Contemplative Practices in Action 15] Index, About the Editor and Contributors

 15] Index

 

Abandonment to Divine Providence

(Caussade), 68 Abba, God as, 63 Abiding Prayer, 74

ablution, 127

Abraham (Prophet), 123 absorption of spiritual content, 40 academic coursework, Passage

Meditation and, 53–54

acceptance, 25

accompaniment, 226 active prayer sentence, 69 Adon Olam, 110

adrenaline, 164

advocacy, 226

Aitken, Robert, 161

Alcoholics Anonymous, 239

Allah, 124

altered consciousness, pain and, 217–18

Aminah, K., 137

amygdala, 172

Anthology of Christian Mysticism (Eagan), 71–72

anxiety, mindfulness and, 19

apophatic prayer, 66, 197–98

Arico, Carl, 74

art therapy, mindfulness-based, 29 asana (postures), 146, 147

Askwith, Richard, 240

 

Astin, John A., 28, 69–70

attention: essential nature of, 8, 9;

mindfulness and, 30; training, 1, 10–11t

attitude, mindfulness and,  30 attitudes, cultivation of, 25–26 austerity or burning desire (tapas), 147

Austin, James, 169, 173; Selfless Insights,

169; Zen and the Brain, 169;

Zen-Brain Reflections, 169 autonomic nervous system, mindfulness

and, 28

Axis I and II disorders, mindfulness and, 28

Azhar, M. Z., 137, 138

Azusa Street revival (1906), 209

Baal Shem Tov, 115 Bandura, Albert, 47 Baucom, D. H., 28 Beddoe, A. E., 26 beginner’s mind, 25

behavior, human models of, 47 being present, 168

Benson, Herbert, 2, 86–87, 107;

Relaxation Response, 42

Berry, Wendell, 241 Bhagavad Gita, 38f Bhakti yoga, 146

Bill W., 239

 

bio-psycho-social-spiritual pain model, 206–7

Birchot HaShachar, 112 Blessings of the Dawn, 112 Bodhi, 30

“Body, Mind, Spirit: Yoga and Meditation,” 154

body scan, 21–22

Boorstein, Sylvia, 159

boundless compassion, 160–61

boundless equanimity, 160–62 Bourgeault, Cynthia, 63; Centering

Prayer and Inner Awakening, 65

Brahma Viharas, 160–62

brain function, Zen and, 172, 174

breath meditation, 20–21, 192

bridging tool, 42 Bromley, D. G., 212 Brown, K. W., 30

Buddhism: faces of love in, 160–61; mindfulness and, 18

Burkan, Tolly, 213 “B’yado afkid ruchee,” 110

“calming” practices, 225 Carlson, L. E., 30 Carmody, J., 28

Carson, J. W., 28

Cassian, John, 63–64; Conferences, 63–64

Castan˜ eto, May Lynn, 70 Castellanos, Isabel, 74–75

cataphatic prayer, 66

Catch it, Check it, Change it, 87 Catechism of the Catholic Church, 62–63 Caussade, Jean-Pierre de: Abandonment

to Divine Providence, 68 centering, 9, 10–11t, 13

Centering Prayer, 7, 9, 192;

accompanying practices, 67–69;

applications, 71–74; cross-cultural

considerations, 74–75; distinguish- ing features, 66–67; experimental studies, 69–71; four guidelines, 63–64; historical roots of, 63–64; methods, 64–69; personal relation- ship with God, 61; religious context, 61–63

 

Centering Prayer and Inner Awakening

(Bouregeault), 65

character strengths, 9

Charismatic Christianity, 209, 211–12,

220–21

Chief Yellow Lark, 38f Christian contemplative prayer

tradition, 9, 60–61, 62, 192 chronic pain, spiritual practice and:

applications for health practitioners, 219–20; biological, psychological, and social factors, 206; historical and religious context, 207–11; music and dance, 208; and punishment by God, 207

“Circle of Living Voices” meditation, 191

cleanliness (saucha), 147

cognitive-behavioral interventions, mindfulness and, 29–30

coherent resemblance, 8

Coleman, Arthur, 215

college students, Passage Meditations and, 51–52, 52f

Comparative Effectiveness Research, 97 compassion, 9

complete attention (dharana), 148 concentration, 1, 9, 148

Conferences (Cassian), 64

contemplatio (resting), 68 contemplation and consciousness,

Islamic practice of, 145 Contemplative Non-Dual Inquiry, 70 Contemplative Outreach, 62

contemplative practices, 1, 192; Eastern and Western traditions, 3; faith traditions and, 2; interconnectedness of, 243; introduction to, 226–27;

secularization of, 2

contemplative spirituality, 64 contemporary rock music, spirituality

and, 215

content absorption, 41

contentment (samtosa), 147 control of sensual pleasure

(brahmacharya), 147

conversion in Christian tradition, 193 Cook, Francis, 165–66

 

coping, suffering and, 230

coping styles, Relationship-with-God, 70 courage, 9

cultivation of attitudes, 25–26 cultivation of silence, solitude, and

service, 67

curiosity, 26

da Silva, T. L., 152, 153 dance, spirituality and, 208 dance theology, 211

dance therapy, 219–20 Davidson, R. J., 29 Dench, Judi, 235

denial, 227–31, 230

DePaul  University,  154 depression symptoms, mindfulness

and, 19

Dervish spirituality, 209–10

desert spirituality, 63–64 Desikachar, T. K. V., 146–47 dialectical behavior therapy (DBT),

29–30

Discourse on Good Will, 39f discrimination, slowing down and, 84 Divine Therapy and Addition: Centering

Prayer and the Twelve Steps

(Keating), 74

Dogen, Eihei: Genjo Koan, 167

dranpa, 17

drumming, chronic pain and, 218

Eagan, Harvey: Anthology of Christian Mysticism, 71–72

Easwaran, Eknath, 14, 39f, 46t, 79; The Mantram Handbook, 81; Passage Meditation: Bringing the Deep Wisdom of the Heart into Daily Life, 40, 53–54

eating, mindful, 23–24, 29 educational interventions, Passage

Meditation and, 35–36 EDUCIZE (dance therapy), 219–20 Edwards, Tilden, 61

Egyptian Desert experience, 61–62 eight-point program of Passage

Meditation, 35–56, 36t, 79–80

Ein Sof, 109

ekagratha, 43

 

electroencephalogram studies, 19–20 elements of practice, Passage

Meditation and, 10–11t, 12–14, 12f emotionalism, 218

endogenous opioid pathways, pain and, 216–17

endorphins, pain and, 216–17 energizing spiritual practices, 211–12,

215–19, 225

English class, Passage Meditation and, 53–55

epinephrine, 164 “establishing the prayer,” 125 Examen meditation, 191 exemplars, learning from, 47 experiential religion, 209

extreme ritual performances, 212–15

faith traditions: commonalties across, 14; Passage Meditation and, 37–38; practice systems and, 7–8

family caregivers, mantram repetition for, 94–95

fearlessness, 9

Fetzer Institute, 69

fight-or-flight reaction, 164, 216–17

fire-handling, 212–13, 214, 218–19

forgiveness, 9

Freeman, Laurence, 61

Full Catastrophe Living (Kabat-Zinn), 25–26

Gallagher, W., 43

Genjo Koan (Dogen), 167 gentleness, 26

Germer, C. K., 31 Gil, K. M., 28

Gingerich, Orval, 240

God, one hundred names for, 234 Goleman, Daniel, 8; The Meditative

Mind, 1 

grief, 237

guided meditations, 190–91

Hamilton Rating Scale for Depression, 138

Hanh, Thich Nhat, 161; “Am I sure?” 175–76; Teachings on Love, 161

 

Hasanah, C. I., 137

Hasid, Yaakov Koppel, 115 Hatha yoga, 22, 146

health interventions, Passage Meditation and, 46t

hesychia, 63

higher education classes, yoga and, 154–55

Higher Self or Soul, 144

HIV, mantram repetition and, 87, 88,

96–97

Hoelter, L. F., 212

holy name (mantram) repetition, 41–42 hospital-based caregivers, Passage

Meditation and, 48–51 hospitals, Centering Prayer in, 73

The Human Condition: Contemplation and

Transformation (Keating), 67

humanity, 9

humility, 196

hyperarousal, 164, 217–18

hyperstress hypothesis, 218

IAA (intention, attention, and attitude), 30

Ignatian Colleagues Program, 240 illumination in Christian tradition,

195–96

immersion, 226, 240

“Impacts on Future Generations” meditation, 191

Indian mythology, 145–46

Indian yoga, 43

informal mindfulness practices, 8, 22–23

insight meditation, 19

Inspirational Reading, 45, 47 integral contemplative practice

system, 13

integrated contemplative practice, 7, 8–9

intention, mindfulness and, 30 intercession,  226, 231–36 Intimacy with God (Keating), 67 Into the Silent Land (Laird), 71–72 Islamic tradition, contemplative

approach to: applications and interventions, 138–39; context,

 

123–24; cultivation of attitudes, 134–35; dimensions of practice, 124–36; formal practice, 124–25; informal practices, 131; literature review, 136–37; new research directions, 140; obligatory prayers, 124–25; remembrance of Allah, 131–32; specific contemplation and reflection, 133–34; spiritual

models, 135–36

isolation, suffering and, 231–36 Iyengar yoga, 153

James, William, 1

Jantos, Marek: “Prayer as Medicine: How Much Have We

Learned?” 107

Jesus, 124

Jesus Prayer, 61

Jewish contemplative practices, 109–11; applications, 120; in context, 104–7; dimensions of the practices, 107–8; meditation, 114–16; prayer, 111–14; review of literature, 119–20; Sabbath time, 116–19

Jnana yoga, 146

Joplin, Janis, 239

justice, 9

Kabat-Zinn, Jon, 19, 23, 29; on fight- or-flight reaction, 164; Full Catas- trophe Living, 25–26; on preception and stress, 162; turning toward suffering, 167; Zen mindfulness practices, 176

Kaivalya pada, 145

kappa opioid receptors, chronic pain and, 216–17

karma, 166

Karma yoga, 146

kavannot, 106

Keating, Thomas, 61, 62; Divine Therapy and Addition: Centering Prayer and the Twelve Steps, 74; The Human Condition: Contemplation and Transformation, 67; Intimacy with God, 67; Open Mind, Open Heart, 65

 

kenosis, 63

kensho, 173

Khalsa, S. B., 151, 152, 156

khikr, 131–32

Kiat, Hosen: “Prayer as Medicine: How Much Have We Learned?” 107

Kristeller, J., 28

kriyayoga, 145

Kundalini yoga, 146

Kwon, Hee-Soon, 74

Laird, Martin: Into the Silent Land, 71–72

Lakota Sun Dance tradition, 208 lamentation, 226, 227–31

Lazarus, Richard, 70

leadership, contemplative practices and, 197–98

Leadership Calling meditation, 191

lectio divina (sacred reading), 45, 68, 191

letting go, 25

liberal arts education, Passage Meditation and, 53–54

lighting candles, Jewish practice of, 118–19

limbic system, perceptions and, 172 the “little way,” 196

loss: characteristics of people facing, 225; of a child, 237–38; suffering

and, 236

loving kindness, 26

Loyola, Ignatius, 191, 225, 227

Maimonides, Moses, 115

Main, John, 61

maitri (boundless kindliness), 160–61 maladaptive thinking, 87

mantra, 79

Mantra yoga, 146

The Mantram Handbook (Easwaran), 81 mantram repetition, 7, 8, 41–42, 42,

81–84, 82t; applications and interventions, 92–96; author’s experience with, 80–81; choosing a mantram, 81–82; explanation of, 79–80; historical perspectives,

85–86; literature review, 86–87;

mental/cognitive perspective, 87;

 

new research directions, 96–97; physical mechanisms, 86; program of research, 88–89; psychological/emotional mechanisms, 87; published

research, 89–91t; religious/spiritual mechanisms, 88

“Mantram Repetition for Relaxation” (course), 88

mantram walk, 83

Masters, Kevin S., 112, 116; “Prayer and Health,” 107

May, Gerald, 61

MBRE (mindfulness-based relationship enhancement), 29, 30

MBSR (mindfulness-based stress reduc- tion), 8, 9, 19, 28–30, 43, 51;

and poetry, 26–27; and spiritual models, 26–27

McConnell Prison Unit, 73 McCullough, M. E., 108

medical disorders, mindfulness and, 28 meditatio (reflecting), 68, 191 meditation, major approaches, 1

The Meditative Mind (Goleman), 1 Menninger, William, 61

mental centering/stabilizing practices, 8

Merriam, P., 28

metta, 44

Mevlevi order spirituality, 210 Middle Path, 44

Mind-Body Medicine Research Group, 69–70

mindful attitudes, 10–11t mindful awareness, 30

mindful eating, 23–24

mindful practice, 30

mindfulness, 1, 7, 17–31, 163, 192; adverse effects of, 30; applications and interventions, 28–30; context, 18–19; dimensions of the practice, 19–30; and health, 160; neuroscientific study of, 31; new research directions, 30; one- pointed attention, 85; other considerations, 27; Passage Meditations and, 52; popularity of

 

current approach, 2; seven attitu- dinal foundations of, 25–26; and stress response, 19; theoretical and empirical literature, 27–28; three key elements of, 30

mindfulness-based eating awareness, 29 mindfulness-based stress reduction

(MBSR), 8, 19

mitzvot, 104

Mizo spirituality, 210–11

mock hyperstress hypothesis, 218

Molecules of Emotion: The Science Behind Mind-Body Medicine (Pert), 108

Montana State University, 29 Moses (Prophet), 124

Mother Teresa of Calcutta, 196 mothers in labor, mantram repetition

for, 95–96

mudita (sympathetic joy), 161 Muhammad (Prophet), 131

multitasking, 43

Mungo, Savario, 72–73 music: chronic pain and, 218;

spirituality and, 208

music therapy, 220

Muslim spirituality, 209–10

Mythbusters (television), 213

Nadwi, Sulaiman, 125

naming god, 234

Native American spirituality, 208

neshamah (soul), 113

neshimah (breath), 113 neurobiology: meditation and, 160;

