Love Loud

When I was in high school, my best friend was gay, and I never knew. When he came out to me years later, I asked him why hadn’t he told me back then, and he answered, “You remember what it was like, right?” Yeah, I remembered. It was the 90’s and it was Utah County. Fear and misunderstanding were the norm, and for many LGBTQ+ youth, day-to-day life could be a terrifying experience. I’d like to think that there have been positive changes since then, but sadly, Utah’s youth suicide rate isn’t one of them.  

Instead of falling, it is climbing steadily, and has been each year, nearly four times faster than the national average. LGBTQ+ youth in unaccepting homes and communities are 8 times more likely to commit suicide and 3 times more likely to engage in risky drug use.  

 But Dan Reynolds, the lead singer of Imagine Dragons, and the LoveLoud Foundation are trying to change that. Last year, Dan started the LoveLoud festival to increase suicide awareness for Utah’s LGBTQ+ youth. We recently sat down to talk with Dan and Tegan Quin from the band Tegan and Sara—artists who are trying to make a meaningful impact in the lives of our youth here in Utah.  

UVHW: What inspired you to start this journey, and LoveLoud, on behalf of the LGBTQ+ community? 

 Dan Reynolds: I watched how difficult it was for friends of mine to feel safe in that space. And then I went on (an LDS) mission, and became good friends with Tyler Glenn of Neon Trees. I watched him go through his process of being Mormon and gay and coming out and how difficult that was for him to feel at odds with God. Then I married a woman who is a badass activist who helped me to find my own inner truth and speak it. It’s been a lot of different things and a lot of different people who have inspired me throughout the years as well as people like Tegan who have been doing things in this realm for a long time. I’m just trying to do my little part with the platform that I’ve been given.  

UVHW: Your film Believer aired on HBO in June. What would you want the Utah Valley audience to know about your film and how to embrace the message that you’re sharing? 

Dan Reynolds:  That it’s a safe film to watch with their children. It’s motivating, it’s emotional, it’s powerful and I truly believe it will create real change in the communities that need it most. We tried really hard to create a documentary that was honest and to convey what’s happening on ground zero with our LGBTQ+ youth within homes of faith. The question is, what can we do to change the statistics, the environment and to create a safe one for LGBTQ+ youth, and that’s what this documentary is looking to do. I hope that everyone would give it a chance to sit down and watch it and see how their heart and mind feels. 

UVHW: How can we create greater safety for our LGBTQ+ youth and as well as adults; what can we do as a community? Tegan, do you want to answer that? 

Tegan Quin: It’s so profoundly moving to watch the documentary and that’s why Sara and I and our foundation got involved with it. We want to bring the community together, not to talk about how we don’t agree, but instead to create an amazing space to come together—to have the LGBTQ+ community speaking their truth, but also have Mormons in the community who want to learn and want to be better allies or want to understand what’s going on. The community is the space to do that, and to use music to bring people together. That’s a really wonderful way to start the conversation. As queer artists, our number one job is to bring people together to a space that feels inclusive and feels warm, and I think that music is really wonderful—a great equalizer. It transcends all of our differences and brings us all together. Encouraging people to watch the documentary or come to LoveLoud is a great way to start that conversation. 

UVHW: I brought my kids to LoveLoud last year, and that really opened up the door to talk about what they heard, and what they saw, and how they felt about it. It was such a cool experience, and was such a great success. What are your hopes for year two of LoveLoud? 

Dan Reynolds:  For me, it’s that dialogue that takes place beforehand and after the concert at home, at the dinner table, at school or at church. I think that change really comes about on people’s own timelines and nobody ever changes in a deep way on matters that are this ingrained in some people’s hearts, by just having someone talk at them. I think the change comes about with time, with patience and with open dialogue and thoughtfulness. What’s the most important thing is the child sitting down with mom and dad and saying, “Hey, this is what I felt at LoveLoud. What’d you guys think?” And then the parents expressing their thoughts and then the child their thoughts and then going to school and talking to their friends about it. And that to me is how you de-stigmatize an issue and that’s how you create a safe place for LGBTQ+ youth where this isn’t even a conversation that needs to be had anymore. But hopefully there’ll be a day where LoveLoud isn’t necessary any longer. Maybe it will just take on a different life of just being a celebration of love. 

