“Touching the hem of her garment” – A Review of Dr Caroline Leaf at Nexus Church, Brisbane, 2nd August 2015

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. She’s currently on tour through Queensland and New South Wales in Australia. Her only stop in Brisbane, my home town, was at Nexus, my former home church. Dr Leaf presented a keynote address at Nexus’s annual Designing Women conference yesterday, and was the guest speaker at their two morning services today.

This morning typified Brisbane winter – cloudless azure skies and a refreshingly cool breeze. In contrast to the air temperature, the hospitality at Nexus was warm and friendly. The worship, soulful and uplifting. I really enjoyed being there.

Then it was Dr Leaf’s turn. It’s amazing just how much misinformation one person can fit into a 30 minute sermon.

The main theme for her sermons was an exposition on the parable of the sower, linking the different ways people receive information, with the story of the woman with the issue of blood. Dr Leaf tried to prove that thought and faith are synonymous by linking verses at the beginning and of the story from the gospel of Mark (5:25-34) – “because she thought, ‘If I just touch his clothes, I will be healed.’” (v28) and “He said to her, ‘Daughter, your faith has healed you. Go in peace and be freed from your suffering.’” (v34).

The link is highly tenuous to start with. Faith is an action, whereas thought is not. We assume that action is always preceded by thought, but it is not. Action does not require thought. Many people act without thinking. This is explained in more detail in my discussion on the Cognitive Action Pathways model.

Though to try and make her explanation more plausible, Dr Leaf padded out the story by telling the Nexus crowds that it was only because the woman had spent 12 years in deep intellectual thinking, meditating on the scriptures, that Jesus could heal her. But that’s Dr Leaf’s conjecture. In truth, no one knows exactly what that woman was doing or thinking in the 12 years that preceded her healing. The Bible never says anything else about the woman, in either version of the story in Mark or Luke (8:43-48), other than “She had suffered a great deal under the care of many doctors and had spent all she had, yet instead of getting better she grew worse” (Mark 5:26). If you have to rely on pure speculation to make your sermon work, then that’s story-telling, not preaching.

The other part of her sermon was an attempt to link the parable of the sower to some neuroscience, specifically the role of hippocampal synaptogenesis in the formation of long term memory (or in English, the changes that take place to nerves in the brain when you hear information and try to remember it).

Dr Leaf interpreted the parable as describing four different types of listener – Listener 1, corresponding to the man who hears the word but the devil takes it away, Listener 2, who hears the word and receives it with joy, but it doesn’t take root, Listener 3 who hears the word but it gets choked out by worries, riches or pleasure, and Listener 4 who hears the word and retains it, and the word produces a harvest.

According to Dr Leaf, these types of listener correspond to different levels of nerve branch growth in the formation of long term memory – Listener 1 doesn’t get past 24 hours before the memory dissipates. Listener 2 only lasts about four to seven days but there isn’t enough emotional salience to continue the growth of the nerve branch. Listener 3 doesn’t get past fourteen days, while the 4th Listener makes it through to a full 21 days, Dr Leaf’s magic number for long term memory.

Sounds great … except that the encoding and consolidation of incoming information is much more complex, and doesn’t rely on just new nerve growth. That, and her numbers are completely arbitrary – with some permanent long term memory encoded in a couple of days. In fact, some long-term memory doesn’t need new synaptic growth at all, just a state of high excitation of the nerve network, known as Long-Term Potentiation, which is reliant on a self-reinforcing chemical cascade (if you want more information on the neurobiology of memory, a good place to start is The Brain From Top To Bottom, maintained by McGill University in Canada).

So the bulk of her sermon is based on biblical conjecture and bad science. Dr Leaf made a myriad of misleading or erroneous statements: we are wired for love not fear, we learn through the quantum zeno effect, every thought effects every one of our 75 trillion cells, your toxic thoughts poison people in relationship with you because of quantum physics, and many, many others.

I’ve only really got room for a few extra-special mentions.

1. “The mind controls brain”, and “the non-conscious mind is not bound by time and space”

No actual cognitive neuroscientist would be caught dead making those sort of statements. Saying that the mind controls the brain is like saying that air controls your lungs. The mind is a function of the brain, because when the brain is changed in certain ways, structurally or chemically, the mind changes. This has been known about for over a century, at least as far back as Freud who experimented with cocaine and other “mind-altering” substances.

Therefore if the brain controls the mind, then the non-conscious mind must be bound by the physical universe, which includes space and time. To suggest anything otherwise is just science fiction.

Besides, Dr Leaf herself tells us in her book “The Gift In You” [1], that our brain controls our mind. Dr Leaf is simply contradicting her own teaching.

2. “75 to 98% of all physical, mental and emotional illness is caused by your thought life.”

This factoid has been thoroughly debunked. If you would like to read more, you can click here or see chapter 10 in my book [2].

Today, in the second service, Dr Leaf took her fiction a step further and categorically stated that “98% of cancer comes your thought life”. What nonsense! There is no rational evidence for such a ridiculous statement, and I don’t think there is anything more insensitive to the victims and families of cancer to blame then for causing their own cancer.

3. Mental Health

(a) “Mental illness is worse in the last 50 years than ever before”

To try and prove this is true, Dr Leaf flashed up a slide of ‘horrifying statistics” on mental illness. She said that,
“35-fold increase in mental illness in children”
“Our children are the first in human history to grow up under the shadow of ‘mental illness'”
“Dramatic increase in the number of mentally ill since 50’s … things are worse not better”
“Mental ill health worst its ever been in history of mankind”

Every one of these statements is patently false. Mental illness has been with humankind for ever. The ancient Egyptians were writing about hysteria in women some two thousand years before Christ [3]. It’s only been up until the last century or so that mental illnesses have become seen for the biological entities that they are, and not some form of demon possession, criminal behaviour or sexual deviancy.

Dr Leaf was quick to malign the DSM (the Diagnostic and Statistical Manual of psychiatry), suggesting that it’s unscientific. The DSM isn’t perfect, true, but before the DSM, there was even less science to the diagnosis of mental illness. As Dr Leaf herself pointed out, mental illness was previously viewed philosophically or spiritually. There was no consistency in diagnosis and no collection of statistics.

The DSM, for all its faults, gave a framework for mental health diagnosis, but as the science has become more refined, and with increasing awareness and general acceptance of mental health conditions, more people have qualified and/or accepted a diagnosis.

Mental illness has always been there, but now we know what to look for, it’s no longer hidden or ignored.

(b) “Psychotropic medications cause damage to the brain”

While on the subject of mental health, Dr Leaf made the litigation-attracting statement that psychotropic medications (anti-depressants, anti-psychotics) cause damage to the brain. That’s a particularly bold statement to make without citations, or a medical degree, to back it up.

Rather than ‘causing’ damage to the brain, there is scientific evidence that psychotropic medications increase synaptogenesis (the growth of new nerve branches) [4], while the NICE guidelines in the UK reviewed the evidence for anti-depressants and found them to be an effective treatment for depression [5], not harmful as Dr Leaf suggests.

(c) Biological causes for psychiatric illnesses have not been proven.

Dr Leaf also made the preposterous claim that biological causes of psychiatric illness have never been proven, but again, changes to brain structure have been associated with psychiatric symptoms ever since a 13-pound, three-and-a-half foot iron rod went through Phineas Gage’s skull and frontal lobe in 1848, and his personality suddenly changed from pleasant and congenial to depressed and angry [6]. Personality changes represent early symptoms of brain tumours. Use of drugs such as crystal meth can cause paranoia and extreme aggression. You don’t even need to be a doctor to know that, you just need to watch ‘Breaking Bad‘. So examples of the biological basis of psychiatric symptoms are everywhere. There are no grounds for Dr Leaf’s assertion.