Zen and, 169–75

neuroimaging evidence, 9 New Age movement, 213 niyamas, 147

nonattachment, 26

nonavariciousness (aparigrha), 147 nonclinical populations, mindfulness

and, 28

nonfatal myocardial infarction, 42 nonjudging, 25

nonobligatory prayers, Islamic tradition of, 130–31

nonreactivity, 26

nonstealing (asteya), 147

 

nonstriving, 25

nontheistic inspirational passages, 39f nonviolence (ahsima), 147

not-knowing, 165

obligatory prayers, Islamic tradition of, 124–25, 127–30

observing the breath, 20–21

one-pointed attention, 43–44, 45, 85 Open Mind, Open Heart (Keating), 65 oratio (praying), 68, 191

outcome measures, mindfulness and, 30–31

pain, spiritual practice and chronic, 205–22

Pargament, Kenneth I.: Relationship- with-God coping styles, 70

Parvati, 145–46

Passage Meditation: Bringing the Deep Wisdom of the Heart into Daily Life (Easwaran), 40

Passage Meditation (PM), 7, 8, 35–37, 36t, 47; academic coursework and, 53; college course, 51–52; contemporary challenges, 37t; eight-point program, 35–56, 36t; four modeling processes, 47; and health interventions, 46t; by health professionals, 50f; history and con- text, 36–37; instructions, 40; program, 37–45; and spiritual modeling, 47–48; and traditional religion, 46t; transformational nature of, 40; two dimensions of, 40–41; two strengths of, 35–36; and

workplace professionals, 48–51

Patanjali, 143, 144

patience, 25

Peace, Justice and Conflict Studies program, 155

“Peace for Activists,” 154 Peck, Edward, 240

Pennington, Basil, 61

Pentecostal spirituality, 209, 211–12,

214, 217–18

perceived threats, 175–76

personal koans, 176

 

Pert, Candace: Molecules of Emotion: The Science Behind Mind-Body Medicine, 108

pilgrimage, 226, 238–40

Pizzuto, Vincent, 71–72 PM. See Passage Meditation

poetry, spiritual modeling and, 26–27 Poloma, M. M., 212

positive emotional states, mindfulness and, 19

posttraumatic stress disorder, 44, 93

powerlessness, 236

practice systems, 7–8, 10–11t praise, spiritual practice and, 235

pranayama (yogic breathing), 146, 147 pratyahara (sensory withdrawal), 148 “Prayer and Health” (Masters), 107 “Prayer as Medicine: How Much

Have We Learned?” ( Jantos and Kiat), 107

prayer of intention, 66

Prayer of St. Francis of Assisi, 38f, 53 prayer (pillar of Islam), 124–30 precari, 112

prescribed  postures,  9 prescribed prayers (Islamic), 126 Prier dans le Secret, 74

Prince, R., 218

prison, Centering Prayer and, 72 Prophet Muhammad, 131, 135–36

Psalm 23, 38f

psychological interventions, Passage Meditation and, 35–36

psychotherapy: Centering Prayer as adjunct in, 73; chronic pain and, 221; Muslims and, 137

PTSD (posttraumatic stress disorder), 44, 93

purification in Christian tradition, 193–95

Putting Others First, 44

Raja yoga, 146

Ralte, Lalrinawmi, 210–11 Ravindran, A. V., 152 Ravindran, L. N. B., 152 Razali, S. M., 137 receptive meditation, 66

 

receptivity, 239

Reed, J., 28

relapse prevention, mindfulness-based, 29, 37

Relationship-with-God coping styles, 70

relaxation response, 86

Relaxation Response (Benson), 42 religiosity and mental health, 136–37 religious psychotherapy with Muslims,

137–38

Religious Science/Science of Mind, 70 right view, Zen and, 175–76

Rinzai Zen, 162

ritual performances, extreme, 212–15 ritual washing, Jewish practice of,

118–19

Robbins, Tony, 213

rock music, spirituality and, 215 Roshi, Darlene Cohen, 247; Turning

Suffering Inside Out, 176 Rumi, Jalaluddin, 26–27, 39f, 210

“runner’s high,” 216–217 Ryan, R. M., 30

Sabbath, 107

sacred words, 65, 66

Sadhana pada, 145

Samadhi pada, 145

samadhi (union with the Divine), 148 Santa Clara University, 29

sati, 17

satori, 173

Scholasticism, 64 Schwartz, G. E., 26

SCT (social cognitive theory), 48 self-efficacy, 48

Self-Realization, 145

Selfless Insights (Austin), 169

Sema (whirling dervish dance), 209–10 serotonin pathways, pain and, 215–16 serpent handling, 214–15

set-aside time, 8–9, 10–11t

Shabbat, 116

Shalem Institute, 61

shared themes, 7–14

sheaths of being (koshas), 144 Shema, 113

 

Siegel, Daniel J., 18–19

Silicon Valley, cultural aspects of, 183 Silicon Valley leaders, meditation

practices of, 183–201

sitting meditation, 8, 20

“slain in the spirit” injuries, 212 slowing down, 42, 43, 45

smrti, 17

social cognitive theory (SCT), 47, 48 social support, importance of, 45 Soeng, Mu, 165

“Song of the Jewel Mirror Samadhi,” 167

Soto Zen, 161, 162

Sperry, Len, 73

Spezio, Michael, 69

Spiritual Association, 45

“spiritual but not religious,” 35, 36t spiritual content, absorption of, 40 spiritual edgework, 212–15

“Spiritual Engagement Project,” 69–70 spiritual fellowship, 13

spiritual journey in Christian tradition, 192–93

spiritual modeling, 26–27, 36, 47 spiritual modeling theory, Passage Meditations and, 51–52

spiritual models, 9, 10–11t, 26–27,

46–48

spiritual practice, U.S. adult interest in, 13

spiritual shopping, 13

spirituality, 9; chronic pain and, 206–7; mindfulness and, 28; physical phenomena and, 211; in the workplace, 14

Spirituality and Health Institute (SHI), 8

Spirituality for Organizational Leadership, 183–84; leadership day, meditative practices and the, 197–98; meditation forms, 190–92; overall pedagogy, 184–86; presence meditation, 186–87; role of contemporary organizations, 187–90

St. Benedict’s Rule, 62 St. Francis de Sales, 65

 

St. John of the Cross, 62 St. Mary Marish, 61

St. Therese of Lisieux, 196 stabilizing, practices for, 9 Strength in the Storm, 88 stress, Zen and, 162–64 stress hormones, 164

stress management, mindfulness and, 19, 28

stress responses, 169–75 stressors, chronic and acute, 19 study of sacred scriptures

(svadhayaya), 147

Subramaniam, M., 137 Sudarshan Kriya Yoga, 153

suffering: coping and, 230; spiritual dimensions of, 226–27

Sufi spirituality, 209–10 Sun Dance tradition, 208 Sunnah, 123, 135–36

supplication, Islamic practice of, 132 support groups, Centering Prayer and, 72 surrender to God (isvara pranidhana), 147 Sutras. See Yoga Sutras

sympathetic joy, 161 Syncletica, Desert Mother, 63

tafakkur, 122

Tao Te Ching, 39

Teachings on Love (Hanh), 161 temperance, 9

Templeton Foundation, 69

Tetragrammaton, 106

theistic inspirational passages, 38–39f Thoresen, C. E., 105

time commitment, set-aside, 8–9, 19–20 time/urgency and impatience

syndrome, 42

Tong Len, 185, 191, 192

Toronto Airport Christian Fellowship (TACF), 211

“Toronto Blessing,” 211 traditional religion, Passage

Meditations and, 46t Training the Senses, 44 transcendence, 9

Transcendental Meditation (TM), 37, 86, 192

 

trust, 25

truthfulness (satya), 147

Turning Suffering Inside Out

(Roshi), 176

Twelve Step programs, 239

Twelve Step recovery, Centering Prayer and, 74

Universal Self, 145

Universal Spirit (Brahman), 143, 144 Upanishads, 39f

upeksha (boundless equanimity), 160–61

Varma, 137, 138

Vatican II, 62

Vedas (1700–900 BCE), 143, 144

Vibhuti pada, 145

Vieten, Cassandra, 69–70

Vipassana, 19, 37

virtues and character strengths, 9

W., Bill, 239

walking meditation, 24–25, 192

Walsh, Roger N., 14, 107

Weil, Simone, 226–27

Welcoming Prayer, 68

“whirling dervish” dance, 209–10 Whitman, Walt, 26–27

widu, 127

Willemsen, Eleanor, 70

wisdom, 9

“Without Fear” (Zen story), 159

 

work-free Sabbath, Jewish practice of, 119

workplace professionals, Passage Meditation and, 48–51

World Community for Christian Meditation, 61

worldview, valid and coherent, 13

yamas, 147

Yoga: applications and interventions, 154–55; contemplative practice of, 144–46, 146–51; eight limbs of, 147; new research directions, 156–57; as a practical discipline, 148; review of literature, 151–52; schools of, 146; system of Indian thought, 143

Yoga Sutras, 143–47

yogic breathing, 147

Your Personal Renaissance (Dreher), 53–54

zazen (Zen sitting meditation), 161, 171

Zen and the Brain (Austin), 169

Zen-Brain Reflections (Austin), 169 Zen practice: applications, 175–76;

fearlessness and awakening, 173–74; lore, 159; oneness with

circumstances, 166–68; perception

and suffering, 162, 163; serenity and, 160–62; sitting meditation (zazen), 161, 171; and well-being

(scientific perspective), 169–75

 

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About the Editor and Contributors

The Editor

THOMAS G. PLANTE, PhD, ABPP, is professor of psychology at Santa Clara University and adjunct clinical professor of psychiatry and behavioral sciences at Stanford University School of Medicine. He directs the Spirituality and Health Institute at Santa Clara University and currently serves as vice-chair of the National Review Board for the Protection of Children for the U.S. Council of Catholic Bishops. He is president-elect of the Psychology and Religion Division (Division 36) of the American Psychological Association. He has authored or edited 12 books including, most recently, Spiritual Practices in Psychotherapy: Thirteen Tools for Enhancing Psychological Health (2009, American Psycho- logical Association) and Spirit, Science and Health: How the Spiritual Mind Fuels Physical Wellness (with Carl Thoresen; 2007, Greenwood), as well as published over 150 scholarly professional journal articles and book chapters. Through his private practice he has evaluated or treated more than 600 priests and applicants to the Roman Catholic and Episcopalian priesthood and diaconate and has served as a consultant for a number of Roman Catholic dioceses and religious orders.

The Contributors

JILL E. BORMANN, PhD, RN, is a research nurse scientist at the VA San Diego Healthcare System and an adjunct associate professor at San Diego State University School of Nursing. She conducts a

 

program of research on the health benefits of a mantram repetition intervention in both veteran and nonveteran groups.

DARLENE COHEN ROSHI, MA, is a Zen priest and Dharma heir in the Suzuki-roshi lineage, trained at the San Francisco Zen Center. She is conducting a National Science Foundation–funded study on the relationship between Zen and stress reduction in the workplace entitled “A Study in Contemplative Multi-Tasking,” which is based on her book The One Who Is Not Busy.

ANDRE L. DELBECQ, PhD, is the J. Thomas and Kathleen McCarthy University Professor at Santa Clara University, where he served as dean of the Leavey School of Business from 1979 to 1989. His research and scholarship have focused on executive decision mak- ing, managing innovation in rapid-change environments, and organi- zational spirituality. He is the eighth dean of Fellows of the Academy of Management. He currently directs the Institute for Spirituality of Organizational Leadership at Santa Clara University, which conducts dialogues between theologians, management scholars, and executives.

DIANE DREHER, PhD, is a professor of English at Santa Clara University. Her most recent book is Your Personal Renaissance: 12 Steps to Finding Your Life’s True Calling (Perseus).

JANE K. FERGUSON, DMin, is Parish Partnerships Director for Catholic Charities CYO in San Francisco.

CAROL FLINDERS, PhD, has taught courses on mysticism at the University of California–Berkeley, and the Graduate Theological Union–Berkeley. Her most recent book is Enduring Lives: Portraits of Women of Faith and Action (Tarcher/Putnam).

TIM FLINDERS, MA, is the author of The Rise Response: Illness, Well- ness & Spirituality, and coauthor of The Making of a Teacher. He teaches courses on contemplative spirituality at the Sophia Center for Culture and Spirituality, Holy Names University, Oakland, California.

AISHA HAMDAN, PhD, is an assistant professor of behavioral sci- ences in the College of Medicine at the University of Sharjah, United Arab Emirates. She has authored over 100 international magazine articles, several journal articles, and two books related to Islam:

 

Nurturing Emaan in Children and Psychology from an Islamic Perspective

(forthcoming from International Islamic Publishing House).

HOORIA JAZAIERI, BS, is a graduate student in counseling psychol- ogy at Santa Clara University and is a research assistant at Stanford University.

DAVID LEVY, PhD, is a professor in the Information School at the University of Washington and has focused on bringing mindfulness training and other contemplative practices to address problems of information overload and acceleration.

GERDENIO MANUEL, SJ, PhD, is an associate professor of psy- chology and rector of the Santa Clara University Jesuit Community. He has published articles on coping with stress and traumatic life events, and the relationship of psychology, faith, and religious life. He is a Jesuit priest as well as a clinical psychologist.

