Importance of Contribution

Importance of Contribution

This post brushes up against the philosophical question, “Is there such a thing as a truly altruistic act?” Despite my many philosophy courses in undergraduate studies, I will try to limit myself here to the scientific research most enlightening to the conversation.

“When one tugs at a single thing in nature, he finds it attached to the rest of the world.”
– John Muir


According to the Corporation for National and Community Service, in their report “The Health Benefits of Volunteering: A Review of Recent Research, 2007” there is a strong relationship between volunteering and health. Specifically, volunteers:

Have lower mortality rates

Have greater functional ability, and

Have lower rates of depression, especially late in life


Across the research cited below, several themes appear. Volunteering has the potential to offer these benefits:

  • Fight mental illness
  • Lower blood pressure
  • Reduce heart disease
  • Reduce risk of Alzheimer’s Disease
  • Reduce pain
  • Create relationships
  • Increase physical activity
  • Improve general health
  • Give one a sense of purpose


Of course, if you suffer from a chronic illness, the act of getting out of bed to perform your daily routines can be a great effort and the thought of trying to find a way or time to volunteer may be overwhelming. While it is undoubtedly the case that better health leads to continued volunteering, these studies demonstrate that volunteering also leads to improved physical and mental health. Thus they are part of a self-reinforcing cycle.


One word about the literature: Most of the literature reviewed focuses on older adults. It seems that we must age into the opportunity to give our time freely. While teenagers volunteer with school or church, they are often “voluntold.” The same holds true for countless parents volunteering on the PTA, the Little League team, and many other children’s activities that we may truly enjoy, but that may not be top on our list of places to volunteer. Those adults without children may have corporate volunteer opportunities forced upon them. The way I interpret these findings that primarily apply to older adults is, “why wait?”


What benefits can you reap today from contributing to your community, your country, your world?


Volunteer to live longer

Volunteering for as little as 40 hours per year has been shown to increase lifespan. Isn’t that good news? You can volunteer to live longer, but you don’t have to spend your entire life volunteering. Researchers at the University of Michigan, Ann Arbor found that their results held true across gender, age, race, and socioeconomic status. This study, along with many other reviewed and not cited here, attributes such findings to volunteers having multiple roles in life, strong self-identity, a reason to get out of the house, and a strong social network that comes from volunteering.


Meanwhile, researchers at Cornell University studied women over a 30-year period (1956-1986) and their various roles in life, from mothers to volunteers, to professionals. They also found a relationship between volunteering and living longer, but their scope of study was focused more narrowly on functional abilities. They studied how volunteers versus non-volunteers were able to go up and down stairs unaided, go out to visit friends, and other daily functions. Volunteers scored higher in functional ability over the 30-year period. Again, these benefits were seen regardless of socioeconomic status.


If you read the Importance of Spirituality post, you may recall that having spiritual beliefs or practices to lean on can help you live longer. Interestingly enough, volunteerism is shown to reduce mortality even more than religious beliefs or practices. In fact, this study indicates that “volunteering to help others in two or more organizations offered a persistent protective effect against mortality in an elderly population.”


Volunteering was more likely to cheat death than physical mobility, exercising four times weekly, and attending weekly religious services. One of the only better things you can do for yourself to live a long life is to not smoke.


There are multiple longitudinal studies that have assessed the correlation between volunteerism and mortality. And they all agree: if you want to live longer, help others.


Keep your sanity

If you’re going to be living a long life, you want your wits about you, right? Crazy fun is one thing. Dementia is another. Physician Susan J Noonan, MD fought her own battle with depression and used volunteerism to help her efforts.

“The first thing to know is that when you volunteer you commit to make yourself available to a person or an organization for a period of time, say 2 or 4 hours per week, on a regular, ongoing basis. You do it in small steps, not all at once. You become accountable to others for showing up, on time and ready to function at some moderate level. They will depend on you for that. It’s a big step. This was good for my depression… “


Having this commitment to others was a strong motivator. Apparently, it was even stronger than the motivation to go to work. The motivation for volunteerism is different than the motivation to go to work. While they both seem obligatory, the internal sense of control that comes from volunteering – showing up completely of your own free will – can drive people into action.


Dr. Noonan continues,

“You come to feel needed and appreciated for what you do for others. When you volunteer your time you have to pull yourself together, get off of the couch and out of the house.”

And perhaps the most revealing sentiment to me was this:

“Action precedes motivation.  Get started and the interest and motivation will follow.”