4. Toxic thinking causes dementia

Dr Leaf claimed at the end of both sermons that toxic thinking results in the tubular backbone of the new nerve branches becoming contorted, which caused the accumulation of the tau protein in the nerve cells, which was responsible for dementia of every type. This, too, is a fallacy. The accumulation of the tau protein is found only in Alzheimers, not in Lewy Body dementia or in vascular dementia. The abnormal tau protein is likely related to the loss of a intracellular clean-up enzyme system [7], but Alzheimers is more complicated than just tau protein deposition, and has nothing to do with toxic thinking.

At the conclusion of the second service, I was outside the church when Dr Leaf and her entourage left the church auditorium before the rest of the crowd did, and I approached them to shake her hand and introduce myself. It was the mature thing to do after all. When I was about two metres from her presidential detail, a women stepped out in front of me, blocking my way.

“You can’t follow them,” she said. “They’re going inside” (ie: hiding in the green room).
“Really?” I said, somewhat caught off guard. “I was simply going to introduce myself.”
“No”, was the firm reply. “You’re not allowed.”

By that time, the presidential detail had disappeared into their fortified sanctuary. The woman with the issue of blood may have got to Jesus, but there was no way I was even getting close to Dr Leaf.

This was a common pattern … Dr Leaf made herself deliberately scarce before and after each service, only coming into the church when the service was well underway, and leaving as soon as she preached, under heavy guard. One has to ask why? What’s she got to be afraid of? Is she so insecure about her teaching that she couldn’t possibly risk speaking to someone and being exposed as intellectually brittle? Or is it that she’s so arrogant as to insist on avoiding the rank-and-file church goer?

The pattern of avoidance of anyone other than her devotees, and her tendency to block anyone who disagrees with her from her social media accounts, would strongly suggest the former, although since she is so insistent on hiding from regular people, it’s really anyone’s guess.

Not that it matters. Dr Leaf could be the nicest person in the world.  Her ministry doesn’t rest on her sociability, but its own Biblical and scientific merits, and on that alone, it has been found seriously wanting.

References
[1]        Leaf CM. The gift in you – discover new life through gifts hidden in your mind. Texas, USA: Inprov, Inc, 2009.
[2]        Pitt CE. Hold That Thought: Reappraising the work of Dr Caroline Leaf. 1st ed. Brisbane, Australia: Pitt Medical Trust, 2014.
[3]        Tasca C, Rapetti M, Carta MG, Fadda B. Women and hysteria in the history of mental health. Clinical practice and epidemiology in mental health : CP & EMH 2012;8:110-9.
[4]        Karatsoreos IN, McEwen BS. Resilience and vulnerability: a neurobiological perspective. F1000prime reports 2013;5:13.
[5]        Anderson I. Depression. The Treatment and Management of Depression in Adults (Update). NICE clinical guideline 90.2009. London: The British Psychological Society and The Royal College of Psychiatrists, 2010.
[6]        Kihlstrom JF. Social neuroscience: The footprints of Phineas Gage. Social Cognition 2010;28:757-82.
[7]        Tai HC, Serrano-Pozo A, Hashimoto T, Frosch MP, Spires-Jones TL, Hyman BT. The synaptic accumulation of hyperphosphorylated tau oligomers in Alzheimer disease is associated with dysfunction of the ubiquitin-proteasome system. The American journal of pathology 2012 Oct;181(4):1426-35.

Dr Caroline Leaf – Still Contradicted by the Latest Evidence, Scripture and Herself

Leaf Cognitive Neuroscientist

Dr Caroline Leaf is a communication pathologist, world renowned author, public speaker, and self-titled cognitive neuroscientist. Her influence continues to grow. She is regularly invited to speak at some of the world’s largest churches. She spoke at her first TEDx conference in February, and she’s about to host her own conference for the second time. She has more than 120,000 Facebook followers, with many more on Twitter and other social media platforms. And she continues to top the sales charts of Christian best sellers.

She is a self-marketing machine.

But there are cracks appearing. More and more, people are realizing that beneath the facade of her numerous Instagram posts, happy snaps, and the allure of popular success, Dr Leafs teachings on science and the Bible don’t match up with actual science and good theology. While many in the church adorn themselves with her teaching, a growing minority are starting to realise that the Emperor has no clothes.

Almost two years ago to the day, I sat in the congregation of Kings Christian Church on the Gold Coast, and heard Dr Leaf speak live for the first time. What I heard troubled me, and I blogged about my concerns to open a dialogue on Dr Leaf and her teaching. Her husband, Mr Mac Leaf, dismissed my concerns out of hand, which only steeled me to take further action. Now, two years of intense research, dozens of posts and a book later, people are starting to take notice.

Not that Dr Leaf has changed her tune. Her fundamental teaching still relies on the idea that our thoughts control our physical and mental health, and toxic thinking causes disease because our thoughts change our DNA and the expression of our genes through epigenetics. And, if we ‘detox’ our thoughts, we will be restored to the health that God intended. Dr Leaf is also expanding her ministry to the subject of mental health and she plans to release a book on food in early 2016.

Dr Leaf can spruik whatever she likes, but her claims of expertise and her scientific and scriptural legitimacy are crumbling.

This post is a little longer than usual, but I’ve divided it up for easier reading:

  1. Dr Leaf is contradicted by her own qualifications
  2. Dr Leaf is contradicted by science
  3. Dr Leaf is contradicted by scripture
  4. Dr Leaf is contradicted by Dr Leaf

1. Dr Leaf is contradicted by her own qualifications

In her books, on TV, at churches, and in promotional material, Dr Leaf describes herself as a ‘cognitive neuroscientist’.

However, Dr Leaf does not have formal qualifications in neuroscience, has not worked at a university as a neuroscientist, has not worked in any neuroscience research labs, nor has she published any papers in neuroscience journals.

Actually, Dr Leaf is trained as a communication pathologist. A communication pathologist is an allied health professional which seems to be unique to South Africa where Dr Leaf trained. It’s a synthesis of audiology and speech pathology. It qualified her to work as a therapist, which Dr Leaf did for children with traumatic brain injuries. Dr Leaf also researched a narrow band of educational psychology as part of her PhD, and she also worked in a number of schools and for educational boards in South Africa. Dr Leaf hasn’t performed any university based research since her PhD was published in 1997.

In contrast, true cognitive neuroscientists actively carry out research into the biological basis of thoughts and behaviours – either mapping behaviours to certain brain regions using electrical currents from the brain, or with functional brain imaging like fMRI, or stimulating or suppressing the activity of a region of the brain and seeing how a person responds.

Simply having some training in neuroanatomy and psychology doesn’t make you a cognitive neuroscientist. Completing a PhD that involved a model for learning doesn’t make you a cognitive neuroscientist. Reading a lot of books on neuroscience doesn’t make you a neuroscientist either, just like reading the Bible doesn’t automatically make you a Pastor.

So no matter how much Dr Leaf may try to convince us that she’s an expert cognitive neuroscientist, truth be told, she is not.

Of more concern is that Dr Leaf is also trying to position herself as an expert in the fields of mental health and nutrition. But if she can’t get her facts right in an area in which she’s had some training, then it’s unlikely Dr Leaf’s teaching will be reliable in areas that she’s had no formal training or experience whatsoever.

I might add, Dr Leaf’s insistence that she’s a cognitive neuroscientist and an expert on mental health and nutrition is also quite insulting for real psychologists, neuroscientists and nutritionists whose opinions are ignored in favour of a self-titled expert whose only ‘authority’ comes by popular demand, not training or experience.

2. Dr Leaf is contradicted by science

There are so many examples of Dr Leaf being directly contradicted by the science that she claims expertise in that I don’t have room in this blog to outline them all. What I can do in this limited space is to outline Dr Leaf’s most egregious and ironic fallacies as a taster.

The 98 percent

One of Dr Leaf’s most fundamental assertions is that “75 to 98 percent of mental and physical illness comes from ones thought life” [1]. She uses this little factoid all the time to justify her belief in the power of thoughts.

