A reflection on preparations for Passover

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I know this is a bit late, as Passover ends on Tuesday night, but I was finally able to find the article online.  Here is my recently published Passover article.

A reflection on preparations for Passover

Seven weeks ago, as I was doing my weekly food shopping, I came across an aisle of food set aside for Passover products. Jewish law is very strict regarding what can and cannot be consumed on Passover.

As such, Jews spend days and weeks before Passover planning and implementing our cleaning, shopping and cooking schedules in order to ensure that Passover can be celebrated in its proper way at the proper time. Additionally, each of those tasks is not simple. For example, when it comes to food shopping, it is an overhaul of all one owns during the year and buying replacement Kosher for Passover products for the one week holiday in addition to needing to know in advance what and how much one needs to purchase. As one can imagine, this preparation becomes all-consuming.

Passover celebrates the Exodus from Egypt of the Israelites 3,500 years ago, a story of going from slavery to freedom, exile to redemption. And yet, in working to prepare for Passover, one gets a sense that there is an irony to celebrating freedom by slaving over our preparations to celebrate. Yet, when we look into the value of freedom versus slavery, we recognize that freedom is not always about absolutely lack of methodical conduct that one must engage. Rather, freedom is having the ability to have dignity and self-worth in the midst of a legal system, a legal system that is ideally established to protect its citizens.

Perhaps this is the lesson of the excessive preparation before Passover. The Jewish mystical tradition presents a fascinating re-read of the laws regarding removing leavened products from one’s home for Passover. Instead of reading the law in the literal sense, it is re-conceptualized to teach people that Passover is a time of introspection, specifically a time of investigating one’s humility in relationship with G-d. We are to remove the arrogance, the leaven, in our hearts, humbling ourselves, symbolized by Matzah, something that doesn’t rise.

While Passover cleaning cannot and should not be the same as spring cleaning, which it becomes for many, there is also a lesson in similar vein regarding the hard work of preparing for Passover.

To truly be able to fulfill the mandate of seeing oneself as having been redeemed from Egypt, which would require a certain humility of perspective as one would be focusing on the idea of redemption from being enslaved, one can see the preparation for Passover as a microcosm of burden before celebration.

May each of us find humility in the renewal time of the calendar, and may we find meaning in the challenges of preparing to celebrate the holiday that truly embodies freedom.

Caring for the Human Spirit: Driving the Research Agenda for Spiritual Care in Health Care – conference recap

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I recently attended the Caring for the Human Spirit: Driving the Research Agenda for Spiritual Care in Health Care conference held by the Health Care Chaplaincy Network.  It was definitely the beginning of something special, with a focus on spiritual care research in Palliative Care.  While the presentations were really just the beginnings of what is hoped will be more focus on showing the efficacy of spiritual care, there was a sense that much has been shown already to indicate that spiritual care is a core discipline in health care.  Here is the accounting of the conference chairperson, George Handzo.

It’s a New Day

This past week, HealthCare Chaplaincy Network (HCCN) with funding from the John Templeton Foundation hosted a landmark conference titled “Caring for the Human Spirit: Driving the Research Agenda for Spiritual Care in Health Care.” The event was originally conceived as the capstone event for a three year grant from the John Templeton Foundation that funded six foundational studies which begin to lay the foundation for the workings of spiritual care and chaplaincy care in health care and begin to develop a cadre of health care chaplains engaged in this research.

Certainly, the event more than satisfied its original purpose. The six presentations from the research groups were extraordinary in both the sophistication and power of the results and in the rigor and professionalism with which they were presented. The question of whether professional chaplains can make significant contributions to research in the field and help advance the evidence base for chaplaincy care is now answered in the affirmative. The question of whether spiritual care can be researched productively is also answered in the affirmative.

However, the event turned out to be much more than simply a reporting out of six research groups- as ground breaking as that reporting was. When HCCN issued its call for proposals on this project, we really didn’t know what the quality and quantity of the response was going to be. One guess was twenty proposals would be generated and this guess was generally thought to be optimistic. The call generated 72 responses of which 56 were judged of high enough quality to be presented to the review panel as finalists. Thus, it became immediately clear that there is a tremendous interest in this kind of research, much of it from highly sophisticated research groups.

Given this beginning to the project, it should not have been a surprise that the conference also drew a response far beyond what many would have guessed. Despite a very short lead time for the publicity and the costs of coming to a conference in New York City, the conference drew close to 250 attendees from all over the US and several other countries with another significant audience attending though live streaming video. Anecdotally, the response of those attendees was overwhelmingly positive.

So what does this all mean?  History will provide the best answer to this question of course but I am impressed by the similarities to integrating spiritual care in health care. Almost every survey published to date is clear that a majority of patients and family care givers want their spiritual and religious needs integrated into their health care- especially as they make decisions about how that care is to proceed. An increasing number of directives and guidelines including from such prestigious bodies as the World Health Organization promote the universal availability of palliative care and with it the inclusion of spiritual care. And yet, many people who could benefit from palliative care, including in the US, do not get it and many who get something billed as palliative care do not get good spiritual care as part of that care.