As anyone who has lived with depression knows, putting one foot in front of the other is sometimes the only thing that you can do. It is okay to “just go through the motions.” It is okay to not feel exuberant about the task at hand. Let the action itself stand on its own and let the mental benefits seep in.


Reduce Risk of Alzheimer’s

This study in Baltimore was very targeted, both in terms of study participants and volunteer activity. But the implications are huge and worthy of the attention of public health officials. The program studied older adults partnering with local elementary school children in a literacy program. The adults were volunteering to help children with literacy and memory skills. Participants were African-American, low-education, low-income women over age 50, who were at high risk of cognitive impairment. After reading with elementary school children in their neighborhood, the results showed improvements in brain function in the prefrontal cortex, the area of the brain important for planning and organizing one’s day. The improvements seen in brain imaging were matched with reported behavioral improvements. One study participant said,


“It removed the cobwebs from my brain.”


Now THAT’s a great testimony. But why did this volunteer program help? According to the researchers, “Complex environments impose cognitive challenges through the diversity of stimuli and the number of decisions required. As a result, they exercise organizational, inhibitory, and working memory skills, all components of executive function.” In other words, our brains need new activities and new challenges, no matter how seemingly small, to function at their best.

The researchers also conclude, “Socially engaging cognitive activities” in adults may enhance “the proliferation of new brain cells and promote brain repair in animal models.”


Lower Blood Pressure

This little bullet point keeps showing up in the importance of these categories. Remarkable. In the Importance of Spirituality, I discussed briefly the dangers of high blood pressure. How does volunteerism help keep blood pressure low?

This four-year study found that regular volunteering lowered blood pressure in participants over age 50. And not by an insignificant amount! Those that volunteered roughly 4 hours per week were 40% less likely to develop hypertension over the four-year follow-up. This result held steady even after controlling for chronic illnesses that were measured at baseline. This was not a case of those who were healthy continued to be healthy. Regardless of the health of the participants at onset, the 40% yardstick held true.

In explaining the results, the researchers state:

“Volunteerism may also function to alter the psychological or biological stress response among older adults. Performing volunteer work may give individuals perspective on their own life struggles, promoting more positive coping strategies in the face of potentially stressful situations.”


Reduce Heart Disease

Kind of goes hand-in-hand with lowering blood pressure, but this study found some other important data. Volunteers are more likely to use preventative health resources, like cholesterol checks and flu shots. An annual flu shot appears to to lower the risk of heart attack and stroke by about one-third of the following year.

Meanwhile, at Duke University, researchers are tapping into the wealth of benefits that former cardiac rehabilitation patients can offer current patients. People who had suffered heart attacks and completed rehabilitation were followed during their time as volunteers to patients and their families that were currently undergoing treatment at the cardiac rehabilitation unit. These volunteers offered the important services of orienting patients to what was happening and what services they were about to receive, providing emotional support, helping to find local lodging and community services (from churches to restaurants). The volunteers from this study had better overall health outcomes than did cardiac patients who did not volunteer.

Improving your brain, your blood pressure, and your heart are of course very important markers for living well. But for me they fall into the category of blind faith. It is difficult for me to FEEL my heart functionally more optimally. Obviously, I can measure my blood pressure, but not without special equipment. Trying to stay motivated using these invisible-to-the-lay-person measures is not easy for me personally. So let’s talk about how contributing to your community can make you feel better today.


Reduce Pain

Something we all want, right? To live pain-free? Millions of people suffer with chronic pain; pain with no known cause or effective treatment, making this population ideal for studying pain. Researchers provided a group of volunteers with cognitive behavioral management techniques and communication skills training at the onset of this study. The volunteers were then followed for almost one year to assess their pain levels. Similar to the cardiac patients at Duke University, these volunteers were paired with others with chronic pain.

Proving the adage that friends can divide your sorrows, volunteers reported declines in the intensity of their pain levels, lower levels of depression, and greater self-efficacy. Sense of purpose, connections with others, and improved coping mechanisms were also cited as benefits. Volunteers were actively learning more about their conditions so they could be well-informed in helping their peers. At the end of the study, all participants reported the experience to bring them multiple benefits with no downsides.


Create relationships

Despite what social media applications would have us believe, we are hard-wired for in-person contact, which includes touch, eye contact, and smiles. Such daily interactions provide a boost of oxytocin, the original love drug. Oxytocin helps us bond with others and care for others while also helping reduce cortisol, a key stress hormone.