Tegan Quin: I think there’s so much negativity in the media and there’s just a lot going on in the world. It can be extremely overwhelming, and maybe a young person is experiencing anxiety or depression. Another wonderful positive about LoveLoud and the documentary is that it’s celebration, it’s positivity–it’s starting the conversation and it’s exploring a different side of the conversation. Just this morning, I was speaking to a grade four teacher who told me that they had taken their students to an event where there had been positive LGBTQ+ representation there and they had been talking about pronouns and a kid who had been really depressed and who had expressed thoughts of suicide at 10 years old, which is just devastating to hear, had come back after the field trip and said, “I now know more about myself.” This kid had been feeling like maybe he was LGBTQ+. And sometimes it’s just giving LGBTQ+ kids something to look forward to, something positive to get them through these things. You know, that’s why I think LoveLoud is important. It’s positive and we need that right now in the community. 

UVHW: Yes, we do. What are your plans or thoughts about doing LoveLoud on a national level?  

 Dan Reynolds:  My focus is really on Utah, because that’s got one of the highest suicide rates in the nation. When someone has a LoveLoud necklace on or a t-shirt, then our LGBTQ+ youth can go up to that person, and find a safe zone there. But I would like it to be an organization that represents safety to all LGBTQ+ youth, not just in the nation, but around the world, and I think it starts here. We hope to continue to do as much as we possibly can to create a real impact. 

Sources:  

https://loveloudfest.com 

https://www.sltrib.com/news/health/2017/11/30/utahs-youth-suicide-rates-growing-at-alarming-pace-new-federal-report-says/ 

 

Originally published on Utah Valley Health and Wellness Magazine 

 

Hidden Signs of Depression by Alberto Souza, MSN, APRN, FNP-C

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.

 

Trouble Sleeping

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.


Losing Interest
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”


Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.


Low Self-Esteem

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.

 

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Sources

Healthtalk.org

helpguide.org

Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Simple Ways to Improve Mood by Alberto Souza, MSN, APRN, FNP-C

We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.

Be With People

Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.

Get Out

Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.

Enjoy Yourself

When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.

Talk to a Professional

Feeling sad or moody are normal human emotions that we all experience from time to time.  Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.

Source: Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Coming Out – Part 2 Parental Self-Care

When he told me he only had crushes on boys and thats why he never dated, I started crying. 

My son told me not to tell his father that he really feels like a girl. Did I let him play with girls too much? 

I asked my daughter why her best friend identifies as lesbian, and she told me she thinks she may be one too. Im sure she is not. 

When teens come out, the world shifts. Some parents respond with denial, wanting to diminish the news. Others feel anger and want to find out who is responsible. Some parents feel sadness, anticipating a loss of shared values, a loss of future. Denial, anger and sadness are all important aspects of grief processing, and for many parents, responding to a child’s coming out is a grief experience. 

Most children talk with their parents only after years of trying to figure out what is really happening inside, and when they finally tell parents, those years are condensed into a moment that – to a parent – may feel like a dropped bomb. 