So we clearly have a lack of alignment between what many patients and many health care authorities think ought to happen and what is happening. Why? One issue has to do with available workforce. Even hospitals that are looking to hire a physician board certified in palliative care often have trouble finding one. One influential palliative care guidelines panel lists a board certified chaplain as “preferred” rather than required because they were aware that it is currently impossible for many palliative care teams to find a board certified chaplain with the proper training. One initiative that is needed here is to continue to educate palliative care providers about the special contributions of palliative care trained, board certified chaplains so they give preference in hiring to those with these credentials which should result in more chaplains seeking those credentials. Hopefully the conference results can help in that regard

But the other issue is developing the evidence base for spiritual care in palliative care. This conference made a huge contribution but the body of evidence is still very small and not yet at a level that should be considered persuasive. Getting over this barrier is a “chicken and egg” problem. Many funders, especially federal funders, want to see some “evidence” that this line of research is worthwhile but funding is needed to develop that evidence. We need to find courageous funders who will follow the lead of the John Templeton Foundation in building this field.

So is this a new day? Absolutely! Have we achieved our goals of developing the work force and the evidence base for spiritual care and chaplaincy care? No. However, I believe we have now answered the question of whether these goalscan be attained. We need to push on because the progress will not happen of its own momentum.  But I think we now have a committed community to develop the evidence and the practice models and we have encouraged a lot of chaplains and researchers that this journey is important and worthwhile. Hopefully, we have also persuaded a few more funders and regulators to join the effort.

Strategies to Help Remove Stress From Your Work Schedule

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We all find ourselves with to-do lists that we never complete.  And the lack of completion often creates extra stress in already stressful situations.  There are many ideas regarding better scheduling methods and better means of prioritizing tasks.  I came across this short piece which offers a mindfulness approach to removing stress from the hectic nature of struggling to complete what we must.

 

Strategies to Help Remove Stress From Your Work ScheduleIf you can define the schedule of your workday or week even a little, yet constantly feel constrained by time, try a new path. Get mindful as to what rigid routine or schedule pattern is causing you stress. Even if you can’t figure it out, try injecting some change-up. Here are two such approaches.

Some people get into the office and absolutely won’t feel organized till they listen to voicemail and scan emails. These folks know they can’t operate on all cylinders until they see and organize what has just come over the horizon.

Others, though, get to these two activities only because they’d feel ashamed if anyone knew they had yet to know about a memo or call. They grit their teeth, tighten up their back and sit for the first hour or two doing this task they abhor.

As odd as it may feel, it would help those in the second group to get past any self-induced shame and dive into what they normally only allow themselves to get to once “catch-up” is over.

 

Really?  Yes.  Besides money, whatever motivates them is what they need to chomp on for an hour or two, to get their brain acclimated and affirming why they are really back at work.  (The other folks are just fine doing the mundane as a warmup to their soon-to-be-productive and inspired efforts.)

A changeup like this can make all the difference in the world in mindset, productivity and connectedness to your work life.  Recognize which of the two groups you fit in and try the strategy. Even if you are of the first mindset, try the approach on for size if you can mentally swing it.  You may learn more.

Another stress-erasing strategy is to break big work into smaller pieces.  We’ve heard that before, right?  The creative difference is not to add stress and scheduling to that new equation.  (The point is to take both those things out of the mix, as the old recipe called for them.)  Here’s how:

If you have to accomplish something by company- or self-imposed deadline, decidedly put it on your “side-desk,” so to speak (physically or figuratively).  When you are restless with another task at hand and need to move toward something else to feel productive (or stay awake), it can be easily grabbed and worked on.

As a writer, I always have several pieces regularly due.  Rather than start and finish any in one fell swoop (which I can do with little stress), I recently stumbled upon getting a start on four works hovering soon-to-be-due.  Seeing them started, drafted out (or even just thought about with a couple notations taken down) really made me feel a sense of progress.  It was nothing to pull them in and work on them; I became more motivated to see their direction take shape. The strategy was effective for me, and I likely should incorporate it more.

If you struggle with attending to tasks on dates you schedule them to be done, try the approach. Incrementally chipping away at work load, with low pressure, could indeed get you ahead of the game (in yours and your bosses’ eyes).

This strategy, too, might not be for everybody.  It is worth the try, though, to see if you can make yourself work differently and whether it has an effect on your productivity. No one knows that better than you; you may surprise yourself.

Think on both examples.  The key is to find a way to think about flow and ease of work schedule, rather than rigid patterns possibly not serving you well.  The potential reward is more balance and satisfaction.  The driving factors are doing what motivates you instead of making you feel stuck.

Stop agonizing over your work schedule.  Try to arrange it to pull you forward with energy, rather than keeping you stagnant and stressed.

 

  • Lisa A. Miles

Negative Self Talk: Top 10 Things NOT to Say to Yourself

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Many of us tend to defeat ourselves before trying something because we don’t trust ourselves.  I came across this list of things to avoid thinking and saying about oneself.  I think the list and ideas the article shares below will provide much to consider.

 

negative self-talkWe tend inflict so much suffering upon ourselves through negative self talk. It’s really amazing when you think about it. So much suffering due to words running through our minds…

In this post I’d like to share my top 10 self-damaging things we tend to say to ourselves. I have my own experience with negative self talk, believe me!

One tool for overcoming negative self-talk is to call it what it is. I’ll say more about that in a minute. Here is my list of the top ten things to avoid saying to yourself.