Because you get to decide where and how often you volunteer, contributing to your community is a powerful way to meet others, make new friends, and share common beliefs and goals. These connections can become more important when you face an ordeal, either individually or together with your neighbors. An existing social support network can direct you to necessary services or offer a shoulder to cry on.


Peer volunteering seems to provide a particularly strong bond. Have you ever told someone about a difficult situation you are facing and heard the response, “I know exactly how you feel” and then listen to their completely unrelated, perhaps even trivial, recounting of an event? While such people have good intentions, these researchers state, “Honest empathy is a powerful balm.”


Get your movement in

How cool is it that the Indiana University has an Interdisciplinary Program for Empathy and Altruism Research? Director Sara Konrath, PhD has studied the science of giving extensively. One of the benefits repeatedly noted in the research is physical movement. At the very least, you have to get off the couch and get out of the house, which will make us stronger and more physically fit. The increase in physical activity (even if you are not volunteering with Habitat for Humanity) may directly improve cardiovascular function, or may provide an indirect benefit of delaying functional limitations. In other words, it can get you strong or keep you strong.


Overall Health

Obviously, right? Here I’m referring not to the specific conditions mentioned earlier, but to use of medical services. This Harvard School of Public Health study found that over a two year period, volunteers were more likely to use preventative medical services such as flu shots, mammograms, cholesterol tests, Pap smears, and prostate  exams. Most importantly, volunteering was positively correlated with a reduction in hospital stays. Volunteers spent 38% fewer nights in hospitals than their peers.


“I’ve been looking at this for years now, and I haven’t found a study where volunteering didn’t affect health positively in some way.”

– Dr. Eric Kim, Harvard School of Public Health


Sense of Purpose

Have you ever had a day when you simply did want to leave the bed? Not due to illness, but due to lack of reason? Whether it was a midlife crisis, existential angst, overwhelming grief, or just a crap day, sometimes it is hard to find a reason to get up. As reported in Journal of Gerontology, volunteering can give people, especially older adults, a sense of purpose. A friend of mine in her early 70’s recently told me that she is having the time of her life now that she is coming out of the fog of grief over her deceased husband. In her words, “I am no longer anyone’s daughter. I’m not a caretaker. I don’t have to mother my grown children everyday. I’m not a working professional. I am just me. I get to do whatever I want!” She is reveling in her new freedom and is enjoying finding what it is that she wants to do now that she isn’t obligated to do anything.


Importance of Posture

Importance of Posture

You likely have a childhood memory of someone – a parent or a piano teacher – chastising you for bad posture. When we are young, our good posture makes us seem older. When we are older, our good posture makes us appear younger. This is one instance of duality working in our favor.

“We tend to think the brain and body relationship goes one way. In fact, the passages go both ways. When you choose to put your body in a different mode, it’s harder to drop into depression.”  Erik Peper, PhD

What exactly is good posture?

Good posture is a matter of training your body to stand, sit, and lie in positions where the least strain is placed on supporting muscles and connective tissue. Good posture keeps the bones and joints in aligned properly so that the muscles function properly.  Harvard Medical School outlines good posture as defined below.

When seated (as you likely are right now reading this), good posture involves:

  • Hips pushed back far in the chair
  • Feet flat on floor
  • Knees and toes facing forward
  • Shoulders relaxed away from ears
  • Chin parallel to floor

When standing, good posture involves:

  • Chin parallel to floor
  • Shoulders relaxed away from ears
  • Spine in a neutral position (you don’t want to feel an arch or a curve)
  • Arms at your sides with elbows relaxed in a straight position
  • Abdominal muscles lifted up slightly (try pulling your pubic bone up towards your navel)
  • Knees and toes pointed forward
  • Weight distributed evenly on both feet
  • Weight more in heels than in the ball of the foot


Simple enough, right? All you have to do is overcome muscle weakness and/or dysfunction, and years of bad habits. Our modern lifestyle of sitting frequently has allowed our leg and trunk muscles to get weak. If we aren’t working to strengthen and lengthen muscles, inflexible muscles reduce the range of motion of the joints. So we end up with tight hip muscles pulling us forward and weak gluteal muscles that won’t keep us upright. Our chest muscles tighten and shorten as we hunch forward and the back muscles meant to hold up upright get weaker with every next episode we binge watch.

How much is poor posture really harming us? Poor posture has been shown to have a negative effect on:




Tech neck can also lead to headaches. “When sitting at a desk, as the muscles in the back and stomach start to tire and the spine starts to slump, we tend to stick the neck and chin forward to keep the eyes in a good position, so we can still see the screen,’ says osteopath Robert McCoy. ‘Tension in the muscles at the base of the skull, caused by the spine rounding and the neck sticking forward, can pinch the trigeminal nerve in that area, leading to something called cervicogenic headache.”