However, her statement is completely wrong. When considered in the historical and global context [2], most of human illness is related to preventable diseases that are so rare in the modern western world because of generations of high quality public health and medical care.

For example, Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years (DALYs)), and poor-quality drinking water is an important risk factor for diarrhoea.” [3]

De Cock et al write, “Recent estimates of the global incidence of disease suggest that communicable diseases account for approximately 19% of global deaths” and that “2.5 million deaths of children annually (are) from vaccine-preventable diseases.” [4]

Routine screening with the much-maligned pap smear has decreased the death rate from cervical cancer in women by as much as 83% [5]. And having a competent midwife and obstetric support during childbirth can decrease the odds of dying in childbirth from 1 in 6 to less than 1 in 30,000 [6].

Midwives, vaccinations, pap smears, clean drinking water and internal plumbing have nothing to do with our individual thought life. We take all of this for granted in the first-world, so the impact of our thought life becomes artificially inflated. In reality, modern medicine and civil engineering, not our thought life, have everything to do with our good health..

Though what makes this meme such a good example of the weakness of Dr Leaf’s teaching is not just because it’s contradicted by actual science, but in trying to justify her conjecture, Dr Leaf has resorted to twisting, misquoting, and generally fudging information from her ‘sources’ in order to make them support her false conclusions.

For example, Dr Leaf quoted a source on genetics that was over thirty years old, from a time when genetic studies were still in the dark ages. She also misquotes her sources, significantly changing the meaning of the quotes in the process. One source didn’t even mention the figure she attributed to it. As if that’s not bad enough, Dr Leaf also cites biased sources, pseudoscientists, and other sources that directly contradict her assertion [7; Ch 10].

This pattern of relying on mistruths and factoids to paper over the gaping cracks in her irrational assertions is repeated throughout her teaching.

The heart is a mini-brain

Dr Leaf believes that the human heart acts as a mini-brain. She states that the heart has its own thought functions, is an electrophysiological regulator of every cell in the body, and is the source of the human conscience.

Such an assertion is ludicrous, and science proves it to be so – the “still small voice” comes from our brains [8-10], and everyday office-based medical tests prove that the electromagnetic signal from the heart is too small to have any meaningful influence on our body’s cells, let alone our thinking [7: Ch 11].

You control your DNA with your thoughts

Dr Leaf believes that our thinking can influence our DNA. She said this in her 2013 book [1: p35], and several times on her social media streams. The problem for Dr Leaf is that there is no credible scientific evidence that DNA is controlled by thoughts.

Her main evidence comes from a poster presentation at a 1993 psychotronics conference titled, “Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA” [11]. She describes this paper as, “An ingenuous experiment set up by the HeartMath Foundation (which) determined that genuine positive emotion, as reflected by a measure called ‘heart rate variability’, directed with intentionality towards someone actually changed the way the double helix DNA strand coils and uncoils. And this goes for both positive and negative emotions and intentions.” [1: p111]

Actually, the experiment was based on faulty assumptions, and so full of flaws in the methodology and analysis, that it could show nothing at all [7: Ch 13]. All it could prove was that Dr Leaf was so desperate to grasp hold of anything that seemed to support her theory that she was willing to use a twenty-year-old study from a group of pseudoscientists that also believe in occult practices like ESP and telekinesis (http://psychotronics.org).

On and on, the same pattern continues. She claims that our thoughts are powerful enough to control our DNA and our brain, except that the opposite is true – it’s our DNA code, with some influence from our environment, that creates our pattern of neurons responsible for our stream of thoughts. She teaches that thoughts cause stress, when again, the evidence is the opposite – psychological stress starts as a subconscious process which changes our stream of thoughts. Dr Leaf teaches that in order to improve our mental and physical health, we need to fight any ‘negative’ or ‘toxic’ thoughts, when studies show that cognitive therapy isn’t effective when compared to behavioural activation. (This is explained in more detail, and with the appropriate references, in my book [7]).

Dr Leaf even goes so far as to say that our thoughts can control physical matter! [1: p33,38]

Over and over again, Dr Leaf’s teaching conflicts with modern science. That Dr Leaf also regularly misquotes her sources and relies on unpublished opinion from pseudoscientists and new-age practitioners also brings her reputation as an expert scientist into disrepute.

3. Dr Leaf is contradicted by scripture

In her books and on social media, Dr Leaf often quotes scripture in an attempt to reinforce her reputation as some form of Biblical expert. Everything’s fine when she simply quotes scripture, but problems arise when she tries to interpret it. Like her use of science, Dr Leaf often misquotes or paraphrases scripture, or uses it out of context, in order to try and Biblically justify her tenuous hypotheses.

2 Timothy 1:7

One of Dr Leaf’s favourites is 2 Timothy 1:7: “For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.” Dr Leaf interprets the phrases of “spirit of fear” and “a sound mind” as “anxiety” and “mental wholeness” respectively. For example, on the 12th of May 2014, she posted to her social media feeds, “Your mind is all-powerful. Your brain simply captures what your mind dictates. 2 Timothy 1:7” And in her book “Switch on your brain” [1], she said on page 33, “For now, rest in the assurance that what God has empowered you to do with your mind is more powerful and effective than any medication, any threat, any sickness, or any neurological challenge. The scripture is clear on this: You do not have a spirit of fear but of love, power and a sound mind (2 Tim 1:7).”

Simply checking the verse in its full context, and in a different translation, shows it in a completely different light to the way Dr Leaf promotes it. From the NIV, “I am reminded of your sincere faith, which first lived in your grandmother Lois and in your mother Eunice and, I am persuaded, now lives in you also. For this reason I remind you to fan into flame the gift of God, which is in you through the laying on of my hands. For the Spirit God gave us does not make us timid, but gives us power, love and self-discipline. So do not be ashamed of the testimony about our Lord or of me his prisoner. Rather, join with me in suffering for the gospel, by the power of God.” (2 Timothy 1:5-8)

The Greek word for “fear” in this scripture refers to “timidity, fearfulness, cowardice”, not to anxiety or terror. The Greek word that was translated “of a sound mind” refers to “self-control, moderation”, not to mental wholeness. So Paul is teaching Timothy that God doesn’t make him timid, but full of power, love and self-control. Paul is simply saying that through the Holy Spirit, we have all the tools: power, love and the control to use them, so we don’t have to be afraid.

This scripture has nothing to do with our mental health. It certainly doesn’t say that our minds are “more powerful and effective than any medication, any threat, any sickness, or any neurological challenge”. Dr Leaf’s use of this scripture is misleading.

Proverbs 23:7

Another favourite of Dr Leaf’s is Proverbs 23:7, “For as he thinketh in his heart, so is he”.

She used this scripture a number of times on her social media feeds, including on the 4/2/2015, “‘The more you believe in your own ability to succeed, the more likely it is that you will. Shawn Achor’ – ‘For as he thinketh in his heart, so is he …’ Proverbs 23:7”, and the 29/5/2015, “Mind In Action: ‘Genes cannot turn themselves on or off. In more scientific terms, genes are not ‘self-emergent’. Something in the environment has to trigger gene activity.’ Dr Bruce Lipton’ – That ‘something’ is your thoughts! Read Proverbs 23:7″. Dr Leaf also used the same scripture to try and explain how the woman with the issue of blood managed to obtain her healing [1: p111].

What’s interesting is how Dr Leaf only ever uses the first half of this verse. The whole verse (in the King James Version) reads, “For as he thinketh in his heart, so is he: Eat and drink, saith he to thee; but his heart is not with thee.”

So what’s with the second half of the verse? What’s the eating and drinking half of the verse got to do with our thought life?