DOUG OMAN, PhD, is adjunct assistant professor in the School of Public Health, University of California–Berkeley. His research focuses on psychosocial factors in health, especially spirituality and religion. A major current interest is applications to spirituality of Albert Bandura’s social cognitive and self-efficacy theories. Oman’s research publica- tions have explored how longevity is affected by religious involvement, how to conceptualize and measure spiritual modeling (the social learn- ing of spiritual qualities), how various modes of meditation may foster spiritual modeling, and how spiritual modeling may be integrated into college education. He has led randomized trials of spiritual forms of meditation for college students and health professionals.

MICHELLE J. PEARCE, PhD, is an assistant clinical professor in the Duke University Medical Center, Department of Psychiatry and Behav- ioral Sciences. She is trained in clinical health psychology and helps medi- cal patients cope with the stress and lifestyle changes of chronic illness.

ADI RAZ, BS, is a counseling psychology graduate student at the Institute of Transpersonal Psychology, Palo Alto, California.

T. ANNE RICHARDS, MA, is an interdisciplinary  social  scientist in anthropology and psychology. She retired from the University of California–San Francisco and –Berkeley and now continues working

 

on special projects. She is a graduate of the advanced-studies program at the Yoga Room in Berkeley. Her publications include: “Spiritual Resources Following a Partner’s Death from AIDS” in Meaning Reconstruction and the Experience of Loss and “The Effects of a Spiritu- ally  Based  Intervention   on   Self-Management   in   the   Workplace: A Qualitative Examination” in the Journal of Advanced Nursing.

SHAUNA L. SHAPIRO, PhD, is an associate professor of counseling psychology and author of numerous articles and chapters on mindful- ness. Her recent book is The Art and Science of Mindfulness (American Psychological Association).

HUSTON SMITH, PhD, is Thomas J. Watson Professor of Religion and Distinguished Adjunct Professor of Philosophy, Emeritus, Syracuse University. For 15 years he was professor of philosophy at MIT and for a decade before that he taught at Washington University in St. Louis. Most recently he has served as visiting professor of religious studies, Uni- versity of California–Berkeley. Holder of 12 honorary degrees, Smith’s 14 books include The World’s Religions, which has sold over 2.5 million copies, and Why Religion Matters, which won the Wilbur Award for the best book on religion published in 2001. In 1996 Bill Moyers devoted a five-part PBS special, The Wisdom of Faith with Huston Smith, to his life and work. His film documentaries on Hinduism, Tibetan Buddhism, and Sufism have all won international. awards, and the Journal of Ethno- musicology lauded his discovery of Tibetan multiphonic chanting, Music of Tibet, as “an important landmark in the study of music.”

MARTHA E. STORTZ, PhD, is professor of historical theology and ethics at the Pacific Lutheran Theological Seminary at the Graduate Theological Union and a consultant. She is author of A World According to God (2004) and Blessed to Follow (2008).

SARITA TAMAYO-MORAGA, PhD, is a Zen priest in the Suzuki- roshi lineage and a lecturer at Santa Clara University in the Religious Studies Department.

AMY B. WACHHOLTZ, PhD, MDiv, is an assistant professor of psychiatry at the University of Massachusetts Medical School, and the health psychologist on the Psychosomatic Medicine Consult Service at UMass Memorial Medical Center.

 

ZARI WEISS focuses on bringing spiritual direction to the Jewish community and has written a number of articles on the subject. She is currently the chair of the Committee on Rabbinic Spirituality, a past member of the Spiritual Leadership Task Force and the Wellness Committee of the CCAR, and past copresident of the Women’s Rabbinic Network.

Contemplative Practices in Action 14] Contemplative Practices in Action: Now What?

 14] Contemplative Practices in Action: Now What?

Thomas G. Plante and Adi Raz

This book has attempted to bring together many different and thought- ful voices among professionals who specialize in the integration of spiri- tual and religious contemplative practices and apply these practices to the development of a higher quality life by enhancing well-being, stress management, wholeness, and healing of body, mind, and spirit. They come from Eastern and Western traditions as well as the integration of the two. They represent Jewish, Muslim, Christian, Hindi, Buddhist, Zen, and other approaches. To our knowledge, no other book has offered this integrative and multitradition approach to applied contem- plative practices in both a scholarly and practical way.

The various religious and spiritual traditions all have something important to offer us in terms of contemplative practices. While there are only so many voices that can be heard in one volume, it is clear that there are several unified factors or commonalities present among the traditions. Oman well articulated four similar functions that are elemental in many of the contemplative systems discussed in this book. Most approaches involve setting aside time for practices that reshape and train attention; most also include strategies for centering oneself throughout the day, cultivating personal character strengths, and drawing inspiration and guidance from spiritual exemplars or models. Many of these contemplative practices are more similar than different in terms of their approach and outcomes, while language, culture,

 

and history make each unique and special, perhaps suitable for some people more than others.

Too often we hear in the news and in professional circles that there is a great deal of misunderstanding and often tremendous conflict among and between the religious and spiritual traditions. Many pro- fessionals are also not well versed in spiritual and religious matters including contemplative practices.1 In this project, we brought together Jewish, Muslim, Christian, Hindi, Buddhist, Zen, and others for thoughtful, reflective, and productive collaboration. Some of the contributors include members of the clergy as well (e.g., a rabbi, a Catholic priest, a Zen priest) and several colleagues who are very closely identified with their religious and spiritual tradition and who are devout. Throughout the process of developing this book, including an all-day conference in late 2009, the contributors openly discussed their chapter ideas and learned from each other in a welcoming, honest, and thoughtful manner. They each read and commented on various drafts along the way as well. Everyone had the opportunity to provide feedback for each chapter on multiple occasions. Thus, the efforts of each chapter contributor were informed by careful and thoughtful feedback from all of the other contributors, and the project was there- fore truly collaborative in every way.

This book project represents the third edited book that our team at

the Spirituality and Health Institute at Santa Clara University have now published that bring together experts and students from the vari- ous spiritual and religious traditions in psychology, religious studies, public health, nursing, science, literature, and several other fields.2,3 Our institute includes quarterly extended lunch meetings to discuss a wide variety of multidisciplinary and multifaith research, teaching, conference, and book projects as well as collaboration on many other related topics as they arise. We fondly begin our meetings with the question, “Where might the spirit lead us this time?” We are never disappointed at the end of our discussions. Our lunch table includes clergy, professors from many academic disciplines (e.g., psychology, religious studies, biostatistics, public health, engineering, philosophy, English literature), students from a variety of disciplines, and commu- nity leaders in faith-based, nonprofit, social service agencies. Perhaps this institute and current book project could serve as a model of what could be done elsewhere in both professional and lay circles. We do a lot on a little lunch money.

The religious and spiritual traditions offer much. There is much to

learn and celebrate when thoughtful and well-meaning people with

 

Contemplative Practices in Action: Now What? 245

skills and perspectives that are informed by their spiritual and reli- gious traditions come together and learn from each other with an open, caring, and respectful manner. Having table fellowship around meals helps to enhance the working and personal relationships as well. We hope that our book project will be a contribution in the right direction for interfaith understanding and benefits, and might stimu- late further reflection, research, and application and in doing so, make the world a better place.

Since this volume was not able to address all of the contemplative approaches from the spiritual and religious traditions, future books are clearly needed in our view. Future projects might continue to examine how these and other contemplative approaches can be best understood and used in health promotion broadly defined. Further research may wish to expand in both the empirical and theoretical direction. Empirical research might examine how contemplative prac- tices are most effective with certain populations as well as what role belief in and practice of contemplative practices might play in obtaining the greatest desired effect. Future research may also investi- gate the effectiveness of these practices from a cultural, socioeconomic, or religion of origin lens in order to determine how these factors might influence their effectiveness in daily life. As we could offer only but a taste of what the world’s religions and spiritual traditions have to offer in regards to contemplative practices, future volumes may wish to examine traditions not represented in this book (e.g., Sikhism, Jainism, Taoism, Confucianism, Shamanism, Paganism). Furthermore, many additional contemplative practices within the major traditions presented in this book could be discussed in more detail in future volumes. For example, the Christian tradition includes many different contempla- tive approaches from various Roman Catholic religious orders and traditions as well as many Protestant groups. Future research may also further investigate other contemplative mind-body connections, dis- cussing the myriad ways in which, for example, exercise from hiking in nature to dance can be both contemplative and healing within a par- ticular contemplative practice system. A further look at the use of nature or dreams in contemplative practices may also be warranted in subsequent volumes as well.

It is apparent that there are many options for individuals to choose

when using contemplative practices to make the lifestyle change from mindlessness to mindfulness. The various chapters in this volume address using contemplative practices to better manage the many challenges that arise in daily life. It is our hope that this book will serve

 

as an enlightening and thought-provoking guide to those searching for a more thoughtful, mindful, spiritual, and contemplative path to healing, stress relief, and overall well-being, perhaps for themselves and for others with whom they work. We hope that this book has brought forth a way for individuals to experience a new tradition or provided some insight into how their own tradition approaches the contemplative path. Contemplative practices in action can be both wide and deep with many roads to follow. Perhaps all lead to a better quality of life when used thoughtfully and sincerely.

REFERENCES

1. Plante, T. G. (2009). Spiritual practices in psychotherapy: Thirteen tools for enhancing psychological health. Washington, DC: American Psychological Association.

2. Plante, T. G., & Thoresen, C. E. (Eds.) (2007). Spirit, science and health: How the spiritual mind fuels physical wellness. Westport, CT: Praeger/Greenwood.

3. Plante, T. G., & Sherman, A. S. (Eds.) (2001). Faith and health: Psycho- logical perspectives. New York: Guilford.

 

Contemplative Practices in Action 13] A Pilgrimage from Suffering to Solidarity: Walking the Path of Contemplative Practices

 13] A Pilgrimage from Suffering to Solidarity: Walking the Path of Contemplative Practices

Gerdenio Manuel, SJ, and Martha E. Stortz

This final contribution serves as a kind of paradigm case in two ways. First, it treats a specific form of stress, suffering, and it addresses three common characteristics of people facing loss: denial, isolation, and the need for control. Second, it reaches deep within a particular tradition, Christianity, for practices that address these characteristics: lamenta- tion, intercession, and pilgrimage. While some of the practices in this book fall into the category of “calming” practices (Centering Prayer, mantram repetition, the Eight-Point Program), these practices are “expressive,” more like the “energizing” practices discussed in Amy Wachholz’s contribution. These practices handle negative emotions, which have an important place in psychic and spiritual health for indi- viduals and communities.

Indeed, these practices have not just an inner dimension but a social dimension. Advocacy emerges as the outer dimension of lamentation, as those who mourn give voice to the sufferings of others. Accompani- ment stands as the outer dimension of intercession, a focused solidarity with the suffering of another person or community. Finally, immersion, the ability to simply be present for and with others without judgment or distance, remedy or analysis, comes as the outer dimension of pil- grimage. In their inner and outer dimensions, these practices offer a powerful example of what Ignatius Loyola called “contemplation in action.”

 

INTRODUCTION

The loss of a partner, the death of a child, an unexpected diagnosis, a job terminated, the devastating breakup, the experience of margin- alization: suddenly and irrevocably the landscape of the familiar alters. People find themselves lost in the terrain of suffering. They seek solace; yet, denial, isolation, and need for control block the path.

Suffering fragments the soul, whether the soul of a person, a rela- tionship, or a people. What was once integral implodes, and the pieces scatter from a center that no longer holds. Philosopher Simone Weil (1977) identified physical, social, and spiritual dimensions of suffering: physical pain, social degradation, and distress of the soul.1 Coping with suffering requires “re-membering,” literally, forging these scat- tered fragments into a new whole.

Contemplative practices point the way, for the journey from suffering to solidarity is a spiritual one. They reveal a path from denial to accep- tance, from isolation to communion; and finally, from the need to con- trol to surrender. Contemplation aims at union with God, “a long loving look at what is real.”2 Suffering makes God seem distant, remote, even cruel. Suffering blocks union with God, and the psalmist shouts in despair: “My God, my God, why have you forsaken me?” (Psalm 22:1). Those words were also on the lips of Jesus, who is for Christians the human face of God (Mark 15:34). Through Jesus’s life and death, God experienced the full range of human suffering. Through incarnation

God comes into the midst of human suffering.

This contribution examines concrete contemplative practices that invite encounter with the suffering God. Lamentation encourages people to claim suffering, rather than cutting it out with the razor of denial. Intercession opens victims to those around them, who then become fellow travelers. Finally, pilgrimage places people on a path where the journey supplants the destination, pointing to the mystery of a suffering God.

Too often contemplative practices are prescribed as the remedy for individual suffering. We argue that they also point to solidarity with others. We met people whose hard-won compassion opened them to the suffering of others. These practices have then an outer as well as an inner dimension, creating solidarity even as they console. Speaking out for those whom affliction has silenced, advocacy becomes the outer dimension of lamentation. A focused solidarity with the suffering of others, accompaniment stands as the outer dimension of intercession. Finally, in its diffuse availability to the suffering of the world, immersion is the outer dimension of pilgrimage.

 

In their inner and outer dimensions, these contemplative practices connect personal suffering to communal and global realities. They knit together the personal and the social, offering a powerful example of what Ignatius Loyola (1556) called “contemplation in action.”3 In so doing, they carve a path from being a victim to becoming a survivor to acting for change in the world. This volume’s title captures the impulse to solidarity: Contemplative Practices in Action.