It’s hard to concentrate when you have a headache. Your work performance suffers as you endure the pain of a headache. And if you’re like me, headaches make you a bit grumpy as well.

Increased blood pressure

Poor posture, especially a forward head position, may increase your blood pressure. Neuroscientists at University of Leeds found a connection between the neck muscles and the area of the brain that helps regulate blood pressure. Cut off that connection for hours daily while you stare at screens and you may be in trouble. The Mayo Clinic states that high blood pressure can lead to aneurysm, coronary artery disease, heart disease, stroke, dementia, cognitive impairment, and kidney failure.

Are you sitting up straight yet?

Energy Levels

Sometimes it feels easier to slouch. I think our bodies are supremely efficient, which can sometimes translate as lazy. If there is a muscle that doesn’t want to work (or cannot function properly because of injury), there is ALWAYS another muscle group that will jump in. When we get in postural habits, suddenly trying to convince our bodies to be in correct alignment can feel like a lot of work. But the truth is, proper posture increases your energy levels. Relieving uneven pressure on the joints and using muscles as they were designed to be used means your body requires less energy to perform simple daily tasks, like getting out of a chair.


Stress reduction

It seems a logical conclusion that if proper posture can keep your blood pressure regulated, improve your breathing, reduce headaches, help you let the gas out but keep the urine in, improve your mood, and increase your energy, your stress will be greatly reduced. You don’t need to wait for years to feel these results, however. When faced with a stressful situation, sometimes simply sitting or standing upright can help you tolerate stress better in that moment, as this study shows.

Breathing problems

Heard of tech neck? It’s not the latest app. It’s the latest epidemic. Having your neck out of alignment for hours a day is a huge problem. Jutting your chin out results in weakening of the erector spinae muscles, the muscles needed to keep you standing erect. It also lifts the shoulder blades, rounding the shoulders forward, and creates tension in the upper trap muscles (that “knot” that we all feel just above our shoulder blades). More importantly, the very muscles we need to breathe well are weakened (SCM, scalenes, upper trapezius, pectoralis major, and thoracolumbar ES muscles for my fellow anatomy nerds).

Tech neck primarily refers to the forward head position we adopt when using our smartphones, but can also happen in front of a desktop or laptop computer. If you have learned how to hold your phone up higher in front of your face (so it always looks like you’re taking a video of someone), you are a posture pro. Good for you!  

It’s not just smartphones that make it hard for us to breathe, though. Sitting in a crumpled position can constrict your airways and make it difficult to catch your breath. Not straightening your back also leaves your ribcage in an unnatural position, which puts added pressure on your lungs.

If you are this deep into reading about your Quality of Life, I am sure I don’t have to convince you of the importance of breathing deeply. I have read volumes on the yogic practices of breath control, but I will keep this conversation incredibly brief.

Dr. Herbert Benson, Director Emeritus of the Benson-Henry Institute (BHI), and Mind Body Medicine Professor of Medicine, Harvard Medical School, has been researching the connection between breathing and the body’s physiological stress response since the late 1960s. His research has repeatedly proven that the ability and the practice of breathing deeply (for which you need good upright posture) affects the heart, the brain, digestion, the immune system — and maybe even the expression of genes.

If you want to learn more about how to breathe deeply, see the instructions on the stillness page. 

Intestinal Health: Not all farts are created equal

No one likes to be backed up. When our digestion is off, we feel lousy, and depending on the symptoms, perhaps we make others around us suffer, too. (Anybody got a match?) In this National Institutes of Health-sponsored study, eight (8) brave souls allowed themselves to be pumped with gas AND to have their farts measured by having a tube inserted into the rectum and attached to a bag. There is an expression I learned in New Jersey –bag of ass.”  Who knew it was scientific? Conclusion of this small population indicates that expulsion of gases happens significantly faster in an upright position rather than a reclined position. And the faster we can process our metabolic wastes, the better.

Fart jokes aside, poor posture has been cited as a potential cause of constipation, acid reflux and even hernias. All that downward pressure adds up over time, so we must fight gravity with long, strong muscles!