The explanation is that this verse has nothing to do with our thought life at all. Dr Leaf has simply been misquoting it for years, and no one checked to see if she’s right. According to the Pulpit commentary found on the Bible Hub website, “The verb here used is שָׁעַר (shaar), ‘to estimate … to calculate’, and the clause is best rendered, ‘For as one that calculates with himself, so is he’. The meaning is that this niggardly host watches every morsel which his guest eats, and grudges what he appears to offer so liberally … He professes to make you welcome, and with seeming cordiality invites you to partake of the food upon his table. But his heart is not with thee. He is not glad to see you enjoy yourself, and his pressing invitation is empty verbiage with no heart in it.” (http://goo.gl/nvSYUh)

Thus, the scripture does not prove that our thoughts define us as Dr Leaf would suggest. Dr Leaf’s use of this scripture is misleading.

James 1:21

Another example, on the 26 May 2014 on her social media feeds, Dr Leaf said, “James 1:21 How you react to events and circumstances of your life is based upon your perceptions” and then a week later, “James 1:21 Our thoughts and perceptions have a direct and overwhelmingly significant effect of the cells of our body” (4/6/2014).

Except that James 1:21 actually says, “Wherefore lay apart all filthiness and superfluity of naughtiness, and receive with meekness the engrafted word, which is able to save your souls”, and has absolutely nothing to do with our perceptions and our cellular biology.

The same pattern is repeated on social media and in her books. Dr Leaf finds scriptures where one version mentions words like “thinking” or “choice”, isolates them from their context and reinterprets them to suit her meaning, rather the actual meaning of the verse in the original language and the original context.

4. Dr Leaf is contradicted by Dr Leaf

Not only is Dr Leaf’s teaching contrary to science and scripture, but even her own teaching contradicts itself. Dr Leaf also makes claims about her research and achievements that aren’t backed up by her published papers.

To gift or not to gift …

In her 2009 book, “The gift in you” [12], Dr Leaf teaches about the gifts that we have, specifically, our gifts are something uniquely hardwired into our brain, something that we cannot change even if we wanted to, and that it’s our brain structure that gives rise to the way in which we think, the actions that we take, and the gifts we are given from God.

On page 47, Dr Leaf said,

The mind is what the brain does, and we see the uniqueness of each mind through our gifts. This, in itself is delightful and, intriguing because, as you work out your gift and find out who you are, you will be developing your soul and spirit.” (Emphasis added)

This quote in and of itself isn’t actually that significant until we compare it to a quote from the first chapter of Dr Leaf’s 2013 book, “Switch on your brain.” [1]

“The first argument proposes that thoughts come from your brain as though your brain is generating all aspects of your mental experience. People who hold this view are called materialists. They believe that it is the chemicals and neurons that create the mind and that relationships between your thoughts and what you do can just be ignored.
So essentially, their perspective is that the brain creates what you are doing and what you are thinking. The mind is what the brain does, they believe, and the ramifications are significant. Take for example, the treatment of depression. In this reductionist view, depression is a chemical imbalance problem of a machinelike brain; therefore, the treatment is to add in the missing chemicals.
This view is biblically and scientifically incorrect.” [1: p31-32] (Emphasis added)

So … our gifts are hardwired into our brain and can’t be changed because our mind is what our brain does OR our brain is what our mind does, so our gifts aren’t uniquely hardwired into our brain, and we should be able to change our gifting if we want to, based on our choices. Which is it? It can’t be both. Dr Leaf’s fundamental philosophies are mutually exclusive.

Now, we all make innocent mistakes. No one is perfectly congruent in everything they say. But this isn’t just getting some minor facts wrong. These statements form the foundation for Dr Leaf’s major works, and are in print in two best selling books, from which she has used to present countless sermons and seminars around the globe.

To summarise, Dr Leaf has directly called her own beliefs and teaching “biblically and scientifically incorrect”, and not noticed. The confusion and embarrassment are palpable.

But wait, there’s more.

(Not) Making a Difference

From the pulpit, in her books, and in her promotional material, Dr Leaf refers to her ground-breaking research – how her “Switch On Your Brain 5 Step Learning Process” and the Geodesic Information Processing model (which underpins her program), have helped thousands of children to increase their learning and improve their academic results.

For example, Dr Leaf claims that, “The Switch On Your Brain with the 5-Step Learning Process® was assessed in a group of charter schools in the Dallas [sic]. The results showed that the students’ thinking, understanding and knowledge improved across the board. It was concluded that The Switch On Your Brain with the 5-Step Learning Process® positively changed the way the students and teachers thought and approached learning.” (http://drleaf.com/about/dr-leafs-research/ – Original emphasis)

In her TEDx talk, Dr Leaf stated, “I wasn’t sure if this was going to have the same impact cause until this point I’d been working one on one. Well I’m happy to tell you that we had the same kind of results … The minute that the teachers actually started applying the techniques, we altered the trend significantly.” and,
“I stand up here saying this with conviction because I have seen this over and over and over in so many different circumstances … in this country I worked in Dallas for three years in charter schools, and we found the same thing happening.” [13]

Though there is the minor problem of her research results not demonstrating any actual change.

In Dr Leaf’s first case, Dr Leaf herself admitted that the demonstrated improvement of her single patient was just as likely to be related to spontaneous improvement, and not Dr Leaf’s intervention. In Dr Leaf’s PhD thesis, the students improved almost as much in the year without Dr Leafs intervention as they did with her program. In the Dallas charter schools study, Dr Leaf’s intervention either disadvantaged the students or showed no significant difference. In academic circles, Dr Leaf’s research hasn’t so much as generated a stale whimper [14].

So while Dr Leaf may claim that her research has changed the learning and lives of thousands of students all over the world, but her own published research disputes her claims.

The Emperor has no clothes, but no one wants to say anything

In Hans Christian Andersen’s legendary tale, the Emperor was conned by two swindlers into believing that “they were weavers, and they said they could weave the most magnificent fabrics imaginable. Not only were their colors and patterns uncommonly fine, but clothes made of this cloth had a wonderful way of becoming invisible to anyone who was unfit for his office, or who was unusually stupid.”

If you don’t know the story, you can read it here. In the end, the Emperor was duped so badly that he paraded in front of all his subjects au naturel, but “Nobody would confess that he couldn’t see anything, for that would prove him either unfit for his position, or a fool. No costume the Emperor had worn before was ever such a complete success.”

My analogy here is not to suggest that Dr Leaf is deliberately conning the church. Rather, our natural instinct is to suppress our own judgement, even when it’s right, in favour of everyone else’s. We assume information to be true because others in authority tell us it is. We assume that the Emperor must be wearing something because the trusted ministers and noblemen are holding his imaginary train high in the air.

Likewise, it’s very natural for Christians to believe that Dr Leaf’s teaching must be ok because our pastors and leaders vouch for it. Our pastors and leaders vouch for Dr Leaf’s teaching because it’s been endorsed by world-renowned Christian leaders like Kenneth Copeland and Joyce Meyer. And no one wants to say anything, because they don’t want to look sheepish (or be ostracised). Dr Leaf’s ministry may look like a complete success, but only until someone finally says, “But, the Emperor has no clothes …”

It’s time to call Dr Leaf’s ministry for what it is. In my humble opinion, I suggest that Dr Leaf’s ministry is not based on scientific acumen, but on popularity and reputation. And her reputation, in turn, is based on slick self-promotion and an availability cascade (a self-reinforcing process by which an idea gains plausibility through repetition).

Dr Leaf’s teachings are not supported by science, nor by scripture. Her own fundamental philosophies contradict each other. Her assertions about her title and the results of her work are in conflict with her own official data.

Our church leaders need to come clean about why they publicly endorse Dr Leaf’s ministry. I can justify why I think Dr Leaf should not be preaching from our pulpits – in this and many other blog posts, and in my 68,000 word rebuttal to Dr Leaf’s published works. Can Kenneth Copeland and Joyce Meyer, or churches such as Cottonwood Church or Hillsong Church, produce evidence where they considered Dr Leaf’s scientific credibility before endorsing her ministry? I would be happy to publish any responses they may be willing to make, complete and unabridged.