We bring to this project our own experience of suffering, and we remain marked by the suffering of loved ones. As teachers and ministers, we have witnessed the suffering of near and distant neighbors. Finally, as citizens of the world, we have witnessed the genocides of Serbia and Croatia, Darfur and Rwanda, the killing fields of Cambodia, the prisons of Abu Ghraib, Guantanamo, and Tehran’s Evin. We see the daily insult of poverty and disease. Suffering people seek the solace contem- plative practices offer; they are aroused to action by the solidarity contemplative practices invite.

At the outset, we identify three concrete contemplative practices: lamentation, which moves people from denial to assent; intercession, which points from isolation toward communion; and pilgrimage, which liberates people from the need to control to surrender. In each section, we begin with experience, then examine the specific practice, concluding with its outer dimension. In this we hope to highlight the difference contemplative practices make, not simply for the one suf- fering, but for a broken world.

LAMENTATION: FROM DENIAL TO ASSENT TO ADVOCACY

In its inability to acknowledge what is real, denial is a first protest against suffering. Denial wants the world to be what it was before. Buttressed by excuses, fortified by fantasy, driven by dissociation, and quick to blame, denial takes work. Finally, it wears people out and wears them down.4

Moving out of denial takes work as well. Four stages capture the movement:

1. “This isn’t happening!”

He was shocked. He had always known his wife drank a lot, some- times to excess—but she was not an alcoholic! All she drank was wine and occasionally a little too much. He made excuses for her;

 

he believed her own excuses, telling himself she was just “coming down with something.” When the children were younger and their mom was moody and lethargic, they believed him too. Now they were older. He felt under siege, on one hand from his wife’s anger, on the other from their children’s exasperation with them both. He talked to her about drinking, and he believed her repeated prom- ises to cut back.

Then, one day when their mother was not home, the children confronted him.

They showed him all of her secret stashes of alcohol—including hard liquor. He felt tricked; he needed to talk. He had needed to talk for years.

This man faces multiple losses: the loss of a fantasy, a partner, his children’s respect, confidence in his own judgment. If he is ready to talk, he is ready to move out of denial. That means leaving behind a pattern of behavior characteristic of denial: making excuses and living a fantasy.

2. “This isn’t happening to me!”

For years he prided himself on not needing doctors. Regular exercise kept him lean. He looked good; he felt good; he convinced himself he was invincible. He had experienced some discomfort after eating for years but never believed it to be anything an antacid tablet could not relieve. Gradually, he lost his usual energy. When night sweats broke out, his wife marched him to the doctor, who had ordered preliminary tests for colon cancer, the disease that claimed his father. Now the doctor walked into the examining room looking worried: “Let’s just hope we can stop it from progressing to the other organs.”

This man felt he could be an exception, denying medical data that he had actually known, but somehow did not think applied to him. He ignored family pressure to be tested regularly; he had even ignored his own body’s complaints. Moving out of denial means leaving behind an ingrained pattern of behavior: dissociation from information, from family, even from his own body.

3. “This is happening—let’s find out who’s to blame!”

When President Clinton read Philip Gourevitch’s expose´ on the Rwandan genocide, he angrily forwarded a marked copy to national

 

security advisor Sandy Berger. “Is what he’s saying true?” “How did this happen?” “I want to get to the bottom of this!” When news of mass slaughter first surfaced, Clinton had shown no interest. Once the story hit the media, however, he resorted to an excuse the German people used after the Holocaust: “How come we didn’t know what was going on?” It was the same move President George

W. Bush would make a decade later on Darfur.5

Rwanda was set on the administration’s back burner until the pot boiled over. When the situation became too blatant to ignore, some- one else was at fault. The fact that Clinton responded to Gourevitch’s article so passionately indicates a readiness to acknowledge the slaughter, but an unwillingness to take responsibility. To do so, though, he has to abandon another pattern of behavior associated with denial: the need to blame someone else.

4. “I can embrace this.”

In the immediate aftermath of her stroke, the woman woke every morning thinking it had all just been a bad dream. When she opened her eyes, she was in an unfamiliar room. Nurses helped her into a chair for breakfast. “A stroke paralyzed my left side,” she repeated. As she improved, she recovered a sense of agency, and her mantra changed: “I’m using the purple tie-dyed cane my grand- daughter gave me.” She hobbled out of the skilled-nursing facility on her purple cane. Months later, she returned to the facility to thank her caregivers—and give them her cane: “Someone else may need it more than I do.”

Denial is not reserved for addiction or willful ignorance. It is also used by people who have found their lives altered by forces beyond their control. Ambushed by her own circulatory system, this woman fantasizes the stroke was just a “bad dream.” When she opens her eyes each morning, she can no longer maintain that fiction. Initially, she sees herself as a victim. Her early response represents a rudimentary lament: “A stroke paralyzed me.” She narrates her story as a victim of circumstance. Repetition forces her to listen. Gradually she claims her loss, asserting agency. She becomes a survivor: “I use a cane.” As she heals, she becomes an advocate: she donates the cane to some- one else. This woman has embraced her loss. She not only has let her loss “bless her,” she ensures that her loss will bless someone else.6

 

This woman’s story captures the clinical distinction between passive suffering and active coping. Suffering is something that happens to people, bearing down on them like a train with failed brakes. People who suffer refer to themselves in accusative case: “The stroke weakened me.” Active coping is different. Picking up the pieces of loss, coping uses nominative case: “I use a cane to get my balance.” Coping takes charge of suffering.7 Beyond coping is advocacy: this woman gave her cane to someone else.

DEALING WITH DENIAL: THE PRACTICE OF LAMENTATION

The practice of lamentation moves people from suffering to assent to advocacy. Lamentation invites people to speak the unspeakable. As they put words around their suffering, they begin to cope, claiming an agency that has been trampled by silence. In finding a language for their suffering, they give voice to others, who find words to express their own afflictions. Lamentation gives public voice to pain, and in so doing it creates a space of resistance, even hope.

The psalms of the Hebrew Bible stand as classic expressions of per- sonal and social loss. Almost a third are psalms of lament, signaling to worshipers that “authentic worship” emerges only when people bring their deepest pain and most flagrant examples of injustice before God. The God of the Hebrew Scriptures wants people to wail. Loss should not be left outside the synagogue: it belongs inside public worship. Otherwise, worship remains “a shallow affair.”8

These laments address God directly, demanding response. The language is that of command. Over and over again, the psalmist orders God to “Listen up!” “Hear my prayer!” “Hearken to me!” (Psalms 5:1; 55:2–3; 86:1). At other times, the psalmist begs for compassion: “Have mercy on me!” (51:3; 56:2; 57:2). When God seems distant or remote, the psalmist wails even louder: “Don’t rebuke me in your anger!” (6:2). “Don’t be silent!” (109:1). The psalms of lament offer evidence that people suffering get to protest—long and loudly.

In these lamentations, the agency of the one suffering shifts fluidly between being a victim and being a survivor, between accusative and nominative cases. Lament itself invites a kind of agency. People still suffer—but they get to protest. That protest takes on a fourfold form. First, lamentation invites people to name the particularity of their suffer- ing: “All your waves and your billows have gone over me” (Psalm 42:7). This graphic image carries the pain of suffering. Second, lament projects the very real presence of an enemy: “Many bulls encircle me ... 

 

they open wide their mouths at me, like a ravening and roaring lion” (Psalm 22:12–13). Lamentation invites vivid descriptions of danger. Third, the psalmist wrestles with depression: “I am poured out like water, and all my bones are out of joint” (Psalm 22:14). Often, to calm an inquiet soul, the psalmist calls happier times to mind: “By the rivers of Babylon—there we sat down and there we wept, when we remem- bered Zion” (Psalm 137:1). Finally, the presence of God is as real as the presence of the enemy. Psalms begin in direct address, boldly addressing God as “You.” In spite of everything, there is someone listen- ing. Indeed, lament reinforces the sense that all suffering happens within the divine embrace. Lament joins with praise as part of a system of respi- ration that lives in God. Lament invites people into the divine mystery. St. Augustine observes: “If your love is without ceasing, you are crying out always; if you always cry out, you are always desiring; and if you desire, you are calling to mind your eternal rest in the Lord If the

desire is there, then the groaning is there as well. Even if people fail to hear it, it never ceases to sound in the hearing of God.”9

A survivor of 9/11 made it out of the collapsing towers alive, but many of his colleagues did not. He made a habit of heading to the ocean and yelling into the crashing surf: “How could you do this to us?” The practice consoled him. In the midst of aching loss, there was someone to yell at, someone listening. The psalms of lament tell us that the practice is deeply traditioned.

Having given voice to longing and despair, the survivor leaves words that someone else can use. Jesus reportedly died with the psalmist’s lament on his lips: “My God, my God, why have you for- saken me!” (Mark 15:34). He could find no language to express his own pain, so he borrowed the words of Psalm 22. Someone else had been in that place, and their words became his.

The practice of lamentation invites people out of denial, urging them to voice their pains and express their loss in all its awful particu- larity. Lament leaves a language for others to draw upon, as they search for words that speak the unspeakable. Finally, advocacy is speaking for others, who may not have words of their own.

INTERCESSION: FROM ISOLATION TO COMMUNITY TO ACCOMPANIMENT

Suffering grinds people down. It is hard to experience anything but pain; it is hard for others to share that experience. The contemplative

 

practice of intercession invites people to ask for what they need, for themselves and for others. It follows from the practice of lamentation: having found a voice in lament, intercession encourages people to use it. The outer dimension of intercession is accompaniment, which incarnates its prayer.

1. Noli tangere! Don’t touch!

In the weeks after her husband died, the woman remembered grocery shopping at 5 a.m. She was awake anyway—but that was not the only reason. The truth was she could not stand to see anyone she knew. Their expressions of sympathy felt like body blows. When she had to go out later in the day, she wore sunglasses. In time, she noticed people giving her a wide berth: they nodded, but did not approach. That did not feel right either. She hated being alone.

From ancient times lepers were banished to the outskirts of villages and towns. In the Hawaiian chain, Molokai became an island leper colony. Anyone who had the disease was sent there with a one-way ticket. Suffering isolates people. They lose friends on top of every- thing else. While some can stand with them, others drop off the radar screen entirely. “It’s as if this were contagious,” the woman above observed. “If they get too close, they’ll lose their partners too.” The people she thought would be there couldn’t—and people she hadn’t even thought of turned up in their place.

People experiencing loss also isolate themselves, like the woman in this story. They exasperate friends who are able to be there. One of the woman’s friends—it was not one of her “best” friends either— finally got so frustrated, she phoned the house and simply started talk- ing to the answering machine: “I’m going to talk until you pick up the phone. I’m worried about you. We all are. We can’t figure out how to help. You have to tell us what you need.” Only then did the woman answer. Often people experiencing loss create what they most fear: isolation. Suffering imposes isolation; it takes a lot of determination on all sides to break through to connection.

2. Ask for what you need.

The adult children watched their parents diminish with growing concern. They still lived in the family home. But when the parents became too scattered to drive, the kids took away the car keys. Eventually, they even had to forbid their father to walk to the market, because he could not get across the street before the light changed.

 

When a crisis forced the children to deal with their mother’s gath- ering dementia, they had to find a nursing home that would accept Alzheimer’s patients. After intensive networking, interviews—and prayer, a bed opened in a nearby facility. “This is a godsend!” the eldest son exclaimed.

Crisis often clarifies need. Before their mother left a burner on all day, her six adult children had seven different opinions about what should happen. Then suddenly they knew what they needed. Finding the right facility took a lot of legwork, but for this particular family, it also took prayer. They asked for God’s help, confident that the Creator of the uni- verse would also be interested in finding the right place for their mother. After all, they had been raised in a tradition that taught them to “Ask, and it will be given you” (Matthew 7:7). They believed that God hears prayer. That did not mean getting what they had wanted all the time, but it did mean living in relationship with a God who responded, not always on demand, but in mysterious, even inscrutable ways.

3. It is important simply to ask.

The delegation from Santa Clara University had lunch at a tiny res- taurant in the highlands of Guatemala. The only other customers were a group of dirty, sweaty people who ate quickly and left in flatbed trucks with blue tarps lashed over the tops. Later that afternoon, they visited a village that was the site of a mass grave. As the villagers told the stories of the civil war, one of them mentioned that a team of forensic scientists had been there that morning, exhuming bodies for identifi- cation. The group quickly realized they had dined alongside the scien- tists earlier that day. Stunned, a delegate asked: “What do you need?” There was a ready answer, and they heard it through the translator: “Pray for us. Go back to your own country and tell our stories.”

Often what is needed is not as concrete as a care facility, a job, or a peace treaty. What comfort could this delegation offer a village ravaged by war? The villagers asked simply for their presence, their ability to be with them in their suffering. They asked for their voice, telling the delegates to share their stories. Finally, they asked for accompaniment in their struggle. Members of the delegation took accompaniment seriously, remembering the villagers’ stories in their presentations and their prayers back in El Norte. “Those people are still with me,” said a woman, “even after all these years.” Interces- sion reminded her that people depended on her to bear their pain.

 

She carried those people—and they carried her. When suffering pushes people beyond the limits of human effort, there is nothing to do but be with people in their suffering.

BREAKING THROUGH ISOLATION TO CONNECTION: THE PRACTICE OF INTERCESSION

The practice of intercessory prayer opens people to connection with God, to their own needs, and to the needs of others. It frees people to be present to the mystery of divine compassion, and it frees them to be compassionate with one  another.  In its  dimensions of address, praise, and petition, intercession leads necessarily to accompaniment.