Speaking of private areas

I’ve met people who claim to never have gas. While I suspect that claim is bogus, I don’t want to research it in detail. I do know that everyone urinates. And every adult I know prefers to be in complete control of their urination. But if you are sitting slumped in a chair, with your tailbone tucked under you and your spine curved like the letter “C” you may start to lose bladder control. This tucked position leads to more weight bearing down on the pelvic floor muscles. Over time (and time will come), your pelvic floor muscles are left weak and unable to fight the urge to urinate.

William Merritt Chase, The Young Orphan (An Idle Moment), 1884. Oil on canvas.

Ladies, if you want to be able to laugh out loud in public when you’re 65 without fear of peeing on yourself, stand tall. Gentlemen, unless you want to memorize the location of every public restroom in your town so you can go out in public in your 60s, stand tall.

Be Confident

It stands to reason that if you are in complete control of your body’s elimination of waste, you will be confident going out in public. But you can boost your confidence even more with your posture. Social psychologist and TED Talk star Amy Cuddy studied power poses. Putting yourself in a posture that takes up space and feels expansive can not only reflect power to those around you, but can also make you feel more powerful.

“…adopting high power poses increases explicit and implicit feelings of power and dominance, risk-taking behavior, action orientation, pain tolerance, and testosterone (the dominance hormone), while reducing stress, anxiety, and cortisol.”

That’s a pretty good payoff for a minute or two of putting your arms behind your head and your spine tall.

Power poses help you take action. And that’s what improving your quality of life requires. Action. So strike a pose and get to it.

Stand Tall to Boost Your Mood

Certainly if we are breathing better and eliminating our wastes better, we can be in a better mood, right? But there’s more to it than that. Muscular states have been shown to relate to emotional states. Research on body language and facial expressions has historically focused on interpersonal relationships, how our own facial expressions and stances have been interpreted by those with whom we interact. Recently, research has turned to examine how our postures effect our own moods. Body posture is now shown to be important in the initiation and the modulation of emotions. In other words, our bodies can tell our brains what emotional state we should be in AND our brains can tell our bodies to change posture to improve our emotional state.

This may sound like a chicken-and-egg problem, but it’s more of a fake-it-til-you-make-it problem. In the theory of embodied cognition, your brain looks to your body and your face to determine how you are feeling. Your facial expressions and your body posture tell your brain if you are feeling energetic, motivated, bored, lethargic. In her book Choke: What the Secrets of the Brain Reveal About Getting it Right When You Have To, Sian Beilock, PhD states “One of the ways we shape our thoughts is through our physical movements.”

Adopting an upright seated posture in the face of stress can maintain self-esteem, reduce negative mood, and increase positive mood compared to a slumped posture. Furthermore, sitting upright increases rate of speech and reduces self-focus, as noted here.

Dr. Erik Peper at San Francisco State University demonstrated this connection in a study that involved students walking in a slouched position and then skipping down a hallway. The things people do for science! This sounds like a much kinder study than the one measuring intestinal gas. Students were asked to rate their energy levels and their general levels of depression. The conclusion? “What we’re saying is that if you start integrating more body movements into your daily life, your energy level stays higher and your quality of life is better,” he said. “It’s very similar to the principle of ‘fake it till you make it’ — you can convince your body to have more energy.”

Importance of Spirituality

Importance of Spirituality

Let’s start with the word itself. Spirituality. What does it mean?

If you don’t rely on a particular religion to outline some spiritual practices, you may not think of yourself as spiritual at all. I offer these definitions from a variety of sources:

Spirituality is an inner belief system that a person relies on for strength and comfort
     – Psychologist Mark Holder

Spirituality is better thought of as a boundary-less dimension of human experience.
     – Psychologist Larry Culliford

Spirituality arises from your connection with yourself and with others, the development of your personal value system, and your search for meaning in life.
     – From the Mayo Clinic

Spirituality is concerned with a person‟s awareness of the existence and experience of inner feelings and beliefs, which give purpose, meaning and value to life.
– Dr. John Fisher

And perhaps the most thorough definition is from psychiatrist Harold Koenig:

“Spirituality is distinguished from all other things—humanism, values, morals, and mental health—by its connection to that which is sacred, the transcendent. The transcendent is that which is outside of the self, and yet also within the self…

Spirituality is intimately connected to the supernatural, the mystical, and to organized religion, although also extends beyond organized religion (and begins before it). Spirituality includes both a search for the transcendent and the discovery of the transcendent and so involves traveling along the path that leads from nonconsideration to questioning…”

If you have ever asked yourself what you believe and do not believe, what meaning there can be to this mortal coil, or what happens after death, I humbly suggest that you are a spiritual person.