1. I’m not worth it.

This is a direct assault on your self-esteem and it is simply not true! Telling yourself you are not “worth it” only perpetuates negative beliefs you may have picked up early in life.

2. There’s no use.

Telling yourself there is no use steals your personal power and leaves you with no motivation.

3. I can’t do it.

Again, very disempowering. There are times when you truly cannot do something, however, most of the time this one is delivered as more of a self-attack than a statement of fact.

4. I’ll never follow through.

This is a set up for failure before you really get started. We all know that success comes one day at a time. Telling yourself you will fail before you get started is shooting yourself in the foot.

5. People won’t like me.

A set up for rejection. When you enter a new situation telling yourself that people won’t like you, it can become a self-fulfilling prophecy!

6. Others are better than I am.

We all tend to compare ourselves to others. Sometimes we exercise prejudice against ourselves, though. Telling yourself that others are better than you is an assault on your self-worth.

7. I am not enough.

A huge one for people who feel inadequate to meet the demands of life. A sense of personal inadequacy is very discouraging – don’t reinforce it!

8. I must be perfect.

The way to guarantee failure is to criticize yourself whenever you are imperfect, which is all the time. We are perfectly imperfect!

9. My opinion doesn’t matter.

More low self-esteem in this statement. To say this one to yourself, you must consider yourself unworthy.

10. I’ll never be any different.

We say this as if we are written failure into stone. It’s a hopeless thought. Just say no to this one!

What To Do About Negative Self-Talk

Follow these steps to get a better handle on your negative self-talk:

1. Catch yourself. So often we run on autopilot and allow our minds to ruin our day. So, start each day with the conscious goal to catch yourself saying negative things.

2. Call a spade a spade. Next, label what you just said! Recognize it as negative self talk.

3. Use the following formula: “I just had the thought…” (repeat the negative thought here).

If you caught youself saying, “I am not worth it,” for example, then you would pause and say, “I just had the thought, ‘I am not worth it.’”

Using this formula securely labels the thought as a mere thought. If you do not realize that what you said was just a thought, you run a higher risk of taking it personally and allowing it to ruin your day.

4. Take a deep breath and move on!

I hope you found this post helpful! If negative self talk persists in spite of employing these methods, then you may have an underlying attachment that maintains the self-sabotage. Please watch this free video to learn more about negative attachments.

Watch the free video The AHA! Process: An End to Self-Sabotage and discover the lost keys to personal transformation and emotional well-being that have been suppressed by mainstream mental health for decades.

10 Common Emotional Experiences in Grief

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When working with those dealing with loss, we tend to see certain commonalities in the emotions of those with whom we work.  The following is one grief counselor’s list of 10.  As he indicates in his introduction, this is not to suggest that we can ever pigeon hole anyone into these categories.  Additionally, I would add my common challenge to all counselors, chaplains, pastoral care providers, etc, that it is our responsibility to always remember that even when we think we have seen a pattern we must still work with the person as if this is the first person dealing with these issues.

10 Common Emotional Experiences in Grief

Although every grief is unique and unpredictable, there are many common emotional experiences that can happen in any grief due to the death of a loved one or significant person in your life.  Some of them are:
  • A state of shock:
    When sorrow and the pain of loss come flooding in initially, we instinctually shut down our emotions in order to anesthetize ourselves from the grim reality we face in grief.  This initial phase of grief protects us from going into emotional overload – experiencing the full impact of the loss before we can completely accept what has happened to our loved one and to us.
  • Overwhelming pain & emotions:
    When the shock phase begins to fade, the reality of the loss hits us.  The result is overwhelming pain and emotional turmoil.  As we realize how dreadful the loss is, emotional release begins to be expressed, often without warning.  The grief emotions inside turn into observable mourning.  (Remember mourning is simply grief gone public).
    Immense sadness and loss usually is expressed in uncontrollable and unexpected crying.  Our first instinct may be to stifle tears because we feel out of control or embarrassed.  The truth is though that crying opens the way for us to acknowledge and express all grief emotions helping us to progress through grief and toward healing.
  • Depression & loneliness:
    Feelings of utter depression and isolation are common.  Grief causes us to question our deepest held beliefs – especially our beliefs about God and how He works in the world.  It might seem as if God is no longer in control in His heaven – almost as if God does not care and is not present in their lives.  Such depression and feelings of being all alone are normal, healthy grief responses.  These feelings and thoughts will pass as we refuse to be overwhelmed by our feelings or thoughts and progress through grief.
  • Physical symptoms of emotional distress:
    The continued emotional stress of grief can manifest itself in all sorts of physical maladies—real and/or imagined.
  • Experiencing panic/fear:
    The emotional turmoil of grief can be overwhelming to us.  Because the emotional experience is often greater than anything else we have ever endured, a sense of fear and panic is common.  We begin to question our sanity and if we are doing grief “right.”   An overwhelming sense of deep despair causes us to also question if we will be able to endure what lies ahead and if we will ever experience joy and happiness again.
  • Experiencing guilt about the loss:
    We can feel real or imagined guilt for what we did or did not do for the person when he/she was alive.  Guilt can develop into neurotic guilt which is all out of proportion to the reality of the involvement and control we had in the happenings surrounding the loss.  Acknowledging and expressing this guilt, voicing regrets and “asking” forgiveness for perceived wrongdoings can move us toward healing from these grief wounds.  We must also work toward forgiving ourselves for what we did or did not do.
  • Feeling anger & resentment:
    These “negative” emotions are normal.  However, we must admit to ourselves to acknowledge anger without giving into destructive behaviors.
  • Resisting a return to life:
    Something inside keeps us from going back to usual activities.  Perhaps it is the desire to keep the memory of the tragedy alive as a way to honor the life of the loved one lost.  We fear that smiling, laughing, and experiencing joy or pleasure somehow signifies that the life of the deceased is not being honored or remembered.  Since the pain of grief is a reminder of the emotional tie we have to the deceased, we become comfortable in grieving and fearful that everyone has forgotten our pain.  This causes us to become stuck in our grief—failing to move on toward healing.
  • Realizing hope
    One day “the clouds part and the sun shines in” for us.  It becomes possible for us to experience joy and pleasure once again.  There is a realization that there are moments when grief does not dominate our thinking.  There are still bad moments, bad days and bad weeks, but they happen less and less often.  There is an overwhelming feeling of “I can make it after all.”
  • Struggling to affirm reality
    As we move through grief, we realize that we have been changed by the experience.  The deceased’s influence in our life changed us, making us better people.  The loss of the person has also changed us—making us either healthier and stronger in spirit or sicker.

