The document discusses the relationship between meaning, spirituality, and health. It argues that the conventional view in medicine is that disease has no meaning and meanings don't matter, but provides evidence that this view is incomplete. It presents research showing that finding positive meaning and purpose can correlate with better health outcomes, while negative meanings like pessimism or lack of control can relate to poorer health. Overall, the document advocates that meaning, spirituality, and people's interpretations of illness are important factors in health that deserve more consideration within medicine.

1. “Spirituality, Meaning & Health”
Larry Dossey, MD

3. the meaning of meaning:
…what something represents,
symbolizes, signifies, conveys,
refers to, or stands for

4. The conventional view
of meaning and health:
Disease means
nothing, and
meanings don’t
matter.

5. The conventional view:
Disease is a result of the
disordered behavior of the
atoms, molecules, and
organ systems
in the body.

6. The conventional view:
The atoms in the body are
merely following the blind
laws of nature, which by
definition are
meaningless.

7. Making the molecules behave has led to
a very “anti” approach in modern
medicine:
antibiotics
antihypertensives
antiarrhythmics
antipyretics
antacids
antidepressants
antispasmodics
antivirals
antilipidemics
antiinflammatories 37 categories of
antihelmintics “antis”
anticholinergics
antidotes…

8. Meaning is considered
such a minor factor in Meaning —
life that we joke about it. how funny!

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11. the meaning of life

12. Illness means nothing.
Ascribing meaning to illness leads to
blaming the victim.
Susan Sontag
1933-2004 1978
”…Sontag argues that the myths and metaphors surrounding
disease can kill by instilling shame and guilt in the sick, thus
delaying them from seeking treatment.” — Publishers Weekly

13. Yet, saying that iIllness means nothing
is itself a meaning.
Meaning and illness are inseparable.
Susan Sontag
1933-2004 1978

14. Meaning is inescapable.
1885-1962
“The one certain thing is that a
statement like„existence is meaningless‟
is itself devoid of any meaning.”
— Niels Bohr
____________________________________________________________________
Niels Bohr. In: D. S. Kothari, First Steps to Jainism. Appendix C: Modern Physics
and Syadvada (Part 1). http://www.jainworld.com/jainbooks/firstep-2/syadvada-1.htm

15. Meaninglessness is pathological.
1875-1961
“Meaninglessness…is...equivalent to illness.”
— C. G. Jung

16. Does healing
involve more
than molecules?

17. …more than
molecules

18. …more than molecules

19. …more than
molecules

20. …more than
molecules

21. “The Doctor”
Sir Luke Fildes, 1887
Tate Britain, London

22. Q: If meanings matter,
do positive meanings
guarantee good health?
A: No, but they help

23. Spiritual meaning and its correlates…
Spirituality: the sense of connectedness with
something higher and greater than the
individual self or ego; the certainty that
meaning, purpose, and direction are valid
aspects of the world.

24. Spirituality & religion are not the same…
Religion: a codified system of beliefs, rituals,
and behaviors that may or may not involve
a sense of the spiritual; usually involves a
community of like-minded believers

25. Spiritual meaning and its correlates…
People who follow a spiritual path generally
live significantly longer, and have a lower
incidence of all major diseases, than
people who don‟t …

26. …but not always.
Sickly saints
St. Bernadette Ramana Maharshi The Buddha

27. Sickly saints
the nun’s breast biopsy

28. Healthy reprobates

29. Healthy reprobates

30. Healthy reprobates

31. Meaning can be a matter of life or death.
July 4, 1826
The deaths of John Adams and Thomas Jefferson
John Adams Thomas Jefferson
1735-1826 1743-1826

32. Meaning is often expressed
as optimism or pessimism
Is your glass half empty or half full?

33. Meaning: optimism vs. pessimism
Is your glass half empty or half full?

34. Positive meaning: optimism
Daniel B. Mark, MD, Duke University School of Medicine
• …followed 1,719 men and women following cardiac
catheterization. After one year, 12 percent of people
pessimistic about their health had died, compared to
5 percent of the optimists.
Daniel B. Mark, MD
_________________________________________________________________________
Henry Dreher. Mind-Body Unity: A New Vision for Mind-Body Science and Medicine.
Baltimore, MD: The Johns Hopkins University Press; 2003:59-60.

35. Positive meaning: optimism
Nancy Frasure-Smith, MD, Montreal Heart Institute
• Over the course of 18 months, heart patients who
scored high on pessimism were 8 times more likely
than optimists to die.
_________________________________________________________________________
Henry Dreher. Mind-Body Unity: A New Vision for Mind-Body Science and Medicine.
Baltimore, MD: The Johns Hopkins University Press; 2003:59-60.

36. Meaning is unique
The presence of illness probably never means
exactly the same thing in different individuals.

37. Two women with
heart disease and
an impending
divorce

38. Meaning is unique.
There are no “meaning formulas”
in health that work identically for
everyone.
Formula

39. Meaning is unique
Beware the literal read-out approach to illness,
in which the presence of illness is said to mean
a specific personality defect (e.g., cataract =
“you don’t have a clear
vision for your life”).
Formula

40. Meaning and health
“Psychological and social
precursors of coronary
disease”
— C. D. Jenkins
________________
New England Journal of Medicine.
1971; 284: 244-55.