Why is spirituality important to one’s health and overall quality of life?

The most comprehensive research I found is here. In his review of 601 peer-reviewed research papers, Dr. Harold Koenig found positive correlations between spirituality and these aspects of life:

If a pharmaceutical company offered such benefits in a pill, we would all be racing to our doctors for a prescription. Changing our behavior requires more effort than swallowing a pill, though. So it may seem difficult to make spiritual practices part of your life. But it only takes a thought – a single thought – to experience spirituality.

If you are still reading and haven’t run off to the nearest monastery for your own private retreat or clicked back over to the action page, then you, my friend, are a real skeptic. And I love that about you. Everything past this point is just for you.


Skills are Mandatory. Belief is Optional.

Like all the categories in the Quality of Life Initiative, spirituality is a skill that can be practiced and strengthened. The Royal College of Psychiatrists outlines the following skills to “help us to become more creative, patient, persistent, honest, kind, compassionate, wise, calm, hopeful and joyful:”

  • being honest – and able to see yourself as others see you
  • being able to stay focused in the present, to be alert, unhurried and attentive
  • being able to rest, relax and create a still, peaceful state of mind
  • developing a deeper sense of empathy for others
  • finding the capacity for forgiveness
  • being able to be with someone who is suffering, while still being hopeful
  • learning better judgement, for example about when to speak or act, and  when to remain silent or do nothing
  • learning how to give without feeling drained
  • being able to grieve and let go

That a quick how-to list. Below you will find more information on why developing the skill of spirituality improves your quality of life. 


Social Health

What does “social health” mean? 

You can probably guess that social health refers to the social connections you make in life. These are important, even if you are naturally introverted and are quite happy at home with a book and a drink. As evidenced here, social connections increase the flow of information related to disease screenings and maintenance of health. Religious/spiritual congregations can also provide opportunities for practicing altruism through volunteerism. Indeed, simply by gathering together with a group of people who are practicing similar spiritual practices, you encourage the development of basic human virtues such as honesty, courage, dependability, generosity, forgiveness, self-discipline, patience, and humility.


Sex is natural. Sex is good.

Sex is the way of nature.  Just check out these tomatillo plants putting all their business out there in the open for every flying pollinator to see.  It’s veggie porn! tomatillo sexual organs

Even Trappist monk Thomas Merton knows that sexual expression should be more than physical: “The act of sexual love should by its very nature by joyous, unconstrained, alive, leisurely, inventive and full of special delight, which the lovers have learned by experience to create for one another.”

And you’ve probably heard of the Kama Sutra.

Beyond the seemingly impossible physical positions represented in the book, sexuality is a relentless drive to creation and is universal. It should be no surprise that couples who identify as spiritual or religious often report a happy and healthy sex life.


Mental Health

Beyond the psychobabble that fills the positivity movement, psychologists are beginning to welcome spiritually-integrated approaches to treatment. For example, “forgiveness programs to help divorced people come to terms with bitterness and anger; programs to help survivors of sexual abuse deal with their spiritual struggles; treatments for women with eating disorders that draw on their spiritual resources; and programs that help drug abusers re-connect to their higher selves.”

And while some argue that religion brings comfort to the afflicted and afflicts the comfortable, there is a growing body of research that examines the link between spirituality (from regular attendance and involvement in a specific congregation to mindfulness practices) and mental health. 

In this most extensive review of literature, Koenig examines religious and spiritual practices as they relate to these mental health issues:

Substance Abuse
Psychotic Disorders
Bipolar Disorder


For years, mental health professionals assumed that religious and spiritual practices would worsen depressive symptoms due to some religions’ emphasis on sin, eliciting responses of guilt in some people. The research does not bear out that assumption. In the 444 studies reviewed, there was a greater than 60% incidence of spiritual practices providing relief of depressive symptoms. In 30 clinical trials, 63% of the studies “found that religious/spiritual interventions produced better outcomes than either standard treatment or control groups.”  (emphasis added) With these types of findings, isn’t it worth trying to find some spiritual practices that you can do regularly?


It stands to reason that if religious and spiritual practices can reverse depressive symptoms, they can also provide some relief to those who have suicidal ideations or who have attempted suicide. Indeed, the results of 141 studies show 75-80% reduction in completed suicide, attempted suicide, and suicidal thoughts. That is remarkably high. 


You won’t be surprised to learn that the research concerning anxiety shows similar results to that examining depression and suicide. Longitudinal studies found a 47% reduction in anxiety over time. In randomized clinical trials, “69% reported that a religious/spiritual intervention reduced anxiety more than a standard intervention or control condition.” 