Compiled by Larry M. Barber, LPC-S, CT author of the grief survival guide “Love Never Dies: Embracing Grief with Hope and Promise”  and the Spanish version “El Amor Nunca Muere: Aceptando el Dolor con Esperanza y Promesa” available online at Amazon, Barnes & Noble and http://grief-works.org/book.php . Also available for Kindle and Nook. Larry is the director of GriefWorks, a free grief support program for children and their families in Dallas TX http://grief-works.org.

 

American Attitudes Towards Death: 12 Facts From New Pew Research Center Survey

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It seems I missed this Pew Research Report but a survey was published in November describing American’s attitudes toward death and dying.  Here is a synopsis of the report according to Huffington Post.  Keep in mind that it is always best to see the actual report to get a true picture, but I think the information below does present an accurate portrayal nevertheless.

American Attitudes Towards Death: 12 Facts From New Pew Research Center Survey

The Huffington Post  |  By 

Posted: 11/21/2013 12:11 pm EST  |  Updated: 11/21/2013 12:24 pm EST

 
12 facts attitudes death

Pew Research Center‘s new report, “Americans’ Views on End-of-Life Medical Treatment,” explores the individual preferences and choices that surround the universal experience of death.

However, starting the conversation about the end of life is not always easy, and a large chunk of U.S. adults haven’t given much thought to their preferences at all.

But discussing death doesn’t have to be morbid. In fact, it’s often an excellent idea to talk about preferences before it’s necessary. That’s the idea behind “Death Over Dinner,” which are meals organized in order to connect friends and strangers through conversations about life and death.

Laura Sweet, a former hospice volunteer and a “Death Over Dinner” host, says, “We want to talk in an informal way about personal experiences with death. How do people want to die? Have you shared that with anyone? What deaths have you experienced? We don’t want it to be distasteful, or uncomfortable, but an uplifting atmosphere.”

These facts drawn from the Pew survey about American attitudes towards death show the importance of thinking about the end of life, and communicating with loved ones about preferences.

1. America’s elderly population has more than tripled in size over the last century
The share of the total U.S. population that is age 65 and older has more than tripled over the last century, from roughly 4% in 1900 to 14% in 2012.

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2. Over a quarter of U.S. adults haven’t really thought about future medical treatment at the end of their lives
Fully a quarter of adults (27%) say that they have not given very much thought or have given no thought at all to how they would like doctors and other medical professionals to handle their medical treatment at the end of their lives, even those aged 75 or older (25%).

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3. Most Americans are expected to live well into their seventies
The average life expectancy in the U.S. is now 78.7 years.

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4. The majority of U.S. adults would want to stop medical treatment if they were suffering a lot of pain with dire hope for improvement
57% of adults say that they would tell their doctors to stop treatment if they had an incurable disease with no hope of improvement and were suffering a great deal of pain.

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5. About one third of Americans would fight for life no matter what
About a third of adults (35%) say they would tell their doctors to do anything possible to keep them alive, even if the circumstances were so dire that they had a disease with no hope of improvement and were experiencing a great deal of pain.

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6. A majority of adults believe in a moral right to suicide, if a person was in great pain with no hope of getting better
62% of adults say that a person suffering a great deal of pain with no hope of improvement has a moral right to commit suicide.

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7. There is a big split on the issue of the legitimacy of physician-assisted suicide
47% of adults approve of laws to allow doctor-assisted suicide for terminally ill patients, while 49% disapprove.

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8. Race greatly affects the answers of whether people would want to fight to stay alive in great pain and little hope of improvement
Only 26% of white U.S. adults would ask their doctors to do everything possible to save their lives if they had a disease with no hope of improvement and were suffering a great deal of pain, in stark contrast with the 61% of black adults and 55% of Hispanic adults who would want the maximum effort expended on life-saving strategies.

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9. Death has affected most people in the United States
About half of adults (47%) say they have a friend or relative who has had a terminal illness or who has been a coma within the last five years.