If Dr Leaf is preaching at your church, politely ask your pastor to produce his or her evidence that Dr Leaf’s teaching is scientifically and scripturally sound. If your church leaders can’t show that Dr Leaf’s teachings are scientifically and scripturally accurate, then politely ask them why she’s been invited to preach from their pulpit or to sell her wares in your church? Feel free to share your experiences in the comments section.

Critics and sceptics love to use any opportunity they can to embarrass the church, but by parading our own naivety, we’re simply embarrassing ourselves.

It’s time we dressed ourselves in God’s glory, not our own ignorance and ignominy.

References

[1]        Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2]        World Health Organization. GLOBAL HEALTH ESTIMATES SUMMARY TABLES: DALYs by cause, age and sex. In: GHE_DALY_Global_2000_2011.xls, editor. Geneva, Switzerland: World Health Organization,, 2013.
[3]        Hunter PR, MacDonald AM, Carter RC. Water supply and health. PLoS medicine 2010;7(11):e1000361.
[4]        De Cock KM, Simone PM, Davison V, Slutsker L. The new global health. Emerging infectious diseases 2013 Aug;19(8):1192-7.
[5]        Dickinson JA, Stankiewicz A, Popadiuk C, Pogany L, Onysko J, Miller AB. Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC public health 2012;12:992.
[6]        Ronsmans C, Graham WJ, Lancet Maternal Survival Series steering g. Maternal mortality: who, when, where, and why. Lancet 2006 Sep 30;368(9542):1189-200.
[7]        Pitt CE. Hold That Thought: Reappraising the work of Dr Caroline Leaf. 1st ed. Brisbane, Australia: Pitt Medical Trust, 2014.
[8]        Mendez MF. The neurobiology of moral behavior: review and neuropsychiatric implications. CNS spectrums 2009 Nov;14(11):608-20.
[9]        Zysset S, Huber O, Ferstl E, von Cramon DY. The anterior frontomedian cortex and evaluative judgment: an fMRI study. NeuroImage 2002 Apr;15(4):983-91.
[10]      Glascher J, Adolphs R, Damasio H, et al. Lesion mapping of cognitive control and value-based decision making in the prefrontal cortex. Proceedings of the National Academy of Sciences of the United States of America 2012 Sep 4;109(36):14681-6.
[11]      Rein G, McCraty R. Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA. Proc Joint USPA/IAPR Psychotronics Conf, Milwaukee, WI; 1993; 1993.
[12]      Leaf CM. The gift in you – discover new life through gifts hidden in your mind. Texas, USA: Inprov, Inc, 2009.
[13]      Leaf CM. Ridiculous | TEDx Oaks Christian School | 4 Feb 2015. YouTube: TEDx, 2015;20:03.
[14]      Pitt CE, The TEDx Users Guide to Dr Caroline Leaf, cedwardpittcom; 2015   Mar 26, http://cedwardpitt.com/2015/03/26/the-tedx-users-guide-to-dr-caroline-leaf/

Olive Leaf Extract – A potential treatment, but not for what you think

Here in Australia, it’s winter. It’s currently warmer in the fridge than it is outside. We’ve just been blasted by a wall of frigid air straight from Antarctica, and much of the south-eastern corner of our continent has snow drifts over parts that not so long ago were baking under the hot Autumn sun. It’s not something we’re used to in Australia.

Of course, now that winter is firmly entrenched, more people are coming to see me with their viral upper respiratory tract infections, better known as ‘colds’. Yes, ’tis the season to be sneezin’!  Over my years of practice, I’ve seen enough people with a cold to last me a thousand winters.

What always fascinates me are the things that people try to use to cure their cold. I think I’ve heard everything over the last decade: garlic, ginger, peppermint, chicken soup, honey, tea, honey mixed with lemon mixed with tea, or honey mixed with lemon mixed cayenne pepper mixed with tea.   Some people rub Vicks on their feet. Other people douse their pillows in eucalyptus oil.

Another common recommendation that gets around the grape vine and social media is olive leaf extract, used in traditional ‘medicine’ for thousands of years, and those witch-doctors and shamans can’t all be wrong.

One published review described the ‘science’ of olive leaf extract: “Constituents of the olive tree, Olea europaea, have been studied and utilized in folk medicine for centuries. Olive leaf extract, derived from the leaves of the olive tree, contains phenolic compounds, specifically oleuropein, that have demonstrated potent antimicrobial, antioxidant, and anti-inflammatory activity. Oleuropein and derivatives such as elenolic acid have been shown to be effective in in vitro and animal studies against numerous microorganisms, including retroviruses, coxsackie viruses, influenza, and parainfluenza as well as some bacteria. Research suggests that olive leaf constituents interact with the protein of virus particles and reduce the infectivity and inhibit replication of viruses known to cause colds, influenza, and lower respiratory infection. Olive leaf extract has also been shown to stimulate phagocytosis, thereby enhancing the immune response to viral infection. Anecdotal reports indicate olive leaf extract taken at the onset of cold or flu symptoms prevents or shortens the duration of the disease. For viral sore throats, gargling with olive leaf tea may alleviate symptoms, possibly by decreasing inflammation and viral infectivity.” [1]

It’s always a concern when a supposedly peer reviewed journal allows an article to get through which seriously discusses anecdotal evidence as something worthy of attention. Anecdotal evidence is the weakest level of evidence possible. Anecdotal evidence is essentially just stories and opinion [2]. There’s anecdotal evidence for the Tooth Fairy. The other ‘evidence’ that this review describes is from in vitro studies, which are trials in test tubes not in people. In vitro evidence is only helpful in a general sense. Just because a reaction happens in a test tube or petri dish doesn’t mean that it will happen in a real life human being.

So then, do the claims for olive leaf extract stand up to the rigors of modern scientific enquiry or is it like every other cold and flu ‘remedy’ – just another individualised mythology?

Being sceptical, I wanted to find out. So I searched through the published medical literature for quality clinical trials that studied olive leaf extract in humans, and I found only six trials. Interestingly, all of the trials studying olive leaf extract weren’t looking at its effect on immune function but on cholesterol and blood sugar control, blood pressure, and oxidative stress.

In 2009, Kendall et al published a single-centre, randomized, single-blinded, prospective pilot comparison of the effect of dietary supplementation with olive leaf extract on the markers of oxidative stress in 45 healthy young adult volunteers. They found that olive leaf extract had no effect on oxidative stress compared to the control group [3].

Susalit et al (2011) published a double-blind, randomized, parallel and active-controlled clinical study looking at the tolerability, cholesterol-lowering and anti-hypertensive effect of Olive leaf extract in comparison with Captopril (a common blood pressure medication) in patients with early hypertension. After 8 weeks of treatment, there were similar reductions in blood pressure in both the olive leaf extract and the blood pressure pill groups. There was a significant drop in triglyceride levels in the olive leaf extract group, but not in Captopril group [4].

Wainstein et al (2012) performed a randomized controlled trial on 79 adults with non-insulin dependent diabetes, comparing a single 500mg dose of olive leaf extract with placebo over 14 weeks. They measured the HbA1c (a surrogate measurement of the average blood sugar over a three month period) and plasma insulin levels. They also did studies in rats to study the mechanism of action of the olive leaf extract. In the human trials, the subjects treated with olive leaf extract exhibited significantly lower HbA1c and fasting plasma insulin levels. This effect was thought to be reflected in the rat study which suggested that olive leaf extract reduced the digestion and absorption of starch from the intestines [5].

de Bock et al (2013) did a randomized, double-blinded, placebo-controlled, crossover trial on 46 patients in New Zealand, over a 30 week period. The participants were middle aged and overweight. The researchers were primarily studying insulin sensitivity but they also looked at glucose and insulin profiles, cytokines, lipid profile, body composition, 24-hour ambulatory blood pressure, and carotid intima-media thickness. The olive leaf extract group had a statistically significant improvement in insulin sensitivity and responsiveness of the pancreatic β-cell. Interestingly, the olive leaf extract supplementation improved some inflammatory markers, but not others, and made no difference to the patients lipid profile, blood pressure, body composition (their body fatness), carotid intima-media thickness (a risk predictor of cardiovascular disease), or liver function [6].