41. Meaning and health
“Circadian variation
in the frequency of
sudden death”
— J. F. Muller et al
______________________
Circulation. 1987; 75: 131.

42. Meaning and health
Black Monday syndrome:
more heart attacks in men
occur on Monday around
9 a.m. than at any other
time (~20% increase).
_____________________________
Monday morning bad for your health.
CNNinternational.com. Feb. 3, 2005

45. What does going back to work symbolize
or represent in one’s life?
What is the meaning of Monday?

46. Job satisfaction
“Work in America:
Report of a Special
Task Force to the
Secretary of Health,
Education and
Welfare”
_________________________
Cambridge: MIT Press; 1973.

48. job sickness

49. Sisyphus reaction
(Syndrome of Joyless Striving)
_________________________________________________________
Karasek, R. A. & Theorell, T. Healthy Work: Stress, Productivity, and the
Reconstruction of Working Life. New York: Basic Books; 1990.
Work Environment Department, University of Massachusetts, Lowell, MA

50. Sisyphus reaction
(Syndrome of Joyless Striving)
• psychological stress
• lack of control of
the job task
_________________________________________
Karasek, R. A. & Theorell, T. Healthy Work: Stress,
Productivity, and the Reconstruction of Working
Life. New York: Basic Books; 1990.

51. Everything we do has meaning, and these meanings
matter — e. g., is it work, or is it exercise?
• 84 female housekeepers, 7 hotels
• Women in 4 hotels were told that
their regular work was enough to
meet the requirements for a healthy,
active lifestyle; women in 3 hotels were
told nothing.
• After 4 weeks, the informed
women had lost an average of 2 lbs.,
lowered their blood pressure 10%, and
had improved body-fat percentage and
body mass index, all statistically significant,
while exercise and dietary habits remained
constant between the two groups.
_____________________________________
Ellen Langer & Alia Crum. Mind-set matters:
Exercise and the placebo effect. Psychological
Science. February 2007.

52. The meaning of a birth date…
“A winter birth
significantly increases
the risk of schizophrenia.”
“The question is
no longer if the
seasons affect
mental health,
but how.”
_____________________________________________________________
Motluk, Alison. Born under a bad sign. New Scientist. January 27, 2007: 41-43.
http://www.newscientist.com/channel/being-human/mg19325881.700-born-under-a-bad-sign.html

53. Meaning
and the
immune
system
Lennart Nilsson, Behold Man

54. Lennart Nilsson, Behold Man

55. Lennart Nilsson, Behold Man

56. Grief and bereavement…
During this period, certain elements
of the immune system often shut down
and cannot be stimulated,
even by artificial means.
______________________________________________________________________
Schleifer SJ, Keller SE, Camerino M, Thornton JC, Stein M. Suppression of lymphocyte
stimulation following bereavement. JAMA. 1983;250(3):374-377.

57. Negative meaning:
grief and bereavement
In the year following the death of a
spouse, the surviving widow or
widower has a risk of
death up to 12 times
that of married
individuals of the
same age.
_______________
• James J. Lynch, The Broken Heart: The Medical
Consequences of Loneliness. NYC: Basic Books; 1977.
• Rees WD, Lutkins SG. Mortality of bereavement.
BMJ. 1967;13-16.

58. Dana Reeve
1961-2006
(lung cancer,
age 44)

59. Meaning
therapy
meaning
Coaching involves the restoration or transformation
of meaning in someone’s life.

60. Meaning therapy
Bereavement counseling for HIV-positive
survivors in the form of a bereavement
support group lowers the HIV viral load
in the survivors.
the AIDS virus
__________________________________________________________________________________
Goodkin K et al. A bereavement support group of group intervention affects plasma burden of
Human immunodeficiency virus type 1. Report of a randomized controlled trial. J. Human Virology.
2001;4(1):44-54.

61. Meaning therapy
“Can lifestyle
changes reverse
Dean Ornish, MD
coronary heart
disease?”
— Dean Ornish
________________________
Lancet. 1990; 336 (8708): 129.

62. Meaning therapy
“Intensive lifestyle changes for
reversal of coronary heart
disease.”
— Dean Ornish
_______________
J. American Medical Assoc. 1998; 280: 2001-7.

63. Meaning
A “glue” that holds our life
together, and that helps us
MEANING
make sense of healing
Glue, n. from the Greek gloios, “sticky”

64. I caused it!
New-Age Guilt
The tendency to shame and blame
oneself on getting sick

65. What does my
illness mean?

66. Maybe I
caused it!

67. I’m not good
enough!

68. I’m not smart
enough!

69. I’m not spiritual
enough!

70. It’s all my fault!

71. I’m a failure!

72. Maybe…

73. …I need…

74. …some self-
forgiveness!

75. Rx for New-Age Guilt

76. The healing power
of positive meaning
the potted-plant experiment

77. Ellen Langer & Judith Rodin
“The Effects of Choice and Enhanced
Personality on the Aged: A Field
Experience in an Institutional Setting”
________________________________________
J. Personality & Social Psychology. 1976; 34: 91-98

78. Within only three weeks, the potted-plant
group demonstrated improvements in
health and an increase in participation
in group activities.
________________________________________
J. Personality & Social Psychology. 1976; 34: 91-98

79. • By 18 months, their death rate
was reduced by 50 percent.
______________________________________________
J. Personality & Social Psychology. 1976; 34: 91-98

80. thank you!