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10. A majority of U.S. adults believe that an infant should receive as much treatment as possible in the case of a life-threatening birth defect, even if parents want to refuse treatment
38% of adults believe that a parent has a right to refuse treatment on behalf of an infant in the case of a life-threatening birth defect, while 57% say that an infant should receive as much treatment as possible, regardless of the defect.

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11. Religion and race greatly affect people’s response to the idea of a moral right to suicide in case of great pain
Black Protestants are most inclined to reject the idea of a moral right to suicide, out of the religious and racial groups surveyed. Religiously unaffiliated adults were most likely to support a moral right to suicide.

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12. Optimism for the future is harder to find in the older generation
Only about a fifth (19%) of adults aged 75 and older expect their lives to be better in ten years compared with today, though 71% of people aged 18-49 believe that their life will improve in the future.

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Pew Research Center first surveyed American attitudes about death in 1990, then again in 2005. This survey was conducted by telephone with a national sample of adults, 18 years of age or older, living in all fifty U.S. states as well as the District of Columbia. 1,994 interviews were conducted in English and Spanish from March 21 to April 8, 2013. The margin of error for the entire sample is ±2.9 percentage points.

Note: In headlines, ‘Americans’ and ‘U.S. adults’ are sometimes used interchangeably for the sake of flow.

For a Sick Friend: First, Do No Harm

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One of the challenges we all have is being able to be a friend to someone who is sick.  All of us at one time or another go through a sense of being unsure of what to say to someone who faces illness.  In training others, I often remind people to be a friend, because we often lose sight of the most basic emotion.  We are in pain when are friend is sick.  We visit to offer support and companionship.  And the truth is, that is what being a friend is about.  With that, however, there are still things we should all try to avoid saying.  And while the following is related to illness, many of these suggestions could be useful methods of communication in other circumstances as well.

By

LETTY COTTIN POGREBIN
April 12, 2013 7:12 p.m. ET

‘A closed mouth gathers no feet.” It’s a charming axiom, but silence isn’t always an option when we’re dealing with a friend who’s sick or in despair. The natural human reaction is to feel awkward and upset in the face of illness, but unless we control those feelings and come up with an appropriate response, there’s a good chance that we’ll blurt out some cringe-worthy cliché, craven remark or blunt question that, in retrospect, we’ll regret.

Take this real-life exchange. If ever the tone deaf needed a poster child, Fred is their man.

“How’d it go?” he asked his friend, Pete, who’d just had cancer surgery.

“Great!” said Pete. “They got it all.”

“Really?” said Fred. “How do they know?”

A few simple commandments makes a huge difference when conversing with the ill. Ellen Weinstein

Later, when Pete told him how demoralizing his remark had been, Fred’s excuse was, “I was nervous. I just said what popped into my head.”

We’re all nervous around illness and mortality, but whatever pops into our heads should not necessarily plop out of our mouths. Yet, in my own experience as a breast-cancer patient, and for many of the people I have interviewed, friends do make hurtful remarks. Marion Fontana, who was diagnosed with breast cancer eight years after her husband, a New York City firefighter, died in the collapse of the World Trade Center, was told that she must have really bad karma to attract so much bad luck. In another case, upon hearing a man’s leukemia diagnosis, his friend shrieked, “Wow! A girl in my office just died of that!”

You can’t make this stuff up.

If we’re not unwittingly insulting our sick friends, we’re spouting clichés like “Everything happens for a reason.” Though our intent is to comfort the patient, we also say such things to comfort ourselves and tamp down our own feelings of vulnerability. From now on, rather than sound like a Hallmark card, you might want to heed the following 10 Commandments for Conversing With a Sick Friend.

1. Rejoice at their good news. Don’t minimize their bad news. A guy tells you that the doctors got it all, say “Hallelujah!” A man with advanced bladder cancer says that he’s taking his kids to Disneyland next summer, don’t bite your lip and mutter, “We’ll see.” Tell him it’s a great idea. (What harm can it do?) Which doesn’t mean that you should slap a happy face on a friend’s grim diagnosis by saying something like, “Don’t worry! Nowadays breast cancer is like having a cold!”

The best response in any encounter with a sick friend is to say, “Tell me what I can do to make things easier for you—I really want to help.”

2. Treat your sick friends as you always did—but never forget their changed circumstance. However contradictory that may sound, I promise you can learn to live within the paradox if you keep your friend’s illness and its constraints in mind but don’t treat them as if their illness is who they are. Speak to them as you always did (tease them, kid around with them, get mad at them) but indulge their occasional blue moods or hissy-fits. Most important, start conversations about other things (sports, politics, food, movies) as soon as possible and you’ll help speed their journey from the morass of illness to the miracle of the ordinary.

3. Avoid self-referential comments. A friend with a hacking cough doesn’t need to hear, “You think that’s bad? I had double pneumonia.” Don’t tell someone with brain cancer that you know how painful it must be because you get migraines. Don’t complain about your colicky baby to the mother of a child with spina bifida. I’m not saying sick people have lost their capacity to empathize with others, just that solipsism is unhelpful and rude. The truest thing you can say to a sick or suffering friend is, “I can only try to imagine what you’re going through.”

4. Don’t assume, verify. Several friends of Michele, a Canadian writer, reacted to her cancer diagnosis with, “Well, at least you caught it early, so you’ll be all right!” In fact, she did not catch it early, and never said or hinted otherwise. So when someone said, “You caught it early,” she thought, “No, I didn’t, therefore I’m going to die.” Repeat after me: “Assume nothing.”