After listening to hundreds of stories of parents responding to their children’s expressions of attraction and identity, I’ve seen how important it is for parents to take care of their own emotional health afterward.*  

Here are some valuable principles to keep in mind: 

  1. Take a break to figure yourself out. Denial, anger, and grief are expected. However, if your child feels overwhelmed by your denial, anger, and grief, then healthy connecting may be more difficult. Many children “take on” their parents’ reactions and become more isolated. You may want to find another place and time to express and explore your genuine reactions. One mother told her child she loved him and needed some time to figure out her own feelings, and then she spent the afternoon at her sister’s home. Another father immediately called a counselor, reassuring his son that the counseling was intended to help the father provide healthy support for his son.  
  2. Remind yourself, “This is not a crisis.” One mother described feeling completely numb. Because Christmas was only a few days away, she felt both the pressure of the family’s expectation and the heaviness of the news. She found that repeating aloud the words, “This is not a crisis” reminded her that their family would still survive despite the new information.
  3. It’s normal to feel more upset, even though your child may seem happier. While children often feel relief after sharing feelings with parents, your feelings may begin to resemble a roller-coaster. It may seem unfair that your child has just given you the burden to carry. Breathe through these feelings and recognize that this is normal.  
  4. Find safe people to share what you are feeling. Your child may insist that you tell no one. And although it’s important to honor your child’s sense of privacy, it’s OK to let your child know that you need to talk with someone. Perhaps you and your child can agree on a trusted family member, friend, or counselor. 
  5. Limit your contact with others who are uninformed. Sometimes well-meaning friends and family have advice that is not helpful, or that undermines your confidence in yourself and your child. It’s OK to limit your contact with these people for a period of time. Plan what you will say. “We are working hard to support each other right now and I need to focus on that,” may be helpful to repeat.
  6. And finally, when you ask “Why me?” try switching to the question, “Why not me?” and see what strengths you find in yourself. Chances are you are being called to a deeper way of loving your child and yourself. 

SIDEBAR MATERIAL — Find a Parent Support Group in Utah County 

Find a parent support group. Meeting with other parents in similar situations has been a positive emotional turning point for many. Here are a few in Utah Valley: 

  1. PFLAG (Parents and Friends of Lesbians and Gays) meets weekly at St. Mary’s Episcopal Church in downtown Provo (provopflag@gmail.com) 
  2. Encircle Parents’ Meeting (Third Sunday of each month at Encircle in Provo) https://encircletogether.org/supportgroups 
  3. Northstar Parents’ Meeting (Quarterly meeting at a parent’s home in Lehi) 

https://www.lds.org/blog/navigating-family-differences-with-love-and-trust?lang=eng  

 Next time:  Coming Out Part 3 – What do we do now? 

 

Coming Out – Part 1 When your teen opens up

“I wish I could take it back and do it over!” parents say about the moment their teens told them they were gay, lesbian, transgender, or that the teens were worried about their sexual orientation, attractions, or gender identity. “Nothing prepared me for this!” they say. Other parents remember, “My first thought was that what I was hearing was somehow my fault, that I’d been a bad parent, and I just fell apart.” Even parents who managed to say to their teen, “I still love you, it doesn’t change anything,” still sometimes have regrets and wish they could press the re-start button.

As a therapist who has listened to hundreds of family “coming out” stories, I’ve noticed that what happens during these conversations has a strong impact on feelings within the family. This first interaction between parent and teen (and each conversation that follows) either creates stronger bonds or difficult memories that parents and teens have to work through later.

What most parents want is to keep a strong relationship with their teen, to remain a positive influence for good mental, physical and spiritual health. Yet, sometimes, conversations with teens create distance rather than connection.

Why should I think about this?

Chances are you will have a teen in your family, your extended family, your neighborhood, or church community who will eventually come out to you. How you respond to this teen may make the difference in his or her decision to live a healthy life, or even to keep on living. Research suggests that teens who identify as LGBTQ (lesbian, gay, bisexual, transgender or queer/questioning) feel the greatest positive or negative effects from their family’s reaction to them. Negative reactions from family are associated with teens’ increased risk for depression, alcohol use, substance abuse, and other dangerous behaviors including suicide attempts. Your preparing now for a possible family member’s coming out may be one of the most powerful chances you have to be a positive influence in a young person’s life.

What can I say?

Some parents feel authentic simply saying, “Oh, OK, tell me more about it when you feel like it,” and moving on. If you’re reading this, chances are that’s not you. A young person’s coming out may make you feel as if the axis of the world has shifted and you are supposed to set it right somehow. One of the least helpful ways to respond is to assume that the teen has made a choice that rejects your values.

