Breakout session from the Cancer Survivorship Conference held on May 29, 2015 titled: Moving Toward Wholeness: The Relationship between Spiritual, Physical & Mental Health

1. Moving Toward Wholeness:
The Relationship Between Spiritual,
Physical, and Mental Health
Andrew Newberg, M.D.
Director of Research
Myrna Brind Center of Integrative Medicine
Thomas Jefferson University and Hospital

2. What is Wholeness?
Wholeness refers to the sense of unity or
connectedness people can feel with other things
Wholeness can refer to a person’s physical
health and well being
Wholeness can refer to a person’s spiritual
experience or spiritual well being
Wholeness relates to certain brain structures
and functions

3. The Brain and Wholeness
First we must understand how and where
wholeness is experienced
Use phenomenological analysis to
understand wholeness
Correlate wholeness with brain processes
Use modern scientific methods to better
understand biological correlates of wholeness
Neurotheology as a framework for this
discussion

4. When and Where Does
Wholeness Occur?
Wholeness is central part of every religious
and spiritual tradition
Central tenet is that we are separated from the
source (i.e. something sacred or absolute)
The goal is to reconnect and become whole
with God or Absolute reality
Primary means for attaining wholeness is
through various practices
Ritual, meditation, prayer

5. Wholeness in the Brain
Binary function of the brain (inferior parietal
lobe)
Orientation area of the brain (superior
parietal lobe)
Rituals, meditation and prayer can alter
activity in the parietal regions
Brain scan studies of meditation and prayer
practices
These practices also affect the body
creating health and wholeness

6. Other Brain Areas Involved in
Wholeness
Emotions related to limbic system
Amygdala and hippocampus
Frontal lobes associated with increased
attention and willfulness
Modulates emotion
Sense of surrender
Thalamus regulates brain functions and
consciousness

7. Functional Areas of the Brain

8. Orientation Area Orientation Area
Baseline Meditation
SPECT Images at Baseline and
During Meditation

9. SPECT Images at Baseline and
During Meditation
Baseline Meditation
Attention Area Attention Area

10. Superior
Parietal Lobe
Superior
Parietal Lobe
Baseline Scan Prayer Scan
Comparison of Baseline to Prayer

11. How Do Spiritual Practices Change
Your Brain over time?
Combine imaging and other scientific measures
with subjective and phenomenological
evaluation
Longitudinal findings
Comparison of long-term meditators with non-
meditators
Do spiritual practices affect the brain over time?
Kirtan Kriya and memory study

12. Kirtan Kriya Meditation Study
A
C
B
D

13. Neuroemotional Technique
NET is a program that utilizes several
different concepts to provide a sense of
wholeness and reduce stress and anxiety
NET utilizes concepts from acupressure,
biofeedback, and cognitive therapy
NET has been particularly effective in
helping patients with various health and
psychologically related traumas

14. Cancer and Stress
Stress can manifest in a variety of physical and
psychological symptoms
Referred to in the cancer literature as “Distressing
Recollections”
About 1/3 of cancer patients have distressing
recollections
These distressing recollections cause as much
morbidity as PTSD
The two primary psychological symptoms of
distressing recollections are avoidance and
intrusive thoughts

15. Avoidance
Avoidance is driven by strong unpleasant
feelings (primarily fears) triggered by trauma-
related thoughts, places (i.e. hospitals, doctor’s
offices, etc.)
Likely associated with increased amygdala
activity
Avoidance is manifested through staying away
and escaping these provocative cues

16. Intrusive Thoughts
Involuntary, unwanted thoughts,
memories or images
Intrusive thoughts are usually upsetting
and often indicate an ongoing coping
and mental processing of an unresolved
stressful event

17. Jefferson-NET Study
To assess the effect of the NET program on cancer
patients with a history of distressing trauma
To evaluate the effect of the NET on brain function
Patients must have a history of cancer and a
related distressing psychological trauma
Patients are screened, evaluated for inclusion
criteria, undergo psychological evaluation, and then
scanned in the fMRI
After the NET program patients again undergo
psychological evaluation and fMRI

18. Study Design-Subjects
Inclusion Criteria
Age ≥18 years of age
Distressing cancer-related recollection that causes physiological reactivity
(i.e., increased heart rate >5% and/or increased skin conductance level
>33%).
Received a cancer diagnosis between 6 months and 3 years prior to
participating in study
Exclusion Criteria
Any current major psychiatric disorder
History of depression before the cancer diagnosis
Current diagnosis of substance abuse or dependence
Use of some psychotropic medications are allowed such as SSRIs and
certain sleep aids
Currently receiving chemotherapy or radiation

19. fMRI Protocol
Structural scan – required to provide anatomical information
Resting functional connectivity scan (BOLD) (pre) – shows how
different structures are connected to each other
Diffusion tensor imaging (DTI) scan – shows actual connecting
tracts within the brain
Resting perfusion (Arterial Spin Labeling) scan (pre) – shows
the brain’s activity at rest before the stressor task
Neutral perfusion (ASL) scan – shows the brain’s activity while
listening to a control stimulus
Stressor perfusion (ASL) scan – shows the brain’s activity while
listening to the stressor stimulus
Resting functional connectivity scan (BOLD) (post) – shows
how different structures are connected to each other

20. fMRI Results

21. Perfusion fMRI
Stressor – Neutral
Pre NET Treatment

22. Perfusion fMRI
Stressor – Neutral
Post NET Treatment

23. Functional Connectivity Between the Amygdalas
Pre NET Treatment
Pre- Stressor Induction Post- Stressor Induction
LR R L
R=0.36 R=0.50

24. Functional Connectivity Between the AmygdalasFunctional Connectivity Between the Amygdalas
Post NET TreatmentPost NET Treatment
LR R L
R=0.37 R=0.34
Pre- Stressor Induction Post- Stressor Induction

25. Diffusion Tensor Imaging (DTI)Diffusion Tensor Imaging (DTI)
After the NET program,
the fiber density
increased between the
frontal lobes and
amygdala by ~50%.

26. NET Conclusions
The data show marked changes in the fMRI
results between the pre and post NET scans
The amygdala is highly reactive pre-NET and
actually decreases in reactivity post-NET
The frontal lobe appears to be able to
modulate the amygdala’s reactivity post-NET
The NET program normalizes the brain’s
reaction to trauma (stressor)
We now await more data to confirm and
augment these initial findings

27. Final Conclusions: Can we foster
wholeness and well being?
We can turn to practices and beliefs that foster
more compassion, wholeness and well being
Find practices that work best for you and are
consistent with your belief system
Specific practices such as meditation and
prayer affect the wholeness areas of the brain
Practices like NET lower stress response and
anxiety
Wholeness can ultimately fill your brain, health,
and life

30. The End
Andrew Newberg
Jefferson-Myrna Brind Center of
Integrative Medicine
215-955-2221
Andrew.newberg@jefferson.edu
215-503-3422