For completeness, de Bock lead another trial, also published in 2013, although this trial was more a study of the absorption of the compounds in olive leaf extract than a study of their effects [7]. There was a 1996 Belgian study which was written in French. I’m not very good with French, but according to the English abstract, there was no difference between the olive leaf extract and placebo in terms of blood pressure and blood sugar levels [8].

Reconciling the research on olive leaf extract makes for an interesting narrative. There are a couple of really strong, methodologically robust trials on olive leaf extract, and with positive results in favour of it. However, I can count them on one hand, and while the results are encouraging for proponents of olive leaf extract, there needs to be a lot more research before those claims can be made with certainty. And in contrast to its usual selling points, those positive effects for olive leaf extract were for blood sugar control, not the prevention or treatment of viral illnesses.

The bottom line – olive leaf extract may one day prove to be a useful herbal supplement, but there’s not enough clinical evidence to support it at the present moment. And there’s certainly no evidence that olive leaf extract will do anything for your viral upper respiratory tract infections.

So next time you get a cold, don’t bother spending money on olive leaf extract. Have a couple of paracetamol, a long hot shower and a good rest.

And if symptoms persist, don’t forget to see your GP.

References

[1]        Roxas M, Jurenka J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. Alternative medicine review : a journal of clinical therapeutic 2007 Mar;12(1):25-48.
[2]        Fowler G. Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field 2001:93-107.
[3]        Kendall M, Batterham M, Obied H, Prenzler PD, Ryan D, Robards K. Zero effect of multiple dosage of olive leaf supplements on urinary biomarkers of oxidative stress in healthy humans. Nutrition 2009 Mar;25(3):270-80.
[4]        Susalit E, Agus N, Effendi I, et al. Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: comparison with Captopril. Phytomedicine : international journal of phytotherapy and phytopharmacology 2011 Feb 15;18(4):251-8.
[5]        Wainstein J, Ganz T, Boaz M, et al. Olive leaf extract as a hypoglycemic agent in both human diabetic subjects and in rats. Journal of medicinal food 2012 Jul;15(7):605-10.
[6]        de Bock M, Derraik JG, Brennan CM, et al. Olive (Olea europaea L.) leaf polyphenols improve insulin sensitivity in middle-aged overweight men: a randomized, placebo-controlled, crossover trial. PloS one 2013;8(3):e57622.
[7]        de Bock M, Thorstensen EB, Derraik JG, Henderson HV, Hofman PL, Cutfield WS. Human absorption and metabolism of oleuropein and hydroxytyrosol ingested as olive (Olea europaea L.) leaf extract. Molecular nutrition & food research 2013 Nov;57(11):2079-85.
[8]        Cherif S, Rahal N, Haouala M, et al. [A clinical trial of a titrated Olea extract in the treatment of essential arterial hypertension]. Journal de pharmacie de Belgique 1996 Mar-Apr;51(2):69-71.

Join the clots – Strokes and the oral contraceptive pill

 

Doing the rounds on Facebook recently was a story broadcast on Channel Seven News (Brisbane) from the 22nd of June 2015. It was the story of a previously healthy young Melbourne woman who suffered a stroke at work. She was simply sitting at her desk, and was suddenly unable to move her arm to control her mouse. Because of the quick thinking of one of her co-workers, Melissa James got urgent medical attention and appears to have made a very good recovery.

Channel Seven’s angle on this story was that Melissa’s oral contraceptive pill Yasmin was to blame. Perhaps it was. Perhaps it wasn’t. No one can fairly say from the limited information that was given in the two minute clip.

The report also suggested that Yasmin was responsible for strokes in countless other women, stating that Bayer, Yasmin’s manufacturer, was paying out billions of dollars in damages, and that Yasmin caused a “six-fold increase in strokes”, potentially putting hundreds of thousands of women at risk.

That the oral contraceptive pill is associated with an increase risk of strokes is not in contention. Strokes and blood clots are well known to be side effects of the pill. Remember, any drug that has an effect is also going to have side effects. The oral contraceptive pill is no different. The question then becomes: Is the pill still safe to use, or should women be ditching it in favour of other forms of contraception?

To answer that, one has to start trawling through statistics. Don’t worry, I promise there won’t be too many numbers, because statistics make my brain hurt. Instead, I want to show you a few graphs, because it’s actually much easier to understand the risk of the pill if you have the right perspective.

One of the largest and most recent studies on the risk of strokes and the oral contraceptive pill was done in Denmark in 2012 [1]. Lidegaard and colleagues followed 1,626,158 women over a decade, and analysed the risk of strokes while using different forms of hormonal contraception. The sheer number of women involved in the study make the statistics very strong. Overall, women taking Yasmin were 1.64 times more likely to have a stroke than the average woman not taking any contraception.

Even at this early stage, there are two important points to consider:
1. I’m not sure what source the Channel Seven reporter was quoting when she suggested that Yasmin was six times more likely to cause strokes. Certainly, the numbers in this study don’t come close to this, and
2. A relative risk of 1.64 is the same as saying there was a 64% increase in stroke risk. This still sounds bad for Yasmin … until you look at the risks for some of the other pills discussed in the study.

JoinTheClots_Fig1_optimised

The graph shows that there are actually quite a few contraceptive pills that have a higher risk of stroke than Yasmin. According to the numbers of Lidegaard et al, Yasmin is not all that spectacular – just somewhere in the middle in terms of the risk of stroke, compared with common pills.

Though when you factor in a broader array of pills, other contraceptive methods, and other everyday situations for women, the risk of stroke from Yasmin, or any pill for that matter, doesn’t look bad at all.

JoinTheClots_Fig2_optimised

The risk of stroke from taking Yasmin is nothing compared to the risk of stroke in the few weeks after birth, but there are no news reports of the dangers of stroke after having a baby.

There’s probably a couple of reasons for that – post-partum strokes are brought about by babies, which are cute and cuddly, and not by multinational drug companies, which are repugnant and evil, and much more newsworthy. It’s also because even though the risk of stroke in the few weeks after delivery is nearly 25-times higher than the stroke risk for an average non-pregnant woman, that number is still so small on average that the overall chance of getting a stroke in the few weeks after delivery (in statistical parlance, the “absolute risk”), is tiny.

JoinTheClots_Fig3_optimised(additional statistics: [2] and flying risk extrapolated from [3])

In the Lidegaard study, there were 2260 strokes in 9,336,662 person-years. That’s a rate of only 24.2 strokes for every 100,000 women in a year. Even though the risk of stroke after birth is still very high, it hardly creates a impression on the graph of absolute risk. And because the risk from most contraceptives is quite a bit lower, they don’t even make a blip.

Thinking about it in a different way, even with the increased risk of taking Yasmin, for every 100,000 women taking Yasmin for a year, there will only be an extra 16 strokes on average compared to the general population. 16 in 100,000 … that’s like trying to find a straight middle-aged man at a One Direction concert.

Which brings us to the take home messages:

1. Always take health stories on the news with a pinch of salt. The media often use a liberal amount of poetic licence to sell their stories. I’m not sure where Channel Seven got their source material, but it doesn’t seem to fit the data that I’ve unearthed in a quick search of the medical literature. The story of Melissa James is newsworthy as an exploration of the struggle of a young woman who suffered a tragic complication, and I’m really glad for her that she seems to be winning that battle. But her story can’t be extrapolated to every other woman on Yasmin, or any other pill for that matter. The statistics suggest that experiences like that of Melissa James are thankfully rare.