Most teens share their feelings about attractions and identity only after they have wrestled alone with issues for weeks, months, and often years. Most are keenly afraid that their parents will feel that family values have been rejected. Even if you are the wisest person you know, it is unlikely that you will know more about the challenges of what they have been experiencing than they do. It is also unlikely that you will learn what they are experiencing without a lot of listening. The most helpful thing a parent can do may be to set the stage for future conversations.

The statements below encourage further sharing without assuming the teen wants to reject family values. These statements also make it more likely a parent will learn more about what a teen is experiencing:

I’m so glad you’re sharing this with me.

Thank you for telling me this. I’ve been wondering how I could help you.

What you are telling me is important. Most important, however, is that I love you, and this doesn’t change my love for you.

I hope you will keep talking to me about this.

This changes things for me too, and it will give me a lot to think about, but it doesn’t change how I feel about you. I still love and cherish you. We’ll work through this together.

This is hard for me, but I’m willing to do hard things as your parent. I want to be here for you to help you.

 

Next time:  Coming Out Part 2 – What now? Parent self-Care.

By Lisa Tensmeyer Hansen, MS, LMFT

A Healthy Dose of Back-to-School Anxiety by Brent Black, LMFTA, MS

?????????????????What is a Healthy Dose of Back-to-School Anxiety?  As a family therapist, I often meet with parents who want to know if their child has anxiety and my quick response is “I hope so!” Today the mere mention of the word anxiety tends to induce stomach knots, racing hearts, and cold sweats. However, a proper dosage of anxiety is a key component for healthy and successful children. On the other hand, excessive anxiety and the absence of anxiety are debilitating. Since the launching of school can also launch levels of anxiety for many students, here are a few points for parents to consider as they look forward to a successful year.

MP900405644Too Much?
The better question about anxiety is “does my child have excessive anxiety?” All healthy individuals experience at least some anxiety, but excessive levels of anxiety can lead to harmful behaviors. In order to diagnose an individual with Generalized Anxiety Disorder they must meet certain criteria which include excessive anxiety or worry more days than not for at least 6 months, difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability, or muscle tension. These symptoms cause significant distress or impairment in social, educational or other significant areas of functioning. So, a helpful question in determining excessive anxiety is — “has my child been significantly impaired for an extended amount of time in important areas of their life because of the anxiety that they feel?”

The beginning of the school year is a fitting time for parents to consider the possibility that their actions might be creating additional anxiety. One parental trend that often leads children to experience greater anxiety is an excessive family emphasis on achievement. Children who feel like they have to achieve in order to win the approval and respect of their parents are often filled with anxiety. Their motivation for achieving becomes less about personal growth and more about fear of letting parents down.

Kids on School BusNot Enough?
The opposite of anxiety is apathy or carelessness. Children who are apathetic give off a vibe of indifference, laziness, boredom, and unconcern. Faces are unflinching and tones are flat. The default response for many questions is simply “I don’t know.” There is not an official term of diagnosis to describe these characters but they are easily identifiable.

One parental trend that could lead a child toward apathy is a parent who is inconsistent, indifferent, and un-opinionated about their child’s success. I see exceptions to this trend, but I am often unsurprised by a child’s apathy after meeting both parents and understanding that a child is simply following the example of at least one of the parents. In these cases the apple really doesn’t fall that far from the tree.

Achieving the Right Amount of Anxiety
???????????????????????A great question from parents is ‘how do I help my children have the proper amount of anxiety?’ One of the best ways of helping kids reduce to a healthy level of anxiety is by maintaining high expectations while also assuring children both verbally and non-verbally that parental love is not dependent on child outcomes. In other words, parents need to convey that regardless of achievement level their children will always be genuinely loved.
One of the main ways that parents can increase the anxiety level of their apathetic children is to get actively involved. Parents who sincerely check-in and follow-up with their children are likely to see the kind of anxiety that will help motivate their children to succeed.

