this is not a course in physiology and so you are not responsible for the biological details but rather for the general principles.

Note: some of these tapes are a few minutes longer than the class, feel free to leave if you must when the class period is over if you have to.

Day I (10/1/01)

First speaker is Nancy Adler, Ph.D., from the University of California speaking on social-economic status and health. Her talk at the opening session set the agenda for the conference. Her talk is an excellent example of what I called medical pluralism. The second speaker is Esther Sternberg, MD, from the National Institutes of Health. Her talk builds on much of the material in her book and will make more sense if you’ve finished the book by this time.  Her lecture will provide a way to review some of the neural-immune connections we’ve been discussing. The third speaker is John Sheridan, PhD, of Ohio State speaking on how interpersonal experience has a direct effect on the immune system and therefore on health. He provides a good illustration of the physiological connections between the nervous system and the immune system. His example is Herpes where the virus remains latent in the genetic material of the cell and becomes re-activated under social stress. Remember: for this course our concern is to get a sense of how complex and interconnected the system is and what the general principles are, not the specific physiological details.

Day Two (10/3/01)

This tape contains a single lecture by Antonio Damasio, MD, PhD. Dr. Dmasio is probably the leading neurologist to think and write about the relationship of consciousness, emotions, and the brain and body. His two books Descartes Error and especially The Feeling of What Happens are masterful expositions of the problem of consciousness from a neurologist’s perspective. Pay close attention to how he uses the term “consciousness” and associated terms. How confident is he really that the so-called “mind-body problem” (the relationship of consciousness and the brain) has been solved by current neurological research? How convinced are you? Remember that for mind-body medicine to make sense, there must be reciprocal  communication  between consciousness and the brain and between the brain and immune system. Most of the talks at this conference concerned the brain and the immune system. Dasmaio’s job was to establish causal links between consciousness and the brain. He clearly demonstrates, as will the speakers on Monday’s tapes, that brain activity impacts conscious experience (thoughts, feelings, intentions). How well in your opinion does he also establish a scientific basis for conscious experience impacting back on brain/body function? Remember to keep your focus on general principles and not get lost in neural-physiological detail.

Day Three (10/8/01)

Following on Antonio Demasio’s talk, in this video three speakers discuss the specific neurophysiology of  behavior and emotion and some of the neural pathways that connect the emotional centers in the brain and the immune system. First speaker is Richard Davidson, Ph.D., University of Wisconsin, talking in detail about the neurophysiology of emotion, the physiological basis of affective experience, and how “affective style” effects health through the mediation of  the immune system. Note his closing example of research on effects of meditation. The second speaker is David Amaral, PhD, of the University of California, talking about the neurobiology of fear, anxiety and social behavior. Following Amaral’s talk, the third speaker is Paul Whalen, PhD, of the University of Wisconsin, talking about fear and anxiety behavior and the role of the amygdala and some of the ways social interaction affects the brain.

Day Four (10/10/01)

This video shows three lectures reviewing the research on the biological and medical effects of social experience. As you watch these lectures pay particular attention to what seem to be some of the physiological and psychological  factors mediating between social experience and disease or health. The first speaker is John Cacioppo, PhD, of the University of Chicago, reviewing research on social isolation and disease. Note how social/political issues have become the concerns of physicians and epidemiologists; we will return to this point at the end of the course when we discuss the medicalization of society. Having reviewed research on the physiological effects of social isolation, the next talks discuss the potential positive effects of social connection. The second speaker is David Spiegel, MD, of Stanford, who pioneered the use of support groups in the treatment of cancer victims. Pay attention to some of the characteristics of the psychological interventions that appear to aid in cancer survival. The third is Sheldon Cohen, Ph.D., of Carnegie Mellon University who provides a nice general overview of some of the connections between the positive and negative health effects of social experience. What social experiences seem most salient in contributing to health and to disease?