Intercession begins in address; petitioners name the mystery to

whom they pray. As the chapters in this volume show, religious tradi- tions exercise great care in naming the one to whom they pray, because address simultaneously identifies both the speaker and the one spoken to. Historically, Jews refused to utter the name of God aloud, writing it as the unpronounceable YHWH. Human speech was inadequate. Muslims recognize the limits of language differently. According to a Sufi proverb, there are a hundred names of God. Humans know 99; only the camel knows the hundredth. The camel’s knowledge preserves a space of unknowing. Mosques often display the names of God in gold-lettered calligraphy around the dome, so that believers literally can stand in the presence of the many names of Allah. Christians gather in the name of a Triune God. During the course of a worship service, that name is spoken over and over again. Often it is a signal for believers to cross themselves, as if to inscribe that name on their bodies. Repetition of the name recognizes that there are a lot of other gods out there, each eager to stake its claim. Like a licked stamp waiting for an envelope, the human heart stands ready to adhere to all manner of unlikely gods. This first part of inter- cessory prayer reminds believers of the reality that claims them.

Naming God simultaneously identifies the speaker. Addressing God

as “Father or Mother” identifies the speaker as “child.” Addressing God as “Creator” states the creature’s derivative status. Addressing God as “Shepherd” claims the role of sheep, the chief characteristic of which is dithering. Whatever the name, intercession begins with address, and that address places the one praying in a certain posture before the mystery. Intercession invites connection.

 

After address comes praise, and praise both remembers and gives thanks. Praise flows naturally from address, for each of the names tele- graphs a story. For example, “Creator” plays back to the story of creation; “Deliverer” remembers  Exodus; “Father” or  “Mother” recalls Jesus’s unique and familiar way of addressing a sometimes dis- tant God. Praise fleshes out the connection that naming identifies, reminding us to whom we pray and recalling a history of relationship. Praise not only recounts the past; it minds believers toward a shared future. Like a magnet dragged through a pile of filings, praise orients them, turning toward connection. Parents train their children to “mind” them, so they do not have to watch the child’s every move. In time, children internalize parental instruction. They learn to act in any given situation as their parents might expect. They have been “minded.” The apostle Paul calls on this natural pattern, as he urges the community at Philippi to “mind” Christ: “be of the same mind, having the same love, being in  full accord  and of one mind. .. .

Let the same mind be in you that was in Christ Jesus” (Philippians 2:2, 5). Praise places people in the posture of “minding” the God to whom they pray.

Address and praise ground petition, for petition presumes the con- nection that address and petition create. Petition may be the hardest part of intercession. In part, a culture that values independence stum- bles over suffering. But in part, wants always get confused with needs. Actress Judi Dench recalls a holiday in Spain, where she sighted a pair of expensive shoes. She wanted those shoes with all the yearning of a 15-year-old girl. Her father suggested they consider the purchase over lunch. At a seafood buffet, shrimp caught her eye, and she wound up ordering the most expensive item on the menu. At the end of the meal, her father observed: “You’ve just eaten your shoes.” Wants take people everywhere, now to shoes, now to shrimp. What do we really need?

A woman whose partner was dying confided: “I don’t know what to ask for.” As she sorted wants and needs, she realized she could always ask for prayer. Like the villagers, she knew she was surrounded by people who would carry her. All she had to do was let them. She discovered a prayer for such situations: “Behold and bless.” It was the prayer she finally offered for her dying partner; it was the prayer people offered for her.

Intercession works to connect. It first establishes a connection with a God “in whom we live and move and have our being” (Acts 17:28). In connecting to this God, people find themselves drawn into the whole of creation. The member of the Santa Clara delegation put it

 

well: “They  are still with  me.”  Intercession bears one  another’s burdens, accompanying people in their suffering.

I am that child

with a round face and dirty

who on every corner bothers you with his “can you spare a quarter?”

I am that child with the dirty face certainly unwanted that from far away contemplates coaches,

where other children emit laughter and jump up and down considerably.. . .

I am that repulsive child that improvises a bed out of an old cardboard box and waits,

certain that you will accompany me.10

PILGRIMAGE: FROM CONTROL TO SURRENDER TO IMMERSION

Suffering means loss, whether of one’s abilities, one’s relationships, one’s homeland, one’s sense of security. Whatever the tragedy, loss introduces the element of contingency. Nothing can be taken for granted; everything could change in a moment. Finally, all loss is a loss of control that defies competence and remedy, diplomacy and persuasion. The responses to sudden helplessness range from paralysis to manipulation to resignation.

1. “We admitted we were powerless.”

He sat glumly in the meeting, listening intermittently to the speaker’s story. He did not want to be here, and the precipitating events were a blur. Then, words his wife shouted last night in the midst of a lot of yelling floated to the surface: “You’re out of control!” She’d threatened to leave if he did not come, and now he was part of a whole new family: the family of Alcoholics. That’s how everyone introduced themselves. As the meeting closed, everyone read the 12 Steps, and the first step echoed his wife’s words: “We admitted we were powerless.”

If he sticks it out, this man will learn a valuable lesson: he is not in control. For years, alcohol controlled his life, and his resulting behav- ior has controlled his family. If he stops drinking, they have all got to

 

change. His addiction was a center  of  gravity  for  the  whole family; no one can imagine what recovery looks like. But no one will get there without taking a first step.

2. From grief to?

She lost her husband of 25 years just 25 months ago, she thought ruefully. Despite the age difference, they had been a great match, sharing professional interests like business, personal hobbies like golf and hiking. Now he was gone. Initially, she had been devastated, losing weight even as she lost herself in work. Now she just felt an aching loneliness, grief in a different key. People were beginning to “set her up” with people or opportunity or even travel. She turned everything aside that felt like going backward. She knew that after 25 months people expected some kind of plan of where she was going. She had none. All she knew was to keep going forward, destination unknown.

Popular literature reminds people that “grief is like a fingerprint”: everyone’s experience is distinctive. Yet there are some commonalities, and this woman’s story displays them. Early grief feels like shattered glass. Gradually, time rounds the rough edges. A lot of people grieve the acute pain of early grief: it makes them feel somehow closer to the one they mourn. Yet, the physical and emotional intensity of early grief is hard to maintain over time. Even if they do not know where they are going, people move forward. Sometimes they fast-forward to a “New Normal,” catapulting themselves into a new relationship or situation. Addiction literature calls this “doing a geographic”; inevi- tably, unresolved grief catches up. A better strategy is to limp ahead, without knowing exactly where the path leads. Often, as in this case, the only direction available is the certain knowledge that there is no going back.

3. “Core of love”

“She had four children in five years. The most significant thing that happened to her in her life, she told us, was losing one of those children to cancer when he was five years old. ‘I don’t talk about this very easily,’ she said, looking down and speaking very quietly, ‘but it was pivotal for me. It changed my life—jelled it in a profound way. I have an image that comes to mind about that time. It’s of a white fire roaring through my life and burning out what was superficial, frivolous or unimportant and leaving a core of .. . I don’t think

 

there’s any other word for it than love. A core of love. It’s hard to convey what that means.’ ”11

The loss of a child ranks as one of the cruelest, and this woman puts it graphically. Yet, the “huge fire” she describes could have left a lot of things in its aftermath: rage, bitterness, despair, or simply black ashes. How did she find herself in this space of love? Love symbolizes ulti- mate connection between two people. It is a delicate balance between enmeshment, where one self dissolves into another, and narcissism, where every other self functions as nothing more than a mirror.

THE PATH FROM CONTROL TO SURRENDER: THE PRACTICE OF

PILGRIMAGE

What points the path from control to surrender? The ancient reli- gious practice of pilgrimage offers a compass. Understood as “a trans- formative journey to a sacred center,”12 pilgrimage may take people to sites held holy by a religious tradition, Mecca or Jerusalem. Or pilgrim- age may take them to sites made holy by intense struggle or bloodshed, like Auschwitz, the killing fields in Cambodia, the battlefields at Gettysburg or the beaches of Normandy. Pilgrimage can also be more personal. People use the term to describe visits to the residences of authors or statesmen or even celebrities. Indeed, the homes of Emily Dickinson or Jane Austen attract a kind of reverence usually seen in places of worship. Finally, whether it floats to consciousness or not, people who visit gravesites are on pilgrimage.

Whatever the destination, pilgrimage involves a journey, with the planning travel requires and the dislocation it brings. Further, pil- grimage involves some kind of physical effort, often walking, whether on a trail, through a graveyard, or from room to room. Even journeys described as “inner pilgrimages” employ some regular physical prac- tice, like mantram repetition, yoga, or Centering Prayer.13 As is the case with all spiritual practices, pilgrimage invites “the body to mentor the soul.”14

Many world religions look on pilgrimage as a spiritual practice, and Islam recommends that every pious Muslim make the hajj at least once a lifetime. Medieval Christians made their way to Rome or Jerusalem or Santiago de Compostela. They walked to do penance, seek healing, visit holy sites or the relics of saints. Their journals recount stories and companions along the way. At the outset, the point of pilgrimage

 

seemed to be reaching the destination. Along the way, though, the journey became an end in itself. Wherever its destination, pilgrimage taught believers to travel light, be receptive, and rest.

Since pilgrims carry everything they need on their backs, they find out very quickly to travel light. Pilgrims physically feel the weight of their possessions, and as they plod along they may well begin to pon- der how their possessions in fact possess them. Everything borne on the back registers on the feet. In a spirit of surrender, pilgrims learn to let go of all but the essentials.

Like pilgrimage, loss strips everything away. The mother above remembers that the death of a child hollowed her out. It cleared away everything “superfluous, frivolous, or unimportant,” leaving behind only emptiness. Janis Joplin (1970) put it more bluntly: “Freedom is just another word for nothin’ left to lose.”15

The experience of loss creates a terrible freedom. Just as the pilgrim chooses what she will carry, one whom suffering has hollowed out chooses what will fill the emptiness. That is the freedom. The danger is that anything can fill that hollowed space: love, peace, bitterness, despair. That is the terror.

It is not clear that Bill W., founder of Alcoholics Anonymous, stud- ied pilgrimage, but he certainly understood emptiness. Alcoholics Anonymous speaks of that “God-shaped hole” in every person. Twelve Step programs encourage people in recovery to fill that hole with spirit and not spirits, with divine mystery and not substances: “Let go and let God.” Alcoholics Anonymous also picks up on another dimension of pilgrimage: receptivity.

Because they carry so little, pilgrims learn to receive. Dependent on others for food, for shelter, for companionship, pilgrims relinquish control over their surroundings. Wrestling with pain and fatigue, they relinquish control over their own bodies. Whatever the weather and whomever the company, pilgrims move forward into a space of sur- render. On the way, they discover the daily graces. Grace comes incar- nate in the person of shopkeepers and concierges, hospitalers and fellow travelers. Unbidden and unmerited, the kindness of strangers sustains pilgrims along their way: a sign of divine compassion.

Physically and spiritually, walking is work, and pilgrims relish reach- ing the day’s destination. Rest becomes a mini-sabbath, and pilgrims learn to honor it. Tutoring people in rest and sabbath, pilgrimage emphasizes being rather than doing. Pilgrims are not doing anything. They may begin by thinking they will achieve  their  goal of  making it to Mecca or Jerusalem, but it does not take long to be disabused of

 

that idea. The point is as much making the journey as reaching the destination.

A woman who climbed Kilimanjaro put it this way: “The other members of our party spoke of conquering the mountain, I think the mountain let itself be climbed. I understood ‘majesty’ after that climb.” Only in retrospect did she identify the climb as pilgrimage, but she put its sense of sabbath into words. Just as she leaned into the moun- tain, pilgrims lean into the holy.

Together traveling light, learning to receive, and honoring rest: these aspects of pilgrimage cultivate a spirit of surrender that is at the heart of pilgrimage. Surrender works to unclench the grip of con- trol, acknowledge life’s contingency, giving thanks for what has been and being hopeful for what lies ahead. In these three aspects of letting go, receptivity, and rest, pilgrimage is similar to Centering Prayer, itself an inner pilgrimage. Jane Ferguson’s chapter in this volume sug- gests striking similarities.

Pilgrimage extends outwardly into immersion. Many colleges and universities offer opportunities for “immersion experiences,” which take students abroad for an in-depth encounter with another culture. Minneapolis’s Center for Global Education offers immersion experi- ences to interested adults, and Director Orval Gingerich is quick to distinguish them from mission trips or service learning projects: “We encourage people to go as receivers. We want to disabuse them of the idea that they have something to offer. We want them simply to receive” (O. Gingerich, personal communication, July  10,  2009). The Ignatian Colleagues Program runs a curriculum for college and university administrators, part of which involves a 10-day immersion in a Third World country. Director Edward Peck calls this part of the program “pilgrimage,” and he reminds participants: “You’re not there to give; you’re there to receive” (E. Peck, personal communication, July 7, 2009).16

Why do this? Immersion affords a kind of deep knowing of some- thing else, and that knowledge has a double edge. It opens both to beauty and to pain. Describing a sport he loves, long-distance runner Richard Askwith (2008) captures that double-edged knowing: “The man who is truly at home in the mountains .. . enters into an intimate relationship with them is so deeply in touch with himself.”17 Such inti- macy bears pain as well as beauty. Askwith claims it is crucial to get “cold, or wet, or lost, or exhausted, or bruised by rocks or covered in mud.      The point is not the exertion involved, it’s the degree of

involvement, or immersion, in the landscape. You need to feel it; to

 

interact with it, to be in it, not just looking from outside. You need to lose yourself—for it is then you are most human.”17

Immersion returns to incarnation, for this athlete gives a luminous description of the divine immersion in humanity, living deeply into the beauty of being human—but also into the suffering. Through Jesus Christ, the divine-human, God became one of us, even to the point of death. Jesus laments, and he draws on the psalms to give voice to his suffering. Jesus asks for his own suffering to be lifted, interced- ing with the divine parent for his burden to be lifted. Then, as he dies, he intercedes for the very people who put him to death, asking his divine parent to forgive them. Finally, his entire life on earth was a pilgrimage. Some would say it led only to Jerusalem and his death. We argue that it led deeper and deeper into the human soul. God knows suffering, because God has been there. In these contemplative practices we walk in the steps of an incarnate God, a God who suffers with us. This was how God came to know the beauty and pain of being human.

