Why we heal: The evolution of psychological healing and implications for global mental health

Kohrt, Brandon A.; Ottman, Katherine; Panter‐Brick, Catherine; Patel, Vikram

doi:10.1016/j.cpr.2020.101920

Cited by 42 publications

(34 citation statements)

References 179 publications

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“…This implementation strategy is entitled Reducing Stigma Among Healthcare Providers (RESHAPE). The conceptual foundation of RESHAPE is promoting empathy between PCPs and PWLE using intergroup contact theory from social psychology, as well as reduction of intergroup discrimination by lowering threat and anxiety, as informed by social neuroscience; this is framed as a "what matters most" approach to understand stigma using a moral framework from medical anthropology [32,33].…”

Section: Preliminary Studies Of the Reshape Implementation Strategymentioning

confidence: 99%

Implementation strategy in collaboration with people with lived experience of mental illness to reduce stigma among primary care providers in Nepal (RESHAPE): protocol for a type 3 hybrid implementation effectiveness cluster randomized controlled trial

Kohrt

Turner

Gurung³

et al. 2022

Implementation Sci

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Background There are increasing efforts for the integration of mental health services into primary care settings in low- and middle-income countries. However, commonly used approaches to train primary care providers (PCPs) may not achieve the expected outcomes for improved service delivery, as evidenced by low detection rates of mental illnesses after training. One contributor to this shortcoming is the stigma among PCPs. Implementation strategies for training PCPs that reduce stigma have the potential to improve the quality of services. Design In Nepal, a type 3 hybrid implementation-effectiveness cluster randomized controlled trial will evaluate the implementation-as-usual training for PCPs compared to an alternative implementation strategy to train PCPs, entitled Reducing Stigma among Healthcare Providers (RESHAPE). In implementation-as-usual, PCPs are trained on the World Health Organization Mental Health Gap Action Program Intervention Guide (mhGAP-IG) with trainings conducted by mental health specialists. In RESHAPE, mhGAP-IG training includes the added component of facilitation by people with lived experience of mental illness (PWLE) and their caregivers using PhotoVoice, as well as aspirational figures. The duration of PCP training is the same in both arms. Co-primary outcomes of the study are stigma among PCPs, as measured with the Social Distance Scale at 6 months post-training, and reach, a domain from the RE-AIM implementation science framework. Reach is operationalized as the accuracy of detection of mental illness in primary care facilities and will be determined by psychiatrists at 3 months after PCPs diagnose the patients. Stigma will be evaluated as a mediator of reach. Cost-effectiveness and other RE-AIM outcomes will be assessed. Twenty-four municipalities, the unit of clustering, will be randomized to either mhGAP-IG implementation-as-usual or RESHAPE arms, with approximately 76 health facilities and 216 PCPs divided equally between arms. An estimated 1100 patients will be enrolled for the evaluation of accurate diagnosis of depression, generalized anxiety disorder, psychosis, or alcohol use disorder. Masking will include PCPs, patients, and psychiatrists. Discussion This study will advance the knowledge of stigma reduction for training PCPs in partnership with PWLE. This collaborative approach to training has the potential to improve diagnostic competencies. If successful, this implementation strategy could be scaled up throughout low-resource settings to reduce the global treatment gap for mental illness. Trial registration ClinicalTrials.gov, NCT04282915. Date of registration: February 25, 2020.

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Section: Preliminary Studies Of the Reshape Implementation Strategymentioning

confidence: 99%

Implementation strategy in collaboration with people with lived experience of mental illness to reduce stigma among primary care providers in Nepal (RESHAPE): protocol for a type 3 hybrid implementation effectiveness cluster randomized controlled trial

Kohrt

Turner

Gurung³

et al. 2022

Implementation Sci

Self Cite

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“…Psychedelics’ imagery-inducing ( de Araujo et al, 2012 ), meaning-enhancing ( Hartogsohn, 2018 ), and contextual effects ( Carhart-Harris et al, 2018b ) can play an important role in boosting imagination, the placebo effect, and hypnotic suggestibility, thereby favoring salutogenesis through psychoendoneuroimmunological processes ( Ray, 2004 ). Psychosocial healing is a component of human cooperation that comprises empathy, mirroring, emotional contagion, self-regulation, and mentalizing; it also recruits symbolic processes requiring shared meanings of symbols ( Kohrt et al, 2020 ). Thus, besides the psychedelic substance, other ritual elements (e.g., cultural expectations, mimetic enactments, verbal displays, songs, and dances) also serve an important function in enabling healing ( Winkelman, 2008 , 2019b , 2021a , c ; Uthaug et al, 2021 ).…”

Section: Psychedelic Instrumentalization In the Human Socio-cognitive Nichementioning

confidence: 99%

Psychedelics, Sociality, and Human Evolution

Arce¹,

Winkelman

2021

Front. Psychol.