2. There is more to the oral contraceptive pill than just the risk of strokes. The oral contraceptive pill has a number of other potential complications, and each form of contraception needs to be matched correctly to the woman who’ll be taking it. This is why the pill remains on prescription in Australia (and most other countries), not sold off the shelf at the pharmacy or the supermarket. If you have any concerns about your risk from the pill, or any other method of contraception, see your GP for a full assessment.

References

[1]        Lidegaard O, Lokkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. The New England journal of medicine 2012 Jun 14;366(24):2257-66.
[2]        Izadi M, Alemzadeh-Ansari MJ, Kazemisaleh D, Moshkani-Farahani M, Shafiee A. Do pregnant women have a higher risk for venous thromboembolism following air travel? Advanced biomedical research 2015;4:60.
[3]        Centers for Disease Control and Prevention. CDC Health Information for International Travel 2014. New York: Oxford University Press, 2014.

Declaration: For the record, I declare no conflict of interest in the publication of this post. I do not receive payment, commission, or any kind of gratuity, from Bayer, or any pharmaceutical company. I do not directly own shares in Bayer or any other pharmaceutical company. Nor do I have any professional links to any pharmaceutical company. I wrote this post to promote rational use of medicine, not to specifically promote or defend one particular brand of medication.

Seven Elements of Good Mental Health: 7. Create social networks – The Prospering Soul

Life shouldn’t just be about avoiding poor health, but also enjoying good health. Our psychological health is no different.

Before we take a look at poor mental health, let’s look at some of the ways that people can enjoy good mental health and wellbeing. This next series of posts will discuss seven elements that are Biblically and scientifically recognised as important to people living richer and more fulfilling lives.

These aren’t the only ways that a person can find fulfilment, nor are they sure-fire ways of preventing all mental health problems either. They’re not seven steps to enlightenment or happiness either.   But applying these principles can improve psychosocial wellbeing, and encourage good mental health.

7. Create social networks

Before 2004, everyone knew what social networks were. Now when you talk about ‘social networks’, people assume you’re referring to Facebook. It seems like virtual social networking has been around forever, whereas in contrast, real social networking actually has.

We know this, because we’re wired for social interaction, with specific areas of the brain devoted to social behaviour, such as the orbitofrontal cortex, and there are neurotransmitters and hormones that are strongly associated with bonding and maintenance of social relationships, like oxytocin and β-endorphins. Research has also shown that both humans and other primates find social stimuli intrinsically rewarding – babies look longer at faces than at non-face stimuli, for example [1].

People who engage in social relationships are more likely to live longer, some estimate by an extra 50% [2]. Certainly it appears that the opposite is true. Loneliness predicts depressive symptoms, impaired sleep and daytime dysfunction, reductions in physical activity, and impaired mental health and cognition. At the biological level, loneliness is associated with altered blood pressure, increased stress hormone secretion, a shift in the balance of cytokines towards inflammation and altered immunity. Loneliness may predict mortality [3].

So what is loneliness, and conversely, what defines good social relationships? Fundamentally, good or bad social relationships are related to the quality of the social interaction. This rule applies equally to real social networks [3] and their on-line equivalents [4]. So quality is fundamentally more important than quantity in terms of friendships, with that quality strongly determined by the connection within those social relationships. For example, loneliness “can be thought of as perceived isolation and is more accurately defined as the distressing feeling that accompanies discrepancies between one’s desired and actual social relationships” [3].

The corollary is that friendship can be thought of as perceived connection within social relationships, or the comforting feeling that accompanies the match between one’s desired and actual social relationships.

So healthy social relationships aren’t defined by the size of your network, but by the strength of the connections that your network contains, relative to what’s important to you. Just because you’re not a vivacious extrovert who’s friends with everyone doesn’t mean that your social network is lacking. It also means that you can have meaningful connections to friends through social media, just as much as you can have meaningful connections through face to face interactions. It’s not the way you interact, but the quality of the connection that counts.

What is it about other people that makes us more likely to be their friends? Connection between friends is often the result of attraction to individuals of similar personalities or skills, although recent research suggests that friendship may be related to a much deeper level. Brent et al notes that “Humans are especially predisposed toward homophily, with recent evidence suggesting this even extends to the genetic level; people are more likely to be friends if they have similar genotypes. Taken together, these findings advocate the need to consider not only an individual’s genome, but also their metagenome, when asking questions about the causes of friendship biases … Unrelated friends are more likely to be genetically similar, equivalent to the level of fourth cousins, compared to unrelated strangers.” [1]

As Christians, we’re encouraged to engage with other Christians on a regular basis, which in our modern world, is through regular church attendance. As the Bible says in Hebrews 10:23-25, “Let us hold unswervingly to the hope we profess, for he who promised is faithful. And let us consider how we may spur one another on towards love and good deeds, not giving up meeting together, as some are in the habit of doing, but encouraging one another – and all the more as you see the Day approaching.” But as the research has shown, it’s not just being part of the crowd, but connecting with those in the church in a meaningful way. It’s very easy to be lonely in a crowded church.

Always remember: “Befriend, and be a friend” – that’s how you’ll find benefit to your spirit, soul and body.

References

[1]        Brent LJ, Chang SW, Gariepy JF, Platt ML. The neuroethology of friendship. Annals of the New York Academy of Sciences 2014 May;1316:1-17.
[2]        Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS medicine 2010 Jul;7(7):e1000316.
[3]        Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Social science & medicine 2012 Mar;74(6):907-14.
[4]        Oh HJ, Ozkaya E, LaRose R. How does online social networking enhance life satisfaction? The relationships among online supportive interaction, affect, perceived social support, sense of community, and life satisfaction. Computers in Human Behavior 2014;30:69-78.

Seven Elements of Good Mental Health: 6. Forgiveness – The Prospering Soul

Life shouldn’t just be about avoiding poor health, but also enjoying good health. Our psychological health is no different.

Before we take a look at poor mental health, let’s look at some of the ways that people can enjoy good mental health and wellbeing. This next series of posts will discuss seven elements that are Biblically and scientifically recognised as important to people living richer and more fulfilling lives.

These aren’t the only ways that a person can find fulfilment, nor are they sure-fire ways of preventing all mental health problems either. They’re not seven steps to enlightenment or happiness either.   But applying these principles can improve psychosocial wellbeing, and encourage good mental health.

6. Forgiveness

“You’d think after five months of lying on my back, I would have given up any idea of getting even, just be a nice guy and call it a day. Nice guys are fine: you have to have somebody to take advantage of… but they always finish last.”

Mel Gibson’s character spoke these words as an introduction to the movie “Payback.” It’s plot line sees him maim or kill every person linked in the chain of thugs and organised crime that ripped him off of his seventy thousand dollars. At the end of the movie, after he exacts the final revenge on the last villain, he drives off with a smile on his face, his money and his renewed romance. But if this was real life, would he have been happy, or would he have just been even?

It’s human nature to repay wrong with another wrong. Eye for an eye, tooth for a tooth. If you hurt me, natural justice is fulfilled if I make you feel the same pain in return. So what choices do you have if someone hurts or wrongs you? Well, you could retaliate. You could plan retribution. Ask for recompense. Or simply push for recognition of your pain. Sometimes these strategies lead to resolution, but usually not immediately, and in order to stay motivated to achieve a delayed resolution, you have to keep reminding yourself of the pain caused to you, so that the effort you’re making will be worthwhile.