Although anxiety is often viewed in a negative light, a healthy dosage of anxiety helps children to be successful. Of concern are children who are experiencing excessive anxiety or no anxiety at all. Great parents are those who feel appropriate anxiety about helping their children to be balanced in their anxiety.

brentAbout the Author: Brent is an Associate Marriage and Family Therapist. During his Master’s Degree at Brigham Young University he worked at Wasatch Mental Health where he gained experience in working with families who have children that struggled with depression, anxiety, autism, trauma, or addictions. Learn more about Brent at st.georgefamilies.com.

Gratitude: More Powerful than Stress by Dr. Lee Johnson

balanceMany of us are overly stressed. We strive to balance our demands at home, work, and other community obligations. With these competing demands it is easy to understand why people don’t want to add anything else to our busy life. However, there is one emotion that has the power to put stress in its place—gratitude.
Stress is a chronic problem and wastes our energy and can actually have a negative impact on our health and our personal relationships (Childre & Martin, 1999). Researchers have discovered that our heart is much more than a pump. Our heart is part of our nervous system and even has it own brain. Additionally, researchers originally thought that our brain controlled our heart but we now know that our heart can influence and even override signals from our brain while regulating our body (Childre & Martin, 1999). In sending signals to our brain and to aid in body regulation our heart produces neurotransmitters and hormones. One of these is hormones is atrial natriuretic factor (ATF) or the “balance hormone”. This hormone regulates many of our bodily functions, blood pressure, and electrolyte balance (Childre & Martin, 1999). Gratitude is one of the keys to having our systems balanced to facilitate being calm and relaxed.
debtGetting away from some of the negative thoughts and feelings in our head such as frustration, anger and stress and focusing on our hearts with positive feelings of affection, appreciation, love, compassion and gratitude keep or heartbeat consistent and coherent and allow us to perform at our best (Childre & Martin, 1999). When I am overly stressed or negative, I have found that gratitude or appreciation is one of the easier positive emotions on which to focus to reduce the stress. An example from my life will illustrate how this works.
Lone Tree in SnowOne night it snowed a lot. I was scheduled to go for an 8 mile run the next morning. I grew up with cold winters and spent many childhood winters playing in the snow and as a teenager many weekends skiing. However, since moving to the south I have come to appreciate the warm winter weather and the luxury of year around training outside. I looked out the window and the negativity started; I hate being cold, I don’t need this workout, I can’t run that far, etc. With encouragement from my wife I got dressed and headed out. I discovered early on that I was correct—it was cold outside and I hated it, my legs felt like cement and I had strong doubts about completing the workout, and I thought I should just stop and go home. As I rounded a corner the wind started to blow snow from the trees into the sunlight. It was absolutely beautiful. My focus shifted from negativity and doubt to appreciation for the scenery, my ability to run, and being grateful to be outside. My ability to perform dramatically improved. My legs lightened up, I did not notice the cold and had a great run. What made the difference? I shifted to positive emotions (different from just positive thoughts) and the subsequent physiological heartbeat changes that accompany those feelings. I have used this moment as a guide and I have had similar experiences when work, family, or other obligations have stressed me.

 

So what is the key to applying this information to reducing stress? Shift your focus to the positive emotion of appreciation or gratitude. It may be helpful to focus on the scenery, the enjoyment you get out of your family, or think of someone you love and appreciate. This is more involved than making a list of things you are grateful for, it is focusing on theses things until you feel the appreciation or gratitude. It is important to practice these skills at various times during the day. Build them into your day and make them a part of your routine. While these skills take practice the return on the little investment of time will be worth the rewards.

Reference: Childre, D. & Martin, H. (1999). The heartmath solution. San Francisco: Harper.