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Our hominin ancestors inevitably encountered and likely ingested psychedelic mushrooms throughout their evolutionary history. This assertion is supported by current understanding of: early hominins’ paleodiet and paleoecology; primate phylogeny of mycophagical and self-medicative behaviors; and the biogeography of psilocybin-containing fungi. These lines of evidence indicate mushrooms (including bioactive species) have been a relevant resource since the Pliocene, when hominins intensified exploitation of forest floor foods. Psilocybin and similar psychedelics that primarily target the serotonin 2A receptor subtype stimulate an active coping strategy response that may provide an enhanced capacity for adaptive changes through a flexible and associative mode of cognition. Such psychedelics also alter emotional processing, self-regulation, and social behavior, often having enduring effects on individual and group well-being and sociality. A homeostatic and drug instrumentalization perspective suggests that incidental inclusion of psychedelics in the diet of hominins, and their eventual addition to rituals and institutions of early humans could have conferred selective advantages. Hominin evolution occurred in an ever-changing, and at times quickly changing, environmental landscape and entailed advancement into a socio-cognitive niche, i.e., the development of a socially interdependent lifeway based on reasoning, cooperative communication, and social learning. In this context, psychedelics’ effects in enhancing sociality, imagination, eloquence, and suggestibility may have increased adaptability and fitness. We present interdisciplinary evidence for a model of psychedelic instrumentalization focused on four interrelated instrumentalization goals: management of psychological distress and treatment of health problems; enhanced social interaction and interpersonal relations; facilitation of collective ritual and religious activities; and enhanced group decision-making. The socio-cognitive niche was simultaneously a selection pressure and an adaptive response, and was partially constructed by hominins through their activities and their choices. Therefore, the evolutionary scenario put forward suggests that integration of psilocybin into ancient diet, communal practice, and proto-religious activity may have enhanced hominin response to the socio-cognitive niche, while also aiding in its creation. In particular, the interpersonal and prosocial effects of psilocybin may have mediated the expansion of social bonding mechanisms such as laughter, music, storytelling, and religion, imposing a systematic bias on the selective environment that favored selection for prosociality in our lineage.

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“…Indeed, some research considered that healing cannot be accomplished by an individual alone and requires social intervention (Ayalon, 1998;Powley and Cameron, 2006). Healing includes supporting, caring for, helping and strengthening one another (Powley and Piderit, 2008) and comprises empathy, mirroring, emotional contagion, self-regulation and mentalizing (Kohrt et al, 2020). Jit et al (2017) related the orientation of leaders for emotional healing as strongly related to his/her characteristics of listening, empathy and compassion.…”

Section: Theoretical Background 21 Emotions and Leaders' Emotional Healingmentioning

confidence: 99%

Effects of emotional healing on organisational learning and radical innovation: a leadership-based approach

Domínguez-Escrig

Broch

Chiva

et al. 2021

JOCM

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PurposeThe objective of this study was to provide empirical evidence of the relationship between emotional healing, analysed as a leader behaviour and radical innovation.Design/methodology/approachTo test the hypotheses, structural equations were used, with organisational learning capability as an explanatory variable. The study was conducted in a population of 402 Spanish companies. A sample frame of 292 questionnaires was obtained from 146 different organisations. The fieldwork took place in two stages, in 2010 and again in 2015.FindingsResults confirm the hypotheses proposed in the model. Emotional healing promotes organisational learning capability and, in turn, radical innovation.Practical implicationsOur results provide some guidelines for companies that are trying to develop radical innovations by improving the workplace conditions.Originality/valueTo our knowledge, there are no previous studies which studied the relationship between emotional healing and its effect on radical innovation. Therefore, providing empirical evidence of such a relationship is the main contribution of this paper.

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Why we heal: The evolution of psychological healing and implications for global mental health

Cited by 42 publications

References 179 publications

Implementation strategy in collaboration with people with lived experience of mental illness to reduce stigma among primary care providers in Nepal (RESHAPE): protocol for a type 3 hybrid implementation effectiveness cluster randomized controlled trial

Implementation strategy in collaboration with people with lived experience of mental illness to reduce stigma among primary care providers in Nepal (RESHAPE): protocol for a type 3 hybrid implementation effectiveness cluster randomized controlled trial

Psychedelics, Sociality, and Human Evolution

Effects of emotional healing on organisational learning and radical innovation: a leadership-based approach

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