5. Get the facts straight before you open your mouth.Did your friend have a heart or liver transplant? Chemo or radiation? Don’t just ask, “How are you?” Ask questions specific to your friend’s health. “How’s your rotator cuff these days?” “Did the blood test show Lyme disease?” “Are your new meds working?” If you need help remembering who has shingles and who has lupus, or the date of a friend’s operation, enter a health note under the person’s name in your contacts list or stick a Post-it by the phone and update the information as needed.

6. Help your sick friend feel useful. Zero in on one of their skills and lead to it. Assuming they’re up to the task, ask a cybersmart patient to set up a Web page for you; ask a bridge or chess maven to give you pointers on the game; ask a retired teacher to guide your teenager through the college application process. In most cases, your request won’t be seen as an imposition but a vote of confidence in your friend’s talent and worth.

7. Don’t infantilize the patient. Never speak to a grown-up the way you’d talk to a child. Objectionable sentences include, “How are we today, dearie?” “That’s a good boy.” “I bet you could swallow this teeny-tiny pill if you really tried.” And the most wince-worthy, “Are we ready to go wee-wee?” Protect your friend’s dignity at all costs.

8. Think twice before giving advice.Don’t forward medical alerts, newspaper clippings or your Aunt Sadie’s cure for gout. Your idea of a health bulletin that’s useful or revelatory may mislead, upset, confuse or agitate your friend. Sick people have doctors to tell them what to do. Your job is simply to be their friend.

9. Let patients who are terminally ill set the conversational agenda.If they’re unaware that they’re dying, don’t be the one to tell them. If they know they’re at the end of life and want to talk about it, don’t contradict or interrupt them; let them vent or weep or curse the Fates. Hand them a tissue and cry with them. If they want to confide their last wish, or trust you with a long-kept secret, thank them for the honor and listen hard. Someday you’ll want to remember every word they say.

10. Don’t pressure them to practice ‘positive thinking.’ The implication is that they caused their illness in the first place by negative thinking—by feeling discouraged, depressed or not having the “right attitude.” Positive thinking can’t cure Huntington’s disease, ALS or inoperable brain cancer. Telling a terminal patient to keep up the fight isn’t just futile, it’s cruel. Insisting that they see the glass as half full may deny them the truth of what they know and the chance to tie up life’s loose ends while there’s still time. As one hospice patient put it, “All I want from my friends right now is the freedom to sulk and say goodbye.”

Though most of us feel dis-eased around disease, colloquial English proffers a sparse vocabulary for the expression of embarrassment, fear, anxiety, grief or sorrow. These 10 commandments should help you relate to your sick friends with greater empathy, warmth and grace.

—Ms. Pogrebin is the author of 10 books and a founding editor of Ms. magazine. Her latest book is “How to Be a Friend to a Friend Who’s Sick,” from which this essay is adapted.

Joy of celebrating with others

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Below you will find my recently published piece on Purim.

Rabbi Bryan Kinzbrunner
Oscar and Ella Wilf Campus for Senior Living, Franklin

Jewish holidays have always included the idea that celebration goes beyond the immediate household to include all of society. The Book of Deuteronomy delineates that the celebration should include “you, your son, your daughter, your slave, your maidservant, the Levite, the convert, the orphan and the widow who are in your cities” (Deuteronomy 16:14). True rejoicing occurs when everyone has a place in the societal enjoyment of the festivals.

In today’s Jewish communities, inter-relational celebration is especially experienced during the upcoming holiday of Purim. The holiday celebrates the Jewish survival described in the book of Esther. The particulars of how to celebrate are clearly laid out.

The Book of Esther states, “Mordechai recorded these events and sent letters to all the Jews who were in all the provinces of King Ahasuerus, the near ones and the distant ones; they are to observe annually the 14th day of the month of Adar and its 15th day as days on which the Jews found relief from their enemies and the month which had been turned about for them from one of sorrow to gladness, and from mourning to festival. They are to observe them as days of feasting and gladness, sending food to one another, and gifts to the poor” (Esther 9:20-22).

Celebrating holidays in a societal way is an expression of a fundamental principle of happiness and joy. An adage in “Ethics of our Fathers” notes that a person who is rich is someone who is content with his portion. I recently read an article on parenting that described how in order to teach children the value of money and objects, a parent needs to work hard on not actively pursuing the newest and the best things. Rather, one should work toward being satisfied with what one already has, not always running out immediately to buy the latest gadget or item even if one has the financial means to make those purchases.

It is further incumbent upon the parent to verbalize a commitment to being satisfied in the face of pressure to keep up with society. Similarly, when we work to include others at our table and make the effort to ensure that everyone is able to partake, we are able to exemplify the idea that what we have is not just for our own use.

The Book of Esther also challenges the reader in the same manner when Mordechai persuades Queen Esther that she must confront her husband, King Ahasuerus, about Haman’s evil decree to wipe out all the Jews of the Persian Empire. Esther expresses doubt as to whether she should approach the king to rescind the decree. In responding to this doubt, Mordechai states, “and who knows whether it was just for such a time as this that you attained the royal position?” (4:14)

We are not always privy to the whys of life. The mandate of celebration with all of society is perhaps meant to remind people, “it was just for such a time” that we have the means and the ability to uplift those who otherwise do not have the means to celebrate. As we celebrate Purim, may we remember that true celebration comes from a place of giving, and may we find joy in bringing joy to others.