CONCLUSION

Retrospectively, we recognize that the entire journey from suffer- ing to solidarity with others and with God has been a pilgrimage. These contemplative practices invite us to follow in the footsteps of Jesus, who leads us deeper into the mystery of being human. At the same time, as they did for Jesus, they take us further into solidarity with the suffering of all people. Poet, essayist, and farmer Wendell Berry has a beautiful poem that ends with the counsel to “practice resurrection.” These contemplative practices invite us to “practice incarnation.”18

REFERENCES

1. Weil, S. (1977). The love of God and affliction. In G. A. Panichas (Ed.),

The Simone Weil reader (p. 440). Mt. Kisco, NY: Moyer Bell.

2. Burghardt, W. (2008). Contemplation: A long loving look at the real. In G. W. Traub (Ed.), An Ignatian spirituality reader (p. 93). Chicago: Loyola Press.

3. Loyola, I. (1970). The constitutions of the Society of Jesus (G. E. Ganss, Trans.). St. Louis, MO: Institute  of Jesuit Sources. (Original  work  published in 1556)

 

4. Kubler-Ross, E. (1997). On death and dying. New York,: Simon & Schuster.

5. Gourevitch, P. (2006). Just watching. The New Yorker. http://www

.newyorker.com/archive/2006/06/12/060612ta_talk_gourevitch (accessed August 5, 1009).

6. Rolheiser, R. (1999). The holy longing: The search for a Christian spirituality. New York: Doubleday.

7. Anderson, H. (1993). What consoles? Sewanee Theological Review, 36(3), 374–384.

8. Pleins, J. D. (1993). The Psalms: Songs of tragedy, hope, and justice (p. 15). Maryknoll, NY: Orbis Press.

9. Augustine. (1975). In Psalmo 37:13–14. In The liturgy of the hours

(p. 303). New York: Catholic Book.

10. Schnabel, J. (Director). (2000). Before Night Falls [Film]. New York: Fine Line Features.

11. Ray, P. H., & Anderson, S. R. (2000). The cultural creatives. New York: Three Rivers Press/Random House.

12. Cousineau, P. (1998). The art of pilgrimage: The seeker’s guide to making travel sacred (p. xxiii). San Francisco: Conari Press.

13. Several chapters in this volume emphasize the importance of specific physical disciplines: rhythmic breathing (e.g., T. Anne Richards, “The Path of Yoga”), silence (e.g., Jane Ferguson, “Centering Prayer”), or the repetition of a word or phrase (e.g., Jill Bormann, “Mantram Repetition,” Tim Flinders et al., “The Eight-Point Program of Passage Meditation”), or even repetitive motion (e.g., Amy Wachholz, “Shaking the Blues Away”).

14. Brown, P. (1988). The body and society: Men, women, and sexual renunci- ation in early Christianity. New York: Columbia University Press.

15. Kristofferson, K., & Foster, F. (1970). Me and Bobby McGee [Janis Joplin]. On Pearl [CD], New York: Columbia (1971).

16. For more information on the Center for Global Education, see http:// www.centerforglobaleducation.org. For more information on The Ignatian Colleagues, see http://www.ignatiancolleagues.org.

17. Coffey, M. (2008). Explorers of the infinite. New York: Penguin.

18. Berry, W. (1994). Manifesto: The mad farmer liberation front. In

Collected Poems: 1957–1982 (pp. 151–152). San Francisco: North Point Press.

 

CHAPTER 14

Contemplative Practices in Action 12] “Shaking the Blues Away”: Energizing Spiritual Practices for the Treatment of Chronic Pain

 12] “Shaking the Blues Away”: Energizing Spiritual Practices for the Treatment of Chronic Pain

Amy B. Wachholtz and Michelle J. Pearce

If you would lose your weary blues Shake ’em away

—Original words and music by Irving Berlin, 1927; revised edition: revived by Ann Miller in Easter Parade, 1948

While there is a great deal of research supporting the use of meditation and quieting spiritual practices for the treatment of chronic pain, there has been less mention of those practices that energize and focus the spi- rit in the effort to decrease pain. In this chapter, we will explore the use of energizing spiritual practices to reduce the experience of chronic pain. This will include a review of multiple religious cultures, including Native American and Pentecostal Christian, which will provide a unique insight into this relatively unexplored area of pain management. We will also briefly discuss how physical activation may positively affect the physiological pain pathways and the perception of pain. Finally, we will discuss how other individuals may begin to integrate these practices into their own pain management techniques.

An unknown author once wrote, “Pain is inevitable; suffering is optional.” This inspirational quote suggests that we are able to both influence and transcend our experience of pain. Pain is not a one-to- one relationship between the tissue damage and the pain sensation. Instead, we are active interpreters of our pain sensations. We make these interpretations through the filter of our belief systems, and resulting emotions and behavior. Chronic pain is more than simple tissue damage.

 

Instead it is a multidimensional experience. Biological, psychological, social, and spiritual factors each affect the individual’s interpretation of the pain experience. Chronic pain is a complex disorder that often defies traditional treatments. The ongoing experience of chronic pain can span years of an individual’s lifetime and severely impede the qual- ity of life for that individual. While certain pharmacological options can be very effective in treating pain, most often have secondary side effects that patients would rather avoid. Given the intractable nature of chronic pain, patients may choose to take treatment into their own hands by seeking out alternative pain control methods, which may include integrating spiritual beliefs and practices into their pain man- agement regimen. There is a wide range of individual experiences related to chronic pain and the potential harmful interaction between pain and suffering. These complex interactions, the need to better manage negative pain experiences, and the desire to improve treatment for chronically ill populations, makes chronic pain a critical area for further study.

Pain is often best described within the framework of the bio- psycho-social model of disease. This model seeks to understand the impact of chronic pain holistically on individuals via the biological, psychological, and social aspects of their lives. Rather than just focus- ing on disease, this model advocates treating pain by recognizing com- plex multifaceted interactions that comprise individuals’ experience. These may include interactions with their environment, social interac- tions among other individuals, biological interactions with nonspecific disease factors, and bidirectional pathways that occur among each aspect of the bio-psycho-social parts that make up individual experi- ence. Specific to the treatment of pain, the bio-psycho-social model may also account for the experience of pain without an identifiable patho-physiological etiology.

Specifically, in the context of the bio-psycho-social model, the gate control/neuromatrix theory of pain identifies a construct that explains how spiritual beliefs and practices influence the pain experience and may contribute to improved pain management by describing the impact of psychological (descending pathways) and moderate biological (ascending pathways) pain factors.1 It has become widely accepted that the experience of pain is not a simple equation of: X tissue damage = X level of pain. The biochemical transmission of pain cannot fully explain the pain experience for the patient. Instead, these theories identify multiple descending pathways that integrate cognitions, emotions, and behavior, which, in turn, influence the perception and interpretation

 

of pain by modulating (up or down) the individual experience of pain, all of which occurs in real time. The psychological and biological states interact to create the experience of pain. This theory facilitated the dis- covery of the relationships among psychosocial factors, such as negative emotions, social support, sense of self-efficacy, coping strategies, and reports of pain.2

Both of the models described above (gate control/neuromatrix models and the bio-psycho-social model) elucidate the role of the individual as an active interpreter of the pain experience and the immediate and direct impact that psychological states play in mediat- ing the experience of pain. They also provide a framework as to how psychosocial variables may be used to treat chronic-pain conditions. In addition, the bio-psycho-social-spiritual model expands on the original bio-psycho-social model by integrating spiritual and religious variables, and identifying the role that these variables may play in modulating the pain experience. The bio-psycho-social-spiritual model recognizes the disruptive impact that pain can have on biologi- cal status, psychological health, interpersonal interactions, and spiritual well-being unique to the individual. Since spirituality is an additional coping resource that may affect some patients’ pain experience, inte- grating spirituality into the gate/neuromatrix model is a natural exten- sion of this model. However, the valence of the spiritual practice may impact the direction of the relationship between spirituality and pain sensitivity/tolerance. In a positive relationship, spirituality may reduce the pain experience because individuals feel support from a higher power (e.g., “God is with me in my struggles”), they may have cogni- tions that reduce stress (e.g., “God would not give me more than I can handle”), or they may use religious/spiritual practices to distract them from pain or create reduced physiological reactivity to pain (e.g., spiri- tual meditation), and/or provide social interaction (e.g., attendance at worship services). Negatively, spirituality may increase the pain experi- ence by increasing stress among those who view the experience as a pun- ishment from God/Higher Power, or feel abandoned by God in a time of need.

HISTORICAL AND RELIGIOUS CONTEXT

Multiple cultures throughout history and around the world have used music and dance as integral components of health and healing ceremonies. In this section we will explore only a few examples from

 

around the world, although we would encourage those who are inter- ested in pursuing further information to consider the anthropological literature, which provides rich descriptive detail of how cultures use energetic music and dance rhythms as a source of healing traditions. In the context of this chapter, we define religion and spirituality as aspects of “ideas, beliefs, groups, or institutions associated with a higher power” (p. 311).2 We define dance as intentional, purposeful, rhythmic movements, outside of typical motor movement, that are designed to express a thought, an emotion, or an experience. Dance may be supplemented by music or drums, but can also stand alone with no other accompaniment.

NATIVE AMERICAN—LAKOTA

Arguably the most famous Native American example of spiritual dance and pain is the Sun Dance. While many of the Native American cultures based in the Great Plains region celebrated variations of the Sun Dance, in this section we will be focusing on the Lakota Sun Dance tradition. Traditionally, the Lakota tribe engaged in the Sun Dance ceremony in conjunction with the annual community-wide buffalo hunt. The annual celebration culminated in the Sun Dance in which the honored dancer(s) was pierced with a stick through small slits in their back or chest. The stick was woven through the slits and a rope tied to each end of the stick. The rope was then attached to a sacred tree. The dancer would proceed to dance around the tree for multiple days. During this time he (although dancers could be male or female, they were generally male) would forsake food and water. The dancer would continue to dance until the skin tore, thereby releasing him from the tree. This ceremony not only caused identifiable tissue damage, but to the outside observer it would also be considered unnecessarily, and perhaps gruesomely, painful. However, to the Lakotan dancers, the pain was welcomed, and many times the dancers reported experiencing no pain at all. They understood that the pain was sacred and necessary to help the dancer reach a holy world, as they believed the dance continued the process of rebirth or regeneration, subsequently ensuring the prosperity of the community.3 The preced- ing preparatory celebrations, the context of the pain experience, and the postcommunity celebrations of the dancers, provided an energiz- ing spiritual environment that left little room for the experience of pain.

 

PENTECOSTAL/CHARISMATIC CHRISTIANITY

Pentecostalism, often grouped with Charismatic Christianity (Pentecostal/Charismatic or P/C), is the second-largest and fastest- growing Christian group in the world, behind Catholicism. According to the World Christian Database, in 2006 there were 580 million Pen- tecostals and Charismatics in the world, with much of the growth occurring in the global south. Many point to the 1906 Azusa Street revival in Los Angeles as the start of Pentecostalism. Services at Azusa Street did not resemble the typical Christian religious service: wor- shipers shouted, danced, fell into trances, wept, spoke in tongues, and gave interpretations of these tongues into English. Ecstatic and paranormal religious experiences were the norm.

Pentecostalism has been described as an experiential religion, one that involves the entire body. It emphasizes feelings and demonstra- tions of God’s power over thought and contemplation, and encour- ages the loss or yielding of self to God, which is manifested or represented in various somatic forms. It has also been argued that these ecstatic experiences are an important part of evangelic activities that continue to promote church growth.4 These religious experiences or gifts of the Spirit are believed to be given by God to equip his peo- ple for service. Pentecostal ecstatic somatic experiences include glos- solalia (speaking in tongues), prophecy, being slain in the Spirit, miracles, deliverance, and divine healing. Although the purpose of these experiences is not the reduction of pain, as we will discuss later in this chapter, individuals often report experiencing no pain when they encounter noxious stimuli in this ecstatic state.

MUSLIM (SUFI)

Within Islam, dance is a very important spiritual practice—particularly within a branch of Islamic practice called the Sufism. The Sufi move- ment began shortly after Muhammad’s death and focused on the mystical practices and ideas of Islam. Although Sufi was initially a term indicating any mystical practice, it soon became associated with the eschewing of the external world to create growth in the spiritual world.

One specific aspect of these practices is what has become known as the Sema or the “whirling dervish” dance. A Dervish describes an indi- vidual who belongs to a sect of Islam called Tariqah, which is known

 

for its extreme ascetic practices. A Dervish is similar to mendicant priests/friars and hermits in Christianity and to sadhus in  the Hindu and Buddhist traditions.