Substance Abuse

The use of spiritual practices to help people recover from substance abuse is a cornerstone of Twelve Step Programs like Alcoholics Anonymous. The Second Step reads:

                   Came to believe that a Power greater than ourselves could restore us to sanity. 

The research supports this expression. Of 278 studies, a whopping 86% demonstrated a rise in spiritual practices correlated to a decrease in substance dependency. To me personally, the best news was that many studies (roughly 96) had a population of late adolescents or young adults, for many a time of experimentation with drugs or alcohol. If interventions can be found before dependency takes hold, perhaps some people can be spared interruptions to their education, careers, family life, and physical health. Koenig concludes, “Thus, the protective effects of [religious/spiritual practices] on substance abuse may have influences on health across the lifespan.

Psychotic Disorders

Chronic psychotic disorders, such as schizophrenia, are difficult to manage and have devastating effects on families, and possibly society. However, even with a small pool of 43 studies, 33% reported that as spiritual practices increase, psychotic episodes may decrease. Many mental health professionals posit that ruminating on oneself only contributes to psychiatric disturbances. Hence, deliberately turning your attention to a higher power, G-d, the universe, or simply life outside of yourself could provide powerful relief. I believe that any intervention that can ease the suffering of someone diagnosed with schizophrenia is an intervention worth trying, repeating, fine-tuning, and sharing. 

Bipolar Disorder

The goal of many pharmaceutical-based interventions is to reduce symptoms. A reduction in manic episodes, depressive episodes, or suicidal thoughts is considered effective treatment in many cases. However, people diagnosed with bipolar disorder repeatedly report having a low quality of life, an area not generally not addressed in pharmacotherapy. To be clear, it is vital that people with this disease are kept free from the harm that can be caused in either the manic or the depressive episode. However, we humans all want to feel that we are leading full lives, and this is an area where spirituality can help. More recent research examines this gap and finds that “religious resources (beliefs, practices, cognitive framework, and participation in religious services or volunteer work) in order to adapt to challenging circumstances” had a positive influence on quality of life over the two-year period. 


The Pursuit of Happiness

Are there those among us who wouldn’t claim to want happiness in our lives? Certainly we know people who take actions that will clearly make them unhappy. They are not aiming for unhappiness, I’m sure, and would still claim that happiness is a goal in life.

So how do you get there? This review showed that 82% of studies showed an increase in feelings of well-being or happiness in those who identified as having spiritual practices. Which leads me to conclude that if you want more happiness in your life, copy the masters. What are they doing that you can apply to your life? Obviously, if the national bestseller on happiness is written by a man who spent two years living alone in the Himalayas and you are a single mom living in an apartment complex in a large city, you can’t copy that person. What can you copy? Is there a belief system that you want to read more about? Is there a gathering place (synagogue, mosque, church, ashram,etc.) that you have been curious about and want to see what their get-togethers look like?


All In the Family

Family life has many challenges. Even Jesus’ parents left him behind after a family road trip for Passover! Spirituality is a deeply personal aspect of our lives, and our practices and beliefs will likely shift throughout our lives. We cannot force someone to believe what we believe, but we can model our own practices for our families. And the emerging field of relational spirituality indicates that we can rely on spiritual behaviors to enrich, strengthen, or transform our intimate relationships.

Many parents who attend religious services also raise their children in the same faith. This research stood out to me because of the differentiation between “religious” and “spiritual.” Most notably “children who feel that their lives have meaning and value and who develop deep, quality relationships – both measures of spirituality – are happier. It would appear, however, that their religious practices have little effect on their happiness.” The researchers used a couple of measures of spirituality: 

feeling that our lives have meaning, and
having quality relationships with others.

These measures represent a combination of the personal (our own meaning of life) with the inter-personal (relationship with others). So to see children aged 8-12 years report feelings of happiness in finding this balance between the individual and the communal brings me hope. 


Coping Mechanisms

Given that spiritual practices or beliefs can improve mental health and feelings of happiness, it is no surprise that in a review of 39 studies, people identified their spirituality as a means of coping in these situations: general medical illness, chronic pain, kidney disease, diabetes, pulmonary disease, cancer, blood disorders, heart/cardiovascular diseases, dental or vision problems, neurological disorders, HIV/AIDS, systemic lupus erythematosus, irritable bowel syndrome, musculoskeletal disease, caregiver burden,  psychiatric illness, bereavement, end-of-life issues, overall stress, natural disasters, war or acts of terrorism, and miscellaneous adverse life situations.