7 Tips for Authentic Engagement in an Online Support Community

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Here is an article about the use of online support groups.  As something I take an interest in, the intersection of technology and spiritual care, this is something I deem important to discuss and explore.

 

7 Tips for Authentic Engagement with an Online Support Community

Online support communities offer patients, people, caregivers, family members, and even professionals the opportunity to engage with one another in an environment designed to encourage discussion. Not only do people engage in emotional support and discussions, but they also exchange valuable information about their own research, experiences, and techniques that work for them.

Support communities are so much more than a simple social group with a shared purpose. They serve as a lifeline to a person in crisis or need, and the newly-diagnosed who is scared their life may never be the same.

So how do you authentically engage in such communities?

 

When I say “authentic,” I mean to engage meaningfully and mindfully — in a way that’s honest and open with others within the community. To engage authentically is to to understand your health or mental health condition, embrace it, accept it, and make it your own. An online support community can help you do that.

Why do you want to bother to engage or join an online support community of any kind? Because people who do generally feel better about themselves. And those who are actively engaged in feel best about their engagement in an online community. So it’s beneficial that if you’re going to try out an online community, you give it your full effort.

1. Introduce yourself.

This may seem obvious, yet in running online communities now for over two decades, I’ve found you actually have to encourage people to do this. People are uncertain of the social mores of any particular group or online community – especially one that’s been established for years.

Introducing yourself helps do two things. It immediately makes you an active participant within the community, which improves your chances of gaining benefit from it (Houston et al., 2002). And it lets others know, “Hey, here’s a new person. Let’s see if we can help them out…”, or maybe, “They’ll know something that can help meout.”

2. Share what’s worked — and what hasn’t — for you.

While most people might consider online support groups for a health or mental health concern primarily about emotional support, they’re also about exchanging valuable information. Information about treatments, side effects, and what to expect as the condition progresses that you won’t find in the research literature, in most books, or virtually anywhere else online.

While some sites try to quantify this data with pretty graphs, the real value is the personalized exchange of information that directly benefits a study consisting of a single subject — you. It’s the ultimate personal research study, because it’s all about finding out (and sharing) what’s worked for you (and what hasn’t).1

3. Stay engaged.

People who stay engaged in a support group for at least 6 months are likely to benefit from it in the long-term more so than people who visit a group for a few days, and then disengage (Griffiths et al., 2012). Generally, the more you contribute and stick with a health online support community, the more you’ll benefit from it.

This means contributing to conversations and discussions of interest to you regularly, and ensuring you share in the community-building activities that made you feel welcomed at first too (like welcoming new members, offering to volunteer to help out if you can, etc.). “Results revealed that compared to posters, members who only read the messages (lurkers) scored lower in receiving social support and receiving useful information in empowering processes, and lower in satisfaction with their relationship with group members.”

4. Lurking is okay too — but try not to.

Many people complain, “Well, the group has 5,000 members, but I only see the same 10 or 20 people posting all the time.” That’s the norm and there’s nothing too much wrong with that. In fact, lurkers — people who simply read other people’s posts and don’t post much themselves — can benefit almost as much as active participants do.

Mo et al.’s (2010) research sums it up:

“Results revealed that compared to posters, members who only read the messages (lurkers) scored lower in receiving social support and receiving useful information in empowering processes, and lower in satisfaction with their relationship with group members.” However, they conclude: “Our results suggest that lurking in the online support groups may be as empowering as reading and posting messages to the groups.”

Other research (van Uden-Kraan et al., 2008) confirms that if you are a lurker, you may not enjoy the group as much:

“Lurkers were significantly less satisfied with the online support group compared to posters.”

But that you will still receive significant gains:

“However, lurkers did not differ significantly from posters with regard to most empowering outcomes, such as “being better informed,” “feeling more confident in the relationship with their physician,” “improved acceptance of the disease,” “feeling more confident about the treatment,” “enhanced self-esteem,” and “increased optimism and control.””

So while lurking may be the most comfortable thing for you to do, try your best not to. Think of an online support group as an opportunity to reinvent yourself, even if just a little.

5. Make new online friends.

Making some new friends in an online support community creates an emotional bond with the community. You begin to care about coming back and sharing your experiences, because you matter to others and they matter to you. More importantly they know what you’re going through like many others in your life may not. They’ve been through a similar experience too, and shared experience is a core component of authentic engagement.

Online communities were the original 1.0 social networking websites. Just like popular social networks, most online communities today allow you to friend others, and share photos, links and more. Friends — whether online or off — are an important component of your social support system. So even if you don’t have a lot locally, you can still make them online.

6. Don’t be afraid to share your opinion — respectfully.

Many people participate in online support groups to better understand the illness or condition they face. They can’t do this very well if everyone remained quiet, or didn’t share their honest opinions about a specific treatment or how a person was treated by a healthcare professional.

The more you speak up and share your opinions with others, the more others will come to understand your own experiences and knowledge.