Within the Dervish sect exists the Mevlevi order. This is a group of Sufi priests who perform the moving meditation—the whirling dervish dance. The whirling dervish dance originated in Turkey stemming from the songs and teachings of Lord Rumi (1207–1273). Within this form of dance, there are multiple layers of symbolism that represent the rotation of the planets around the sun and the passage of blood flowing from the heart. Even the clothing symbolizes the movement toward spiritual enlightenment and receiving the gifts of God; the dancer’s hat is the gravestone of the self or ego, the flowing white skirt symbolizes the shroud of the self, and the black cloak (which is removed prior to danc- ing) represents the casting off of mourning and the spiritual rebirth of the dancer. Dervish dancers feel that the process of dancing helps them to shed external needs, such as hunger and pain, and become closer to God. The dancers generally move to the music of a reed flute. Fittingly, the flute is a symbol of human pain, indicated by the holes in the flute. However, despite (or because of) the holes in the flute symbolizing pain, the flute makes beautiful music. For the Mevlevi order this provides a powerful metaphor for how pain can be transmuted into something beautiful and a means of growing closer to God.5

MIZO—INDIA

Mizo culture refers to a group of people primarily geographically located in northeastern India. In the Mizoram language, the term Mizo means “people of the hill.” Their culture is originally based in Mongolian groups who moved into the area in the seventh century. While the Mizo people were originally Buddhist, Christian missions during the eighteenth and nineteenth centuries led to mass conver- sions, with approximately 87 percent of contemporary Mizos identify- ing themselves as Christian. Initially, Mizo cultural forms of dancing were banned and related to pagan or animist practices. However, recently the Mizo Christian community has reintegrated the cultural dance practices into their worship services. The contemporary Mizo Christianity is a blended form of worship that includes traditional cultural practices.

According to Dr. Lalrinawmi Ralte, a Mizo Christian apologist and an expert on feminist hermeneutics, Mizo dance is an empowering and

 

leveling experience; especially in the context of a revival ceremony, dance plays a central role.6 Sacred dance in Mizo culture disregards gender, social status, and age. Everyone in the religious community is involved in the dance, and the dance expresses the community’s spirituality. Dance theology in the Mizo culture includes dance as a healing expression within the community. It allows the community to respect the body as a sacred dimension of the individual. It is used as a way to heal or cope with both emotional and physical pain. For example, women dance to celebrate the joy of birth even in the midst of labor pain. Dance is also used as an expression of hope in God to ease the pain of a medical condition. Dance is used in the Mizo Christian community to strengthen the body and the spirit to overcome injury at both the individual and community level to create a healthier, more holistic spiritual healing experience.

CURRENT ENERGIZING SPIRITUAL PRACTICES

CHARISMATIC WORSHIP AND HEALING

The Pentecostal service begins with a lengthy time of singing and music that often follows two stages. During the first stage, called “Praise,” the songs are fast-paced, energetic, and function to stir up the congregation. During the second stage, called “Worship,” the songs are slow-paced, soft, and function to turn one’s attention to God and enter into a state of devotion and openness to “the moving of the Spirit.” Some have stated that the goal is to become filled or possessed by the Holy Spirit, which is evidenced by the way they dance, sing, and speak in tongues. It is not uncommon for worshipers to enter an altered state of consciousness during worship, or to fall backward, which is called “being slain in the Spirit,” when prayed for by elders of the church. In some Charismatic churches, such as the Toronto Airport Christian Fellowship (TACF), known for the “Toronto Blessing,” individuals report experiencing unusual physical phenomena, such as animal-sounding noises, ecstatic states and tran- ces, violent shaking and shuddering, and altered states of conscious- ness, as well as significant, transformative inner experiences resulting from feeling the intimate love of God.7

Pentecostalism has been described as providing a message of hope for

those who are ill or in emotional or physical pain. The somatic manifes- tations  are  understood  as  signs  that  God  is  healing—spiritually,

 

emotionally, socially, and physically. Emphasis is placed on receiving spiritual healing, which is secondary to emotional and physical healing. Emotional pain and fears are believed to manifest somatically, and thus “inner healing” is believed to often have a beneficial effect on physical health. A study by Poloma and Hoelter8 among 918 individuals who had visited the TACF revealed that measures of spiritual healing were significantly related to the measures of inner, mental, and physical heal- ing. Interestingly, a significant minority of Americans (10–30%) claim to have experienced a miraculous healing and many of these individuals are part of the Pentecostal/Charismatic tradition of Christianity.8 Polema7 has suggested that the time of worship and prayer at TACF releases a natural power (called chi, kundalini, or prana in other cultures), as well as a range of human emotions that influence and promote mental and physical health.

Despite the possible effectiveness of decreasing pain through ener- getic spiritual practices, it must also be noted that some dangers are also present. A small number of individuals have sued their churches or pastors for “slain in the spirit” injuries, claiming that the worship- per was “slain” and fell with no one to catch them. This has resulted in several individuals falling to the floor, or off of podiums/alters, causing or exacerbating injuries. There is disagreement within various religious circles as to the validity of the spiritual experience if an indi- vidual is hurt, stating that if the individual was truly slain in the spirit, they would not have been injured. Regardless of these discussions, it is important to know that during states of hyperarousal and altered con- sciousness, it may be possible for individuals to injure themselves or exacerbate an existing injury, but not feel this pain until after they have returned to their usual state of consciousness.

SPIRITUAL EDGEWORK: EXTREME RITUAL PERFORMANCES

Many have argued that religion is a socially constructed way for individuals to gain a sense of power and control, including power over pain. Bromley9 argues that when practitioners engage in a ritual prac- tice that risks physical and emotional injury or death, they experience a sense of empowerment and control because of their believed connec- tion to a source of divine power. Bromley calls these types of rituals “spiritual edgework.” Three examples of spiritual edgework rituals that put the practitioner at risk of injury, pain, and death are fire walk- ing, fire handling, and serpent handling.

 

Fire-handling has a long history dating back to 1200 BCE. In modern times, fire walking has been practiced across the globe: by Native North Americans, shamans of north Asia, mediums among the Bataks of Sumatra, and Haitians in their Voodoo or Santeria ceremonies, to name just a few.10 Fire walking, as an organized and marketed practice in the United States, began in 1978 by Tolly Burkan, and has increased in popularity in America through the New Age movement. It is used as a means for individuals, generally urban professionals, to over- come fear and experience a sense of empowerment, control, and self- actualization. The working metaphor of fire walking is that if you are able to walk on fire, then you are able to face and overcome any limita- tion or problem you are experiencing in your life. As such, fire is trans- formed from being a source of danger and harm to that of a healing force producing wholeness.

Practitioners are instructed to maintain a specific physical state by breathing deeply, walking normally, and clenching their right hand to represent a feeling of power. Tony Robbins, a fire workshop leader, asserts that one must program one’s self with positive, overcoming com- mands and be in a “totally focused state” before stepping on the coals, otherwise one will be burned. The fire walk usually takes only a few sec- onds and covers 8 to 14 feet of coals. People usually report experiencing no pain and often report feeling ecstatic when they finish.

Recent scientific explorations of fire walking, as well as fun experi- ments such as those carried out on the Mythbusters TV show on the Discovery Channel, have identified the physics and power of belief related to walking across 1,000°F coals. As displayed by Mythbusters, after a preparatory class on the physics and a strong trust in the phys- ics behind fire walking, walkers may gain the confidence to walk slowly and evenly so that the pressure on the foot is balanced. If they have the necessary conviction, the walker will not stomp the feet,

increase downward pressure on the foot by running, or have a psycho- somatic reaction that makes the feet perspire since these actions would enhance heat conductivity and allow the person to be burned. How- ever, individuals who are not given this preparation and confidence, through either spiritual means or physics education, are likely to walk over the coals improperly, frequently resulting in burns. While the physics may prevent the individual from being burned while walking over hot coals, it is the belief that you cannot be burned that allows for the proper technique, and courage, needed for the applied physics to protect the walker.

 

A small minority of Pentecostal Holiness churches in the South cur- rently practice a ritual called fire handling in the context of their serv- ices. Services are usually several hours in length and involve energetic dancing, singing, shouting, speaking in tongues, and prophesying. In a heightened collective emotional state and vigorous motor activity, members light torches and touch the flame to parts of their body and clothing for up to 10–15 seconds.10 Fire handlers believe that they are able to touch the flames without being burned because of their faith in God and because of the power of God, called the “anointing of God,” that comes upon the individual, making them immune to the fire. Worshipers assert that they can apply the fire only to the parts of their body that the Spirit directs them to and only for as long as the Spirit is upon them, otherwise they will be burned. Participants describe the anointed state as feeling numb, feeling cold, experiencing a good cold shower, and having hands like a block of ice. It is likely that participants are in an altered state of consciousness when they are “under the anointing.”10

Serpent handling commenced in the United States around 1915 in

the Church of God, a denomination in the Holiness movement, in the hills of eastern Tennessee. It was primarily practiced by rural Christians of lower socioeconomic status. This practice was popular in the 1920s, but was infrequently practiced by the 1930s. There are a few independent Holiness churches that still practice this ritual. The ritual is also seen as evidence that because of their faith in Jesus Christ, they too will be victorious over death and have eternal life. As with the other types of spiritual edgework, serpent handling pro- motes a sense of empowerment and control among practitioners.9

Much like fire handling, serpent handling occurs in the context of intense singing, shouting, dancing, loud music, prayer, and preaching. Serpent handlers have explained their ability to handle poisonous snakes without injury or death by being protected by an anointing from God to carry out his commands. They believe that the Holy Spirit takes control of them, and report feeling sensations such as, energy, joy, peace, physical numbness, tingling in the hands, and elec- tricity. Handlers speak of the importance of waiting until they feel God’s anointing before picking up a snake, and of putting the snake down as soon as they feel the anointing lifting. To do otherwise, they state, is foolish and will result in injury. Injuries are regarded as caused by fear, improper preparation, and ego. It is not uncommon for a han- dler to be bitten; however, there have been only a small number of injuries and deaths as a result of this practice over the years. Engaging

 

in this practice has been described by practitioners as evidence of their obedience to God, of his favor and blessing, and the truth of the Bible.

CONTEMPORARY ROCK MUSIC

Not all individuals who experience spiritual elevation to escape the impact of pain on the body are members of a group or even use these practices as part of a faith tradition. Arthur Coleman, a psychiatrist, struggled for seven years with chronic back pain. He described how he tried multiple forms of physical treatment, physical therapy, medica- tions, chiropractic manipulation, and massage. Yet despite all of these treatments, his battle with chronic back pain continued. Finally, after an eye-opening experience with his son that emphasized how opioid analgesics were damaging his cognitive and social abilities, he began searching for alternative medicine practices. He began to use “strong rock music” and drumming as a way to override his pain experience.11 It created a feeling of elation that would disintegrate the back pain and allow him to not only escape the pain temporarily while engaging in his “rock music therapy,” but to also provide him with relief after he walked away from the drum set. Only by using the intense practices of rock music and drumming was he able to provide the cognitive dis- traction, and physiological relaxation that helped him continue to cope with his pain.11

PATHWAYS LINKING ENERGIZING SPIRITUAL PRACTICES AND PAIN

Across a number of cultures, music has been used to induce strong emotions, dissociative states, trances, and altered states of conscious- ness.12 Uplifting, energizing spiritual music may have a positive impact on the mind, body, and emotions. As we know from the neuromatrix theory of pain, positive changes in any of these domains may effectively decrease a person’s experience of pain.

SEROTONIN PATHWAYS

Physiologically, religion and/or spirituality may potentially impact the pain experience through multiple pathways. However, much of the research on pathways has focused on decreasing arousal and

 

quieting the spirit. Specifically, research has identified that serotonin receptor density is correlated to spiritual activities. Since serotonin is related to both mood and pain regulation, if spiritual practices affect serotonin release/uptake, these practices may have a causal relation- ship to changes in both mood and pain.13 Negative spiritual thoughts (e.g., “God is abandoning me”) can increase pain sensitivity, and neg- ative spiritual practices can increase pain sensitivity, decrease pain tol- erance, and create a depressed mood. Since spirituality is an active coping mechanism for both neuroscientific and a psychological mod- els of pain, a greater understanding of how and why individuals use their spirituality to cope with pain could be a critical ingredient in improved treatments for individuals suffering from chronic pain. While the empirical literature validating the use of intense spiritual activity for pain relief is rare to nonexistent, there are a number of bio- logical pathways that support the theory that this form of pain relief not only is possible but can be very effective.

ENDOGENOUS OPIOID PATHWAYS

There is a high density of endogenous opioid receptors in brain areas related to auditory, kinetic, and visual perception. The neuroendocrine opioid system is linked to areas of the CNS that are involved in the transmission, processing, and integration of pain, auditory, and kinetic perception, as well as to areas involved in affective states. The physio- logical “fight or flight” responses to danger or excitement are converted into endorphins. Endorphins are biochemically very similar to mor- phine; thus in these situations, the human body essentially releases endogenous morphine. Like morphine, endorphins result in diminished pain and a sense of euphoria. This is similar to the “runner’s high,” described by distance runners or frequent exercisers. Prince14 asserts that the vigorous motor activities in dance and the fine tremors that almost always accompany nonhypnotic trance phenomena activate the release of endorphins, which generate and maintain the analgesic effect. This analgesia is then supported by the auditory and visual stimuli and rhythmic sounds that are also associated with trances and reduced pain.

When opioids bind with the mu opioid receptors, a number of neuro- nal changes occur, which influence pain perception, motor behavior, mood, and autonomic responses. In contrast, kappa opioid receptors are implicated in stress and dysphoria. Thus when an individual is

 

experiencing ongoing stress, such as suffering from chronic pain, they are more likely to have elevated activation of the kappa opioid receptors. Therefore, when the release of endorphins shuts down the kappa opioid receptors and activates the mu opioid receptors, the individual would likely feel an even greater “rush” than an individual not experiencing chronic pain. These endogenous opioids exert their analgesic effect by inhibiting pain impulses at the level of the spinal cord from being trans- mitted to the brain, where sensory signals are registered as pain. Endog- enous opioids can be activated by intense emotional states and vigorous physical activity. They can also relieve psychological pain by inducing euphoria and triggering altered states of consciousness.