To cope means to deal with effectively. What does coping look like? Perhaps it means that you don’t scream at your aging parent because you are burnt out with your caregiving responsibilities. Maybe you work with your neighbors after a flood instead of feeling victimized by life. There is no one way to cope with a difficult diagnosis of disease, yet we all seem to know when those closest to us are not dealing well.


Live Long and Prosper

If you can effectively deal with stress, avoid substance abuse problems, ward off depression and anxiety, have a happy sex life, it makes sense that you can also live a longer life with spiritual and religious beliefs. Specifically, “those who attend religious services regularly may have an increased survival rate equivalent to the effects of cholesterol lowering drugs or exercise-based cardiac rehabilitation after myocardial infarction on survival.”

Did you catch that? Attending religious services regularly could be equal to drugs or exercise in terms of survival rates after a heart attack. Remember, this is a controlled study. Religious services aren’t for everyone, which is why it is important to note that in many of the studies cited here, researchers equated individual spiritual practices that were done consistently with regular attendance at a religious congregation. 


I have presented this research in hopes of encouraging you. Many people like to know that whatever ways they are trying to improve their lives are scientifically proven to demonstrate improvements. Perhaps you have tried some practices in the past that you feel ready to return to, or perhaps you are inspired to try something new. If you need a few suggestions, start here. And if you have practices that you think would be helpful to others, I hope you will share them.  

The Reason These Categories Matter

The Reason These Categories Matter

I believe what School House Rock told me every Saturday morning in between cartoons: knowledge is power.

I am known for giving my clients homework. And for checking with them in subsequent sessions if they did their homework. It doesn’t take long to show someone a simple exercise to strengthen a muscle or the mind. I take some extra time to explain why the exercise will help them. Consistently, the clients who know the reason an exercise is important are the most likely to do the exercise and to report benefiting from an exercise.

When people know why they are doing something, it is easier to do that something.

These longer blog posts about the importance of each category are meant only to begin to answer the ultimate question that every toddler knows: WHY?

Why are these 10 categories important to quality of life? How will they help improve your life today? How do they overlap?

It is my hope that the research presented here will help keep you motivated and will help you see the big picture of how these categories of life interact with each other. It is by no means meant to be an in-depth literature review. Sometimes a piece of research may grab my attention and I’ll muse more about it on the blog. Some of this research may grab your attention, and I hope you will share you thoughts with me.

Regarding citations

Most peer-reviewed professional publications only allow full access to their members. While I have reviewed each of the studies presented in full, I am providing links that are usable to you. If the full text is available (usually in a pdf), I am linking to that. In cases where a login is required to access the full text, I am linking you to the abstract only page.

A final caveat: the Quality of Life Initiative has the sole purpose of helping you improve your life. The research presented here is almost exclusively framed in the positive. Of course, every aspect of life has a shadow side. I do not deny that. This is not the place for examining the dark side of life in detail. I may mention it in passing because many people unintentionally end up expressing a negative aspect of their lives. Those people who intend harm to others are not my audience and are free to discuss the shadow side of each category on their own time.

To Move or Not To Move

To Move or Not To Move

I tested gravity this week. It’s still working just fine, so you don’t have to worry. I was walking in my yard, with the very thick weeds from all the rain we’ve had, trying to get over a branch. The branch (and the aforementioned gravity) won. I went down. Hard. Into stinging nettles. Now I know why they’re called stinging nettles.

That was Sunday. I have a standing appointment on Monday mornings for Pilates instruction. I thought about canceling. I was hurting! Nothing major, but a fall puts you out of whack. My neck was stiff, my sciatic pain flared up, my hips were out of place. And I still have stinging nettles in my hand.

But that’s exactly the right time to go.

Pilates Instruction

My options were:

  1. Go to Pilates
  2. Stay in bed

#2 had a very loud cheering section, but my brain was functioning enough to point out that lying in bed is not going to help. Things got out of whack from the sudden movement of falling. The only way to get them back into place was going to be through controlled movements.

To move or not to move is a valid question when you are injured or when you are ill. I have had clients cancel their appointments when what they needed most was to come see me. Moving the body isn’t something to be done only in times of health; it’s something we all need to be doing every day, to whatever extent we can.

This Pilates session didn’t look like much, but I left feeling so much better and, truth be told, damn proud of myself for not giving in to the excuses.

Now I’m going to take some Tylenol and rest on the couch.