However, it’s important to do so respectfully. If touching “healing stones” has helped relieve another person’s stress, you can say, “I tried that once, but it did nothing for me.” It’s far less helpful to say, “Healing stones are a crock and anybody who tries them is just getting scammed.” Try and leave judgment out of your replies.

7. Believe the best in others.

Sometimes it’s hard not to be cynical about our online engagements. While many engage thoughtfully in online communities, others seem bent on being provocative or argumentative.

So it helps to always try and believe the best of intentions in others, rather than to assume the worst. When in doubt about another’s behavior in an online community, ask them privately what they meant, to clear up misunderstandings sooner rather than lettering them fester. Maybe something written in a forum seemed meant for you, but the member was really talking about a family member.

 

References

Griffiths et al. (2012). The effectiveness of an online support group for members of the community with depression: A randomised controlled trial. PLoS ONE, 7, ArtID e53244.

Houston TK, Cooper LA, Ford DE. (2002) Internet support groups for depression: A 1-year prospective cohort study. American Journal of Psychiatry, 159, 2062–2068.

Lintvedt, OK, Griffiths KM, Sørensen K, Østvik AR, Wang CEA, et al. (2011). Evaluating the effectiveness and efficacy of unguided internet-based self-help intervention for the prevention of depression: a randomized controlled trial. Clinical Psychology &Psychotherapy.

Mo, Phoenix K. H. Coulson, Neil S. (2010). Empowering processes in online support groups among people living with HIV/AIDS: A comparative analysis of ‘lurkers’ and ‘posters’. Computers in Human Behavior, 26,  1183-1193.

van Uden-Kraan, Cornelia F. Drossaert, Constance H. C. Taal, Erik Seydel, Erwin R. van de Laar, Mart A. F. J. (2008). Self-reported differences in empowerment between lurkers and posters in online patient support groups. Journal of Medical Internet Research, 10, 101-109.

Footnotes:

  1. Unbeknownst to many, psychology and medicine have long recognized the value of single-subject experimental designs — they’ve been publishing such studies, and single case studies, in the literature for the past century. []

John Grohol, PsyD

Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues — as well as the intersection of technology and human behavior — since 1992. Dr. Grohol sits on the editorial board of the journalCyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

The Surprising Psychological Value of Human Touch

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The following article deals with the value of human contact on our well-being.  Touch allows people to feel attached to others.  And some types of touch are therapeutic.  Having said that, obviously boundaries are still and important issue that we must recognize and respect.  It is quite fascinating how sometimes touch, if used appropriately, can go a long way to alleviate pain.  How many elderly or ill people put there hand out to be held when a professional comes to visit as a means of having a moment of human contact that is for comfort, not merely for physical care?  Touch is a powerful tool.

 

The Surprising Psychological Value of Human Touch

Whenever I’m overwhelmed or feeling down, I tend to crave touch. A hug, a hand to hold; a connection that can manifest into something that’s tangible. And even on stress-free days, I may seek out the healing components that touch has to offer.

Is the act of human touch an innate need, ingrained within? Not necessarily (in my opinion), but on a superficial level, it very well could be. Research demonstrates that touch contains several health benefits for our physiological and psychological well being.

 

A 2011 article on CNN.com discusses the numerous positive effects associated with physical contact and affection.

Hugging induces oxytocin, the “bonding hormone,” that’s renowned for reducing stress, lowering cortisol levels and increasing a sense of trust and security. According to research conducted at the University of North Carolina, women who receive more hugs from their partners have lower heart rates and blood pressure and higher levels of oxytocin.

“Hugs strengthen the immune system,” according to a post onmindbodygreen.com. “The gentle pressure on the sternum and the emotional charge this creates activates the Solar Plexus Chakra. This stimulates the thymus gland, which regulates and balances the body’s production of white blood cells, which keeps you healthy and disease free.”

The CNN post notes that holding hands produces a calming response. James Coan, PhD, assistant professor of psychology at the University of Virginia, administered MRIs to 16 married women, relaying that they may experience a mild shock. The anxietyillustrated various brain activity, but when the women held hands with one of the experimenters, their stress dissipated — when they held hands with their husbands, stress decreased even further.

Coan observed that there was a “qualitative shift in the number of regions in the brain that just weren’t reacting anymore to the threat cue.” The article continues to state that, interestingly enough, hand clasping in happy relationships reduces stress-related activity in the hypothalamus region of the brain, which lowers cortisol levels throughout the system, as well as the area in the brain that registers pain.

Snuggling has the potential ability to bolster communication.

“Most people want to feel understood and communication is the vehicle by which they transmit understanding and empathy,” David Klow, a marriage and family therapist, said. “Non-verbal communication can be a very powerful way to say to your partner, ‘I get you.’ Cuddling is a way of saying, ‘I know how you feel.’ It allows us to feel known by your partner in ways that words can’t convey.”

Human touch — hugging, hand holding, cuddling, and other outlets of contact — can be beneficial, health-wise, physically and emotionally. (Oxytocin for the win!) And as I’m typing this, sifting through cold-recovery mode with a bit of laryngitis, I can’t help but think that a hug would be a great immunity booster at the moment. Hmmm…

APA Reference
Suval, L. (2014). The Surprising Psychological Value of Human Touch.Psych Central. Retrieved on March 14, 2014, from http://psychcentral.com/blog/archives/2014/03/10/the-surprising-psychological-value-of-human-touch/

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