As the old proverb goes, “Two wrongs don’t make a right.” If you hurt me, hurting you back doesn’t make my pain go away. It just adds more pain to the world, because I’m still in pain and now you’re in pain. Then you’ll want to hurt me back, and the cycle escalates. Francis Bacon said, “A man that studieth revenge keeps his own wounds green, which otherwise would heal and do well.” In other words, you may be able to bring about retribution, but during the process, you’ll end up keeping your own wounds open and festering, instead of letting them close and heal. It’s like someone cut you with a knife, and if order to show them what damage they did to you, you keep reopening the wound every few days. The wound may look open and fresh should they ever care to notice, but you’re the one who had to put up with an open wound for an extended time, and re-live the pain every time you reopened it.

Interestingly, research tend to support this notion. One study showed that when subjects were asked to think of reacting aggressively to a given scenario, parts of the limbic system in their brains increased in activity. This isn’t unsurprising, given that our brain subconsciously prepares us all the time for fight or flight responses when it starts to sense danger, in preparation for possible action. What was more interesting is that it also reduced the activity of the subjects frontal lobes as well. As discussed by Worthington and colleagues, “Thus, one implication might be that negative emotion acts antagonistically toward reasoning. This suggests that reasoning is disrupted by anger and that imaginally rehearsing angry and aggressive mental scenarios (i.e., ruminating angrily) could (a) catapult one into negative emotive responding and (b) shut down rational approach and calm emotions. Imagery as well as verbal rumination might stimulate similar effects.” [1]

The other option is a particular form of acceptance, which we know as forgiveness. Forgiveness, the act of moving on from insult or injustice, a actually a complex psychological process. There have lots of studies looking at different aspects of forgiveness, but without getting bogged down in details, forgiveness helps to rebalance things. People who forgive habitually tend to also have lower systolic, diastolic blood pressure, and individual acts of forgiveness and lower hostility predicted lower stress levels, which in turn predicted lower self-reported illness, a strong mediator being reduced negative affect (a “bad mood”) was the strongest mediator between forgiveness and physical health symptoms, although they also noted other variables such as spirituality, social skills, and lower stress also had a role in the forgiveness-health relationship [2].

I understand that talking about forgiveness can bring up some deep and difficult feelings in some people. Just like physical wounds, some are shallow and heal quickly, but others are inflicted so deep that they’re hard to heal – severe trauma like rape, childhood abuse, domestic violence and other deep psychological insults. It’s important to clarify here that memories of such traumatic events often intrude into your conscious awareness, where it replays in your memory, but not of your own volition. That’s different to unforgiveness and rumination, which are memories which we foster and encourage. Forgiveness is still a part of the healing process of these severe traumas, but the healing process may take longer, and the process of finding that forgiveness may require a professional to help walk through the process. If you’ve been the victim of a severe trauma, you don’t need to go it alone. Find a psychologist or talk to your doctor if you’re not sure.

For the Christian, forgiveness is at the very core of the entire life of faith we lead. God forgave us, and we can enjoy that forgiveness if we choose to move away from a life enslaved to sin. It is through the death of Jesus on the cross that we have this chance, and Jesus himself showed the ultimate in forgiveness when, as he hung dying on the cross, he forgave the soldiers that put him there. Throughout his ministry, he preached the same message – forgiveness is a central text of the Lords prayer, he told Peter that he should forgive someone “seventy times seven”, and he showed grace to those around him such as the woman caught in adultery. There are many more examples of forgiveness in the Bible as well.

I don’t know if there is any one particular best method to forgive. Apologies help [3], but they aren’t necessary to be able to forgive someone. Sometimes people find actually saying the words “I forgive you” to be a powerful release. That can be to a person directly, although that may not always go down well. Saying it internally is valid. Sometimes writing it in a letter, and then tearing it up as an act of finality, can be useful.

I hope that you can find it in your heart to forgive those in your life that have wronged you and continue to move forward. Remember, “To forgive is to set a prisoner free, and discover that the prisoner was you.” (Lewis B. Smedes)

References

[1]        Worthington EL, Jr., Witvliet CV, Pietrini P, Miller AJ. Forgiveness, health, and well-being: a review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of behavioral medicine 2007 Aug;30(4):291-302.
[2]        Lawler KA, Younger JW, Piferi RL, Jobe RL, Edmondson KA, Jones WH. The unique effects of forgiveness on health: an exploration of pathways. Journal of behavioral medicine 2005 Apr;28(2):157-67.
[3]        Strang S, Utikal V, Fischbacher U, Weber B, Falk A. Neural correlates of receiving an apology and active forgiveness: an FMRI study. PloS one 2014;9(2):e87654.

Seven Elements of Good Mental Health: 5. Be grateful – The Prospering Soul

Life shouldn’t just be about avoiding poor health, but also enjoying good health. Our psychological health is no different.

Before we take a look at poor mental health, let’s look at some of the ways that people can enjoy good mental health and wellbeing. This next series of posts will discuss seven elements that are Biblically and scientifically recognised as important to people living richer and more fulfilling lives.

These aren’t the only ways that a person can find fulfilment, nor are they sure-fire ways of preventing all mental health problems either. They’re not seven steps to enlightenment or happiness either.   But applying these principles can improve psychosocial wellbeing, and encourage good mental health.

5. Be grateful

As I was trolling through Facebook the other day, I came across this post by Sir Richard Branson, founder of Virgin: “Thanked an airport security worker, he said I was the first to say #ThankYou in three years. Shocked! Saying thank you should be second nature …”

Richard Branson Thank You

Perhaps the security worker was exaggerating for the billionaire, or perhaps everybody hates airport security at the airport where he works. At any rate, three years is a long time to go without someone saying thanks.

As Sir Richard said, “Saying thank you should be second nature …”. Saying thanks is a small part of the much larger psychology of gratitude, which is “part of a wider life orientation towards noticing and appreciating the positive in the world” [1]. In fact, there are several components to the overall orientation of gratitude, including “(1) individual differences in the experience of grateful affect, (2) appreciation of other people, (3) a focus on what the person has, (4) feelings of awe when encountering beauty, (4) behaviors to express gratitude, (5) focusing on the positive in the present moment, (6) appreciation rising from understanding life is short, (7) a focus on the positive in the present moment, and (8) positive social comparisons.” [1]

The research suggests that people who are naturally grateful tend to be less angry and hostile, less depressed, less emotionally vulnerable, and experienced positive emotions more frequently. Gratitude also correlated with traits like positive social functioning, emotional warmth, gregariousness, activity seeking, trust, altruism, and tender-mindedness. Grateful people also had higher openness to their feeling, ideas, and values, and greater competence, dutifulness, and achievement striving.

However, these effects may be simply an association of gratitude with other personality traits. In other words, people who are naturally optimistic or conscientious are also more likely to be thankful, rather than the thankfulness causing someone to be more optimistic or conscientious. There are a few studies that show gratitude interventions improving self-worth, body image, and anxiety, although the evidence is that while gratitude was better than doing nothing, it was equal to, not superior to, currently accepted psychological interventions.

Even though gratitude may not be better than standard psychological treatments, it’s better than being ungrateful.  It’s also something that the Bible exhorts us to do (“In everything give thanks, for this is the will of God in Christ Jesus, concerning you.” – 1 Thess 5:18).  And let’s face it, it’s pretty easy to do.

The best studied gratitude intervention is a gratitude diary – writing something down every day that you are thankful for [1]. It doesn’t have to be long. A single sentence or phrase is good enough. Not that it has to be written if that’s not your thing. I had a friend who was determined to do a gratitude journal, but she also has a love and a knack for photography. So, she decided to take a photo a day of something that she was grateful for, and post it on Facebook. She had her moments where she doubted herself, struggled to find a subject of her gratitude, or struggled to find something unique, especially after day 300, but the end result was amazing. She grew in her gratitude and her photographic skill, and I often found myself blessed by her beautiful images and insights.

So, be thankful and express it in your own unique way.

References

[1]        Wood AM, Froh JJ, Geraghty AW. Gratitude and well-being: a review and theoretical integration. Clinical psychology review 2010 Nov;30(7):890-905.