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What is Hope?

Posted on February 13, 2015

We know that hope is critical to outcomes in social services and public health. It plays a critical role in best practice interventions, such as Motivational Interviewing. Historically, studies have shown that hope, along with the quality of relationships and our techniques, drive outcomes more than any other indicators the helper has control over. (Murphy, 2008)

Few would argue that hope, or the belief that positive change is possible, is essential to our work with traumatized clients. In this post I want to take some time to think about why it is such a strong predictor and the science behind this important concept. To begin to understand the power of hope, it is important to grasp another psychological phenomena: the Placebo Effect.

In the medical profession, the Placebo Effect (or taking a sugar pill or other noneffective treatment with the belief that it has curative effects) has long been the standard by which new medicines are tested. If a new treatment outperforms a placebo, it is a big step on the path to FDA approval. The cool thing about our minds is that if we believe something is going to have a positive impact on our condition, it oftentimes does improve our condition.

Placebos and hope both provide an expectation for a better future state. Whether we are receiving a medical treatment or believe that there is a possibility of a better future, we release endorphins.  As mentioned in the previous post, endorphins create an overall good feeling and sense of well-being. Many of you can probably recall that good feeling after a tough workout – endorphins are mainly responsible for this state.

Endorphins accomplish this by reducing the conscious experience of pain. Since both emotional and physical pain is processed similarly in the brain, endorphins increase our sense of physical and mental well-being. Endorphins also relax our muscles, improve our immune functioning, and are shown to be a key driver of happiness (or depression, if not enough endorphins are being utilized by our biology).

Here is the other cool thing about both hope and the Placebo Effect: when we trust the person helping us, our body releases oxytocin. Oxytocin is released in heavy doses during breastfeeding, orgasms, and also in lesser amounts when we feel connectedness to a helping professional. Oxytocin makes endorphin systems more sensitive to any endorphins that have been released. This increased sensitivity increases the positive physical and mental benefits of endorphins.

In other words, one would expect a greater positive impact if a trusted physician prescribes a sugar pill than if stranger with no medical training or expertise prescribes the treatment. Similarly, if a client has a strong relationship with a case manager, therapist, nurse, or other helper, when the client talks about a certain housing program, drug treatment, or other desired outcome the client will not only experience the endorphin release when considering this better future state, the oxytocin will increase the impact of this release. From a neurobiological perspective, the quality of the relationship and hope are strongly connected with one another.

If the client starts to associate these treatments or referrals with this positive feeling, they will feel pulled towards this future outcome. The more one feels pulled, the greater the motivation to take action to realize the better future. The influence of the relationship and hope in the helping relationship is incredibly powerful. Both come together to help shift the chemical makeup of the brain, from the pain and hurt of past traumatic experiences to one of hope and a possibility of a better future.

My challenge to you this week is to pay close attention to your interactions with clients who seem right on the edge of making the changes necessary to realize a better future life. How has their level of hope increased over time, and can you identify any connection between the level of hope and the quality of trust in your relationship?

What is Hope?

Posted on February 13, 2015

We know that hope is critical to outcomes in social services and public health. It plays a critical role in best practice interventions, such as Motivational Interviewing. Historically, studies have shown that hope, along with the quality of relationships and our techniques, drive outcomes more than any other indicators the helper has control over. (Murphy, 2008)

Few would argue that hope, or the belief that positive change is possible, is essential to our work with traumatized clients. In this post I want to take some time to think about why it is such a strong predictor and the science behind this important concept. To begin to understand the power of hope, it is important to grasp another psychological phenomena: the Placebo Effect.

In the medical profession, the Placebo Effect (or taking a sugar pill or other noneffective treatment with the belief that it has curative effects) has long been the standard by which new medicines are tested. If a new treatment outperforms a placebo, it is a big step on the path to FDA approval. The cool thing about our minds is that if we believe something is going to have a positive impact on our condition, it oftentimes does improve our condition.

Placebos and hope both provide an expectation for a better future state. Whether we are receiving a medical treatment or believe that there is a possibility of a better future, we release endorphins.  As mentioned in the previous post, endorphins create an overall good feeling and sense of well-being. Many of you can probably recall that good feeling after a tough workout – endorphins are mainly responsible for this state.

Endorphins accomplish this by reducing the conscious experience of pain. Since both emotional and physical pain is processed similarly in the brain, endorphins increase our sense of physical and mental well-being. Endorphins also relax our muscles, improve our immune functioning, and are shown to be a key driver of happiness (or depression, if not enough endorphins are being utilized by our biology).

Here is the other cool thing about both hope and the Placebo Effect: when we trust the person helping us, our body releases oxytocin. Oxytocin is released in heavy doses during breastfeeding, orgasms, and also in lesser amounts when we feel connectedness to a helping professional. Oxytocin makes endorphin systems more sensitive to any endorphins that have been released. This increased sensitivity increases the positive physical and mental benefits of endorphins.

In other words, one would expect a greater positive impact if a trusted physician prescribes a sugar pill than if stranger with no medical training or expertise prescribes the treatment. Similarly, if a client has a strong relationship with a case manager, therapist, nurse, or other helper, when the client talks about a certain housing program, drug treatment, or other desired outcome the client will not only experience the endorphin release when considering this better future state, the oxytocin will increase the impact of this release. From a neurobiological perspective, the quality of the relationship and hope are strongly connected with one another.

If the client starts to associate these treatments or referrals with this positive feeling, they will feel pulled towards this future outcome. The more one feels pulled, the greater the motivation to take action to realize the better future. The influence of the relationship and hope in the helping relationship is incredibly powerful. Both come together to help shift the chemical makeup of the brain, from the pain and hurt of past traumatic experiences to one of hope and a possibility of a better future.

My challenge to you this week is to pay close attention to your interactions with clients who seem right on the edge of making the changes necessary to realize a better future life. How has their level of hope increased over time, and can you identify any connection between the level of hope and the quality of trust in your relationship?

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