HYPERAROUSAL AND ALTERED CONSCIOUSNESS

The praise and worship component of Pentecostal services and other services that have similar characteristics elicits not only a strong emotional experience, but also physiological arousal. The cognitive appraisal of the physical arousal further enhances the subjective expe- rience of the emotion. The energizing religious service includes a number of activities that can lead to hyperarousal and altered states of consciousness—clapping, dancing, swaying, raising arms, singing, glossolalia, jumping, repetitive lyrics, and energetic music—to gener- ate enthusiasm and leads to a greater likelihood of experiencing an altered state.15 Indeed, research has shown that movement, noise, group setting, sensory overstimulation, repetitive lyrics, and instru- mental music have all been used to induce a state of hyperarousal, which leads to altered states of consciousness. Not surprisingly then, when participants have been interviewed about their experience in services they use language related to a trancelike state, such as “feeling light, losing track of time, sensing electricity in their body, numbness, and feeling like one’s body was on fire.” Interviewees also stressed the importance of focus to achieve a “successful” worship experience, and often prepared themselves for the time of worship by praying or medi- tating before the service began. The physiological arousal and cogni- tive reappraisal of their experience can act as a powerful analgesic to motivated participants in these religious worship services.

Altered states of consciousness, whether due to hypnosis, meditation,

trance, or religious experience, are the result of similar psychological and neurophysiological factors. Research has shown that a number of conditions may generate an altered state of consciousness: reduction

 

or increase in external stimulation and motor activity, emotional hyper- arousal, rhythmic sensory stimulation, focused hyperalertness, relaxa- tion, and various states such as sleep deprivation and exposure to extreme temperatures. Stress, exertion, hyperventilation, and hypogly- cemia all result in increased adrenaline secretion, and increase one’s sus- ceptibility to rhythmic auditory and visual stimulation.16

MOCK HYPERSTRESS HYPOTHESIS

Prince14 proposed the mock hyperstress hypothesis, which asserts that artificial threat situations (e.g., nightmares, psychoses, ecstasies, trances), although potentially disturbing, are actually helpful healing states because they generate the release of endorphins. Many times the individual will then experience a deep state of peace and euphoria, commonly interpreted as divine intervention. The hyperstress hypothesis may also help explain the elevated emotionalism observed in energizing religious practices cross-culturally.

Emotionalism is a foundational characteristic of energizing spiritual practices. Indeed, energizing spiritual practices are designed to elicit certain emotional experiences and behaviors. Across the multiple cul- tures that engage in energizing spiritual practices there are a few common themes. All of these practices involve rapid music or drum- ming. Research has consistently demonstrated that music elicits spe- cific physiological changes through activating the nervous system.17 Extensive research on music has documented that fast-tempo, percus- sive, rhythmic, and loud, dynamic music is arousing and causes increases in heart rate and muscle tension, creating an escalation of activity in the sympathetic nervous system. In contrast, slow-tempo, melodic, legato style, and soft, dynamic  music  decreases  arousal and leads to decreases in heart rate and muscle tension, as well as increases in skin temperature and skin resistance. These characteris- tics are related to parasympathetic nervous system activity, the body system that creates physiological relaxation. Researchers have also suggested that when an individual listens to music, he or she internally mimics the expression, and the physiological feedback induces the same emotion in the listener.

In addition to the activation of endogenous opioids, a physiologically

based theory has been offered to explain how fire handlers can hold their hand in the flames, without burning themselves. Ample research has demonstrated that the experience of pain is not a linear function of

 

the objective stimuli or degree of tissue damage (e.g., hypnosis as a sub- stitute for anesthesia, soldiers in war reporting no pain until after the battle, shark attacks during which there is no immediate pain). Psycho- logical factors, such as beliefs, attitudes, expectations, attention, anxiety, and conditioning, play an important role in the perception of pain. Given these findings, it has been asserted that fire walkers and fire han- dling church members can handle the coals and flames without injury because their beliefs and expectations in the trance state influence their neural activity, initiating the release of neuropeptides, and mobilizing a protective nervous system process.10 As with Prince’s mock hyper- stress model, the element of danger causes a release of stress hormones, creating increased muscle tension and resulting in vasoconstriction. The coldness and numbness that the handlers report—which notably is the only place to which they touch the flame—is a result of peripheral vasoconstriction, and is one of the factors that inhibits inflammation and damage.10

APPLICATIONS FOR MENTAL AND PHYSICAL HEALTH PRACTITIONERS

While scientific research has largely focused on spiritual practices that calm the spirit, we feel that the concept of energizing spiritual practices has been largely overlooked in both clinical  practice and the research literature. Across a number of disciplines, there is early research beginning to show the benefits of energizing practices.

DANCE THERAPY

The value of physically energizing practices to manage chronic pain, which may involve energizing the spirit as well, has begun to receive recognition. For example, research has shown that dance therapy is efficacious  for  the  treatment  of  rheumatoid  arthriti.18 In this study, “vigor” improved while pain and depression decreased after a 16-week program of “enthusiastic dance-based aerobic exer- cise” in a program called EDUCIZE. Other research in dance therapy has supported this earlier research by showing positive mental and physical health benefits to patients with chronic pain. While there is currently limited research addressing whether these benefits can be explained solely by increased physical activity, the findings do suggest

 

that increasing physical arousal for short periods over a number of weeks can create a decrease in the pain experience.

MUSIC THERAPY

Similar to research emphasizing calming spiritual practices, the majority of music therapy research focuses on decreasing physiological arousal, and emotional reactivity to stress. Calming music therapy has been strongly tied to spiritual experiences in palliative care and pain medicine as means to strengthen the spirit and to enhance spiritual well-being. However, a recent study focused on the physiological arousal related to emotionally powerful music, which was differentiated from loud music and fast music. The emotionally powerful music was shown to increase physiological arousal based on vasoconstriction and skin conductivity biomarkers.19 In other areas of music therapy, actively participating through the production of music, clapping, drumming, or free body movements to melodic or rhythmic sounds appears to create better physical and emotional outcomes than passive listening to music or standard physical therapy. Even the rapid beating of the drum during periods of intense breakthrough pain can provide a physical release of the pain sensation. Music therapy sessions that involve active partici- pation and emotionally powerful music are similar to the energizing spiritual practices described in previous sections. The emotionally powerful music in worship and healing services engages the listener and may facilitate the psycho-physiological hyperarousal that decreases the experience of pain.

CHARISMATIC WORSHIP AND MUSIC

A recent study examined the emotional effects of the P/C style of music and worship. Miller and Strongman20 found that participants in a P/C church had a significant increase in positive mood directly before the service, which increased during the time of worship. In the second part of their study, they compared a P/C group and a non-P/C group’s reactions to religious and secular music. They found that the P/C group had a stronger “energetic” and “awesome” emotional reaction to the religious songs than did the non-P/C group. They concluded that music facilitates an emotional experience in a P/C church through familiarity and associations to music, and that music plays an essential role in shift- ing the mood of the worshipers.

 

PSYCHOTHERAPY

In the field of psychotherapy, there are also lessons to be learned from energizing spiritual practices. In both psychotherapy and bio- feedback for chronic pain, increasing patient arousal to states of hyperarousal and the impact of this arousal have been vastly under- studied. Health psychologists specializing in pain management often use calming psycho-spiritual practices to help a person increase their emotional control, improve their feelings of self-efficacy, and decrease their experience of pain. Entire books on topics such as pain manage- ment, decreasing stress, and improving mood are focused on decreas- ing physiological arousal. While these tools are certainly useful, and have been repeatedly empirically validated, it is quite possible that psychotherapists have been missing out on another significant poten- tial resources. It is possible that energizing practices may be effica- cious as well. Rather than encouraging decreased arousal, we should once again begin exploring, both clinically and in research, the value of cathartic arousal.

Some support for this assertion has been found in the exercise literature. The aerobic-activity research literature shows that moder- ate physical activity (and corresponding physiological arousal) is asso- ciated with decreased depression and anxiety, both of which impact the experience of pain. While we are limited in the conclusions we can draw, and we cannot identify if there are unique characteristics to encouraging energizing spiritual practices, it appears that it is a topic worth exploring with patients. It may be particularly useful with patients who report feeling bored or frustrated, or have difficulties with those activities that decrease physiological arousal such as meditation.

CONCLUSION

It has been argued that as children we learn when and how to express pain from watching others. We also learn what to do to decrease pain. One may choose to attribute the modification in pain intensity to the power of expectations, otherwise known as the placebo effect. For example, it is possible that observing others overcome painful condi- tions creates expectancies that participating in these rituals will also provide relief. Or, one may attribute this learned control over pain to cultural factors, consistent with the bio-psycho-social-spiritual model

 

of pain. From the review of literature above, it also appears likely that spiritual factors—both meditative and energizing—play a role in the modification of pain.

However, if an individual feels a relief of chronic pain, is the meth- odology of that pain relief important? As the famous Buddhist quote states, “There are many paths up the mountain”; and when patients are struggling against the mountain of chronic pain, the more path- ways available, the better for the patient. These pathways may include traditional pain medications, or medications affecting pathways we know to be involved in the pain interpretation process. These path- ways may also include physical manipulation therapies such as occu- pational therapy, physical therapy, chiropractics, and massage. The paths also include multiple complementary medicine techniques, such as acupuncture, herbal treatments, and Reiki. However, we cannot neglect the spiritual pathways, including the entire pantheon of both energizing and calming practices. Given what we know about the neu- romatrix theory of pain and the downward suppression of pain signals through cognitive, behavioral, and emotional states, it is possible that these highly focused, energizing, and elevated spiritual states also create a physiological pathway that down regulates the pain signals, providing partial or total pain relief.

Moderate physical exercise of various types has been recommended for chronic pain patients as part of a multidisciplinary pain manage- ment program. The physiological arousal caused by exercise could be part of the formula that explains the pain benefit of energizing spiritual practices. However, simple movement alone is not likely to explain the overwhelming sensations and altered states of conscious- ness reported cross-culturally by participants in energizing worship services and spiritual practices. As this chapter demonstrated, there are more questions than answers regarding the role of energizing spiritual practices. But as this field continues to develop and engage new ideas for the treatment of chronic pain, it will be exciting, and dare we say energizing, to empirically discover the answers to these questions.

REFERENCES

1. Melzack, R. (1999). From the gate to the neuromatrix. Pain, 6(S1), S121–S126.

 

2. Wachholtz, A. B., Pearce, M. J., & Koenig, H. G. (2007). Exploring the relationship between spirituality, coping, and pain. Journal of Behavioral Medicine, 30(4), 311–318.

3. Andersson, R. H. (2008). The Lakota Ghost Dance of 1890. Lincoln: Uni- versity of Nebraska Press.

4. Poloma, M. M, & Pendleton, B. F. (1989). Religious experiences, evan- gelism, and institutional grown within the assemblies of God. Journal for the Scientific Study of Religion, 28(4), 415–431.

5. Owen, C. (2008). Whirling dervish dance: Where the dance comes from and what it means, http://worlddance.suite101.com/article.cfm/whirling

_dervish_dance#ixzz0Cs8L5eLp (accessed April 16, 2009).

6. Ralte,  L.  (2006).  Dance  theology  in  Mizo  tradition,  http://www

.mizobooks.com/dance_theology.htm, (accessed April 29, 2009).

7. Poloma, M. M. (1997). The “Toronto blessing”: Charisma, institution- alization, and revival. Journal for the Scientific Study of Religion, 2(36), 257–271.

8. Poloma, M. M,  &  Hoelter,  L. F.  (1998).  The  “Toronto”  blessing: A holistic model of healing. Journal for the Scientific Study of Religion, 37(2), 257–272.

9. Bromley, D. G. (2007). On spiritual edgework: The logic of extreme ritual performances. Journal for the Scientific Study of Religion, 46(3), 287–303.

10. Kane, S. M. (1982). Holiness ritual fire handling: Ethnographic and psychophysiological considerations. Ethos, 10(4), 369–384.

11. Colman, A. D. (1997). Pain and surgery: The Shamanic experience. In

D. Sandner & S. H. Wong (Eds.), The sacred heritage. New York: Routledge; : 125–137.

12. Price, C. A., & Snow, M. S. (1998). Ceremonial dissociation in American Protestant worship. Journal of Psychology and Christianity, 17(3), 257–265.

13. Borg, J., Andree, B., Soderstrom, H., & Farde, L. (2003). The serotonin system and spiritual experiences. American Journal of Psychiatry, 160(11), 1965–1969.

14. Prince, R. (1982). The endorphins: A review for psychological anthro- pologists. Ethos, 10(4), 303–316.

15. Shumaker, J. F. (1995). The corruption of reality: A unified theory of religion, hypnosis, and psychopathology. Amherst, NY: Prometheus Books.

16. Neher, A. (1961). Auditory driving observed with scalp electrodes in normal subjects. EEG and Clinical Neurophysiology, 13, 449–451.

17. Krumhansl, C. L. (1997). An exploratory study of  musical  emotions and psychophysiology. Canadian Journal of Experimental Psychology, 51(4), 336–352.

18. Perlman, S. G, Connell, K. J, Clark, A., et al. (1990). Dance-based aerobic exercise for rheumatoid arthritis. Arthritis & Rheumatism. ;3(1), 29–35.

 

19. Rickard, N. S. (2004). Intense emotional responses to music: A test of the physiological arousal hypothesis. Psychology of Music, 32(4), 371–388.

20. Miller, M. M., & Strongman K. T. (2002). The emotional effects of music on  religious  experience: A  study of the  Pentecostal-Charismatic style of music and worship. Psychology of Music, A30(1), 8–27.

 

CHAPTER 13