 

 

LeeAbout the Author: Dr. Lee Johnson is a faculty member in the Marriage and Family Therapy Program at Brigham Young University. He is a licensed Marriage and Family Therapist, AAMFT approved supervisor, and a USAT Certified Triathlon Coach.

Literacy: Raising Strong Readers by Audrey Cornelius

readLiteracy. How can I raise my child to be a strong reader? I walk into the living room to find my six year old daughter snuggled up with her normally rambunctious four year old brother on the couch. She is reading her latest treasure from the library and her brother is completely absorbed by the story.

I know that the gift of literacy to my children is a gift of freedom and potential for their futures. So, how did we get to this moment? Did I higher personal reading tutors or lock my children in their rooms with a dictionary and an order not to come out until they could spell every word? No, that would be crazy! Instead I followed some easy, research driven guidelines set out by the Association for Library Services to Children and the Public Library Association. These are some easy ways to promote literacy in your home and give your child a gift that will last a lifetime:

Read to your child, even if you don’t think he is listening. I’ve done my fair share of reading to a dancing, train playing audience. You may not think they are getting anything out of it, but they are. One day they’ll sit through a whole book and you’ll be so glad you stuck with it.

read2Talk to your child a lot, and make sure you use big words. A strong vocabulary is linked to good comprehension skills. Small children can learn big words and they love using them. My four year old son loves to tell me how “hilarious” his preschool friends can be.

Sing to your child. This builds rhythm, pattern, and sound recognition. Besides, sometimes it feels good to belt out “Itsy Bitsy Spider” and end with a good tick session.

Give your child lots of opportunities to draw and write. Paper and crayons are cheep toys so let them exercise their fine motor skills and their imaginations.

Play with your child. This gives you and your child a chance to bond and build positive feelings while at the same time letting them experiment with story and narrative skills. After all, a super hero has to discover her powers first before she can defeat the bad guy and then save the day.

By following these easy guidelines you can build a home of literacy and learning, while building some happy family memories in the process.

audreyAbout the Author: Audrey Cornelius graduated from Brigham Young University with a BA in English. In 2013 she received a Master’s degree in Library Science from Texas Woman’s University. She is passionate about children’s literacy issues.

The Role of Spirituality in Health Care by Dr. Victor Sierpina, MD

Lone Tree in SnowSpirituality and religious beliefs may seem like an inappropriate topic to discuss in the health care setting. Perhaps such conversations are best held by a pastoral counselor, clergy, or the hospital chaplain. Patients and their families always have some value system in place, whether based in traditional religious structures, personal spirituality, or some philosophy of life. It is often helpful to elicit these beliefs in order to understand a person’s support system, how and why they make health care choices, and how they might affect palliative care or end-of-life choices.
One model for addressing spiritual belief systems has been developed under the auspices of the John Templeton Foundation and is taught to health professionals through the George Washington Institute of Spirituality in Health. It is called FICA. This is a rather straightforward approach that allows a neutral, non-threatening, and supportive approach to inquiring about the patient’s beliefs. FICA is an acronym for:
Faith and Belief. A question like, “Do you consider yourself spiritual or religious?” can open up rich dialogue on personal values and beliefs.
Importance. A physician or health provider might ask, “What importance do your faith or beliefs have related to your health.”
Community. “Are you part of a spiritual or religious community?” This helps determine the support system.

balanceAddress in care. “How would you like me, as your healthcare provider, to address these issues?” They may not want to go any further at this time, but at least we now have permission to enter into this level of conversation.
In my experience, patients are eager and open to discuss spiritual beliefs with their doctor, yet most physicians feel uncomfortable initiating such discussions. By normalizing this kind of conversation and including it in the routine intake history with a patient, it becomes a matter of record and, with practice, easier to discuss. This requires more than dutifully recording the patient’s religious affiliation in the medical record. It also helps to avoid making the patient feel like they are at death’s door, as their doctor is suddenly talking about their belief system or religion.
Of course, healthcare professionals must be cautious not to proselytize their own religious beliefs on patients and to be diligently mindful of any conscious or even unconscious bias about someone of a different faith or spiritual belief than their own. We are there to explore the patient’s support system, to understand how they process the mysteries of life, and how they make decisions. If a patient and provider share the same religious outlook, patients often feel reassured by discussion, prayer in the office, sharing scriptures of relevance, and the like. Be attentive for “faith flags,” like religious symbols, certain verbal expressions, religious jewelry, T-shirt mottos, reading materials, even tattoos, as these might give a clue to a patient’s spiritual orientation and thus occasion a deeper discussion.

