Science & Theology News Feb 04
 
Caregiver can be a partner's best medicine
By Julia C. Keller

When the sculptor Michelangelo Bounarroti looked at a block of marble, he could envision what shapes would emerge from the stone. "In every block of marble I see a statue as plain as though it stood before me ... I have only to hew away the rough walls that imprison the lovely apparition to reveal it to the other eyes as mine see it," he was quoted as saying. The idea of the true self, trapped until someone carves it into a shape, is the idea behind what social psychologists call the Michelangelo phenomenon.

The Michelangelo phenomenon explains how a person's perceptions and behavior sculpt his partner's vision of herself and vice versa. The relationship between caregiver and care recipient can be understood in this way, and new research is looking at how the effect may actually promote healing in patients with chronic illness.

"They're shaping the self of the other in the shape of their relationship," said Kevin Reimer, a professor of marriage and family at the Mennonite Brethren Biblical Seminary in Fresno, Calif. "I'm looking at how there might be co-sculpting between the disabled person and the assistant."

Reimer is one of several researchers studying the relationship between caregivers and care recipients in L'Arche, an international, nondenominational organization that provides care for developmentally disabled people.

Reimer analyzed interviews with caregivers who have been working with disabled members for several years and those who are novices in the program.

"People who are morally and altruistically outstanding are motivated by different factors and the researcher can't apprehend the reasons for those motivations during the interview," Reimer said.

By using a computational technique called Latent Semantic Analysis, however, Reimer thought he could discover why some people continue to chip away at a difficult relationship and found what he called a "striking difference" between the two groups.

"The bulk of the novice folk in L'Arche - those who will leave L'Arche after a year - are unable to see the kind of altruistic care and compassion that's mutual - that it's an exchange between the core member and the assistant," he said.

"When the chips are down, [novice participants] don't have that kind of ideological foundation on which to stand and say that there's something larger than the tedium of what [they're] doing and have the grit to stick it out," continued Reimer.

"It's pretty clear in the experienced group there's an ideological framework that's beyond that kind of exchange. It's more than a matter of what I get or pure empathy."

What the analysis also shows is that "spirituality is significantly implicated in longevity in L'Arche," Reimer said. "The ones that aren't burning out or dying on the vine are incorporating some spiritual or transcendent spirituality into their lives."

What happens when spirituality is incorporated into the caregiver's role is the basis for the research Dr. Ellen Levine is conducting at the California Pacific Medical Center in San Francisco.

"So much has been done for the patient to cope and very little has been done for the partner, and the partner has felt really helpless," said Levine of her research into the relationship between cancer patients and their partners.

Levine collected data on couples in two groups; one group was taught to practice basic Buddhist meditation techniques with their partners for three months, while the other group was taught the technique only before they arrived for evaluation at the medical center.

"It's a meditation practice that's common to all religions ... in terms of accepting yourself," Levine said. "It's accepting yourself and to feel compassionate with yourself and focus it onto the partner. So you're sending these impressions of loving compassionate thoughts and feelings."

Partners in both of Levine's groups were monitored in separate rooms for changes in brain activity and heart rate as they focused their meditation energy on the patient.

"This is building on the literature in distant healing - using prayer and other forms of healing traditions to heal people from a distance," said Levine, citing the 1999 landmark study on remote intercessory prayer by researchers in the coronary care unit at Saint Luke's Hospital, Missouri.

Although the data is still preliminary, Levine said she is hoping to find several things: "One is that the partners themselves feel more calm, more at ease, more accepting of themselves; the patient has improved quality of life and improved mood; and that their partner relationship stays the same or gets better."

Even if Levine does not find what she expects, she is confident that teaching compassionate, goal-directed techniques can only help the relationship. "With most spiritual traditions, there's an emphasis in healing yourself and healing the world and some people ... won't really practice that faithfully," she said. "We're giving them something that's really goal-directed and someone that they're really motivated to help."

According to Sally Zierler, a professor in the Department of Community Health at Brown University, it is precisely this understanding of compassion that contributes to the health of patients.

Zierler interviewed more than 100 HIV-positive people and their partners to study the effects of compassionate love on mental health.

"We specifically asked, 'How often do you feel a selfless caring for others?' and it was really quite a threshold," said Zierler. "Once we had love in the model, it overwhelmed everything."

Controlling for factors associated with depression, including diagnosis of the disease, prognosis and function of the immune system, Zierler found "a protective effect of caring for others" when she interviewed patients.

The protective effect included high levels of CD4, a protein found in white blood cells that help combat the virus' spread in the body and delay the necessity for treatment.

"Compassionate love, altruistic love - we see this associated with above-threshold CD4 levels, so that we don't need to start meds," Zierler said. "What always stood out was this construct of compassionate love."

For Zierler, the results are not surprising. "There's nothing counterintuitive touching on the kinds of results that we found," she said. "There's real biologic plausibility to the outcomes we're talking about."

The outcome she is talking about is a direct link between love and health, with the phenomenon of caring for others and being cared for oneself providing a kind of resilience to outside stress, like complications from HIV.

"Physiological resilience can come from this way of living in which one is so 'others-centered' that the kinds of ... stressors that you and I might see are not the focus of the mind of someone who is out there to love in the world," Zierler said.

Continued research into compassionate love is still needed to tease apart the different aspects of the Michelangelo effect on the relationship between the caregiver and care recipient. But researchers like Levine want to stress that techniques of compassionate love that could positively affect the caregiver relationship should be implemented as they are developed.

"It would be wonderful just in general if a person goes to a doctor and they say ... 'This is something you can do,'" she said, "'and here is something your partner can do, as well.'"


Julia C. Keller is aquisitions editor of Science & Theology News

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Introduction
Love makes scientists go bananas

Studies on love and kindness get better with age

Love and science now like a horse and carriage

Self
See me, feel me: the twists of empathy

Two women sacrificed themselves for the glory of love

Psychology still has to justify its love

Heal me: altruism more than a step on the road to recovery

Another
Egoism and altruism share our hearts

Conduit model of love helps us pay it forward

Caregiver can be a patient's best medicine

Family
Caring for children is its own reward

Good mothers make the ties that bind

Old tribal tradition: elders help new moms

Humanity
Heroes save day by not walking away

Veterans who loved country healed by love of others

Little space makes world a better place

A friend in need: not enough gifts of life to go around

Conclusion
National survey aims to take pulse of America



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