In his landmark book, Victor Frankl, a Jewish psychiatrist and death camp survivor, observed that even under the horrific conditions of the concentration camp, those who held onto some kind of personal goal, hope, or meaning for their life frequently survived. Often, those right next to them without such a spiritual construct were the first to die. Without hope, without meaning, without spirit, the body shuts down.
Our goals as health providers are to value our patients as human beings, mind, body, and spirit; to relieve both physical and metaphysical suffering; and to offer love, support, and caring on as many levels as the patient is ready to accept. Spirituality belongs in the clinical setting for these reasons.

Sierpina_Victor_5x7About the Author: Dr. Victor Sierpina is currently the director of the Medical Student Education Program at UTMB, Galveston. He is a WD and Laura Nell Nicholson Family Professor of Integrative Medicine, and also a Professor in Family Medicine. He is a University of Texas Distinguished Teaching Professor. His clinical interests have long included holistic practices, wellness, lifestyle medicine, mind-body therapies, acupuncture, integrative oncology, nutrition, and non-pharmacological approaches to pain.

Forgiveness: Spiritual & Medical Implications by Christina Puchalski

This is an interesting article taken from The Yale Journal for Humanities in Medicine.

“Forgiveness: Spiritual and Medical Implications”  by Christina Puchalski, MD.

(http://info.med.yale.edu/intmed/hummed/yjhm/spirit/forgiveness/cpuchalski.htm)

 

MP900385327“On a societal level, we face social injustice, urban crime, terrorist acts and war. These realities of society can also lead to resentment, territorialism and hatred. While many of these aspects of our society are wrong and perhaps even warrant a justifiable anger and hatred until we can forgive even the most horrendous of these acts, how can we as a society, or as a civilization, live together in peace? Thus, forgiveness is the basic building block of a tolerant society.
There have been many studies looking at the role of forgiveness in health. Unforgiving persons have increased anxiety symptoms, increased paranoia, increased narcissism, increased frequency of psycho-somatic complications, increased incidence of heart disease and less resistance to physical illness. Others have found that people who are unable to forgive themselves or others also have an increased incidence of depression and callousness toward others. The act of forgiveness can result in less anxiety and depression, better health outcomes, increased coping with stress, and increased closeness to God and others.
MP900440326There have been numerous studies looking at forgiveness interventions. The interventions involved counseling and exercises which were used to help people move from anger and resentment towards forgiveness. In one study, incest survivors who experienced the forgiveness intervention had at the end of the intervention increased abilities to forgive others, increased hopefulness and decreased levels of anxiety and depression. In another study, college students were randomized to a group that received a forgiveness education program and another group who studied human relations. The group that received the forgiveness education program showed higher levels of hope and an increased willingness to forgive others. This greater self-forgiveness was associated with increased self-esteem, lower levels of anxiety, lower levels of depression and a more positive view of their patient.
In many of these studies, it was shown that people who are able to forgive are more likely to have better interpersonal functioning and therefore social support. In terms of social support, there is a large body of literature that demonstrated the value of social support. Social support has been shown to reduce cardiovascular risks, promote faster recovery and increased survival rates from several types of cancer. Therefore, forgiveness, since it improved interpersonal functioning, might mediate these better health outcomes through the ability of people to have increased social support.
MP900289480Thus, act of forgiving from a research end seems to indicate that forgiveness can improve personal, interpersonal, and societal well-being.”