Yesterday we began to look at Aaron Antonovsky’s concept of Sense of Coherence.

Here is one of the most widely used sets of questions to determine an individual’s Sense of Coherence, derived from Antonovsky’s The Sense of Coherence Quest.

The questions concern a number of aspects of our lives.

Each question has seven possible answers. The person doing the evaluation marks one number from 1 to 7 for whichever one most closely corresponds to their beliefs or feelings.

1. When you talk to people, do you have the feeling that they don’t understand you?
Never 1 2 3 4 5 6 7 Always have this feeling

2 In the past, when you had to do something that depended upon cooperation with others, did you have the feeling that it:
Surely wouldn’t get done 1 2 3 4 5 6 7 Surely would get done

3. Think of the people with whom you come into contact daily, aside from the ones to whom you feel closest. How well do you know most of them?
You feel that they’re strangers 1 2 3 4 5 6 7 You know them very well

4. Do have the feeling that you don’t really care about what goes on around you?
Very seldom or never 1 2 3 4 5 6 7 Very often

5. Have you in the past ever been surprised by the behavior of people whom you thought you knew well?
Never happened 1 2 3 4 5 6 7 Always happened

6. Have you ever had people that you counted on, ended up disappointing you?
Never happened 1 2 3 4 5 6 7 Always happened

7. Life is:
Full of interest 1 2 3 4 5 6 7 Completely routine

8. Until now your life has had:
No clear goals or purpose at all 1 2 3 4 5 6 7 Very clear goals and purpose

9. Do you have the feeling that you’re being treated unfairly?
Very often 1 2 3 4 5 6 7 Very seldom or never

10. In the past ten years your life has been:
Full of changes without your knowing what will happen next 1 2 3 4 5 6 7 Completely consistent and clear

11. Most of the things you do in the future will probably be:
Completely fascinating 1 2 3 4 5 6 7 Deadly boring

12. Do you have the feeling that you are in an unfamiliar situation and don’t know what to do?
Very often 1 2 3 4 5 6 7 Very seldom or never

13. What best describes how you see life:
One can always find a solution to painful things in life 1 2 3 4 5 6 7 There is no solution to painful things in life

14. When you think about your life, you very often:
Feel how good it is to be alive 1 2 3 4 5 6 7 Ask yourself why you exist at all

15. When you face a difficult problem, the choice of a solution is:
Always confusing and hard to find 1 2 3 4 5 6 7 Always completely clear

16. Doing the things you do every day is:
A source of deep pleasure and satisfaction 1 2 3 4 5 6 7 A source of pain and boredom

17. Your life in the future will probably be:
Full of changes without your knowing what will happen next 1 2 3 4 5 6 7 Completely consistent and clear

18. When something unpleasant happened in the past your tendency was:
“To beat yourself up” about it 1 2 3 4 5 6 7 to say, “Ok that’s that, I have to live with it ” and go on

19. Do you have very mixed-up feelings and ideas?
Very often 1 2 3 4 5 6 7 Very seldom or never

20. When you do something that gives you a good feeling:
It’s certain that you’ll go on feeling good 1 2 3 4 5 6 7 It’s certain that something will happen to spoil the feeling

21. Does you have feelings inside you would rather not feel?
Very often 1 2 3 4 5 6 7 Very seldom or never

22. You anticipate that your personal life in the future will be:
Totally without meaning or purpose 1 2 3 4 5 6 7 Full of meaning and purpose

23. Do you think that there will always be people whom you’ll be able to count on in the future?
You’re certain there will be 1 2 3 4 5 6 7 You doubt there will be

24. Does it happen that you have the feeling that you don’t know exactly what’s about to happen?
Very often 1 2 3 4 5 6 7 Very seldom or never

25. Many people - even those with a strong character - sometimes feel like sad sacks (losers) in certain situations. How often have you felt this way in the past?
Never 1 2 3 4 5 6 7 Very often

26. When something happened, have you generally found that:
You overestimated or underestimated its importance 1 2 3 4 5 6 7 You saw things in the right proportion

27. When you think of the difficulties you are likely to face in important aspects of your life, do you have the feeling that:
You will always succeed in overcoming the difficulties 1 2 3 4 5 6 7 You won’t succeed in overcoming the difficulties

28. How often do you have the feeling that there’s little meaning in the things you do in your daily life?
Very often 1 2 3 4 5 6 7 Very seldom or never

29. How often do you have feelings that you’re not sure you can keep under control?
Very often 1 2 3 4 5 6 7 Very seldom or never

There are no right or wrong answers, but the overall pattern of your scores will give you some useful insights. There is a large research literature in which scores on this scale have been related to everything from career choices to the risk of getting PTSD.

One of the central concepts of Integrated Health and Integrated Medicine is the idea of coherence. This is not a new idea, but was developed in new ways and formalized by the American/Israeli sociologist Aaron Antonovsky. It is such an important concept that I have mentioned something about it before

Antonovsky developed his theory of health and illness, which he termed Salutogenesis. This model was described in his 1979 book “Health, Stress and Coping”, followed by “Unraveling the Mystery of Health”
in 1987. I remember its publication, and the strong feeling amongst many of us interested in Integrated Health that it was a most important
contribution to understanding the relationship between health and
illness. A key concept in Antonovsky’s salutogenic theory concerns the way in which
specific personal dispositions serve to make us more resilient
to the stressors that we encounter in daily life.

Antonovsky identified
these characteristics, which he said helped a person better cope and remain healthy by providing “a sense of coherence” (SOC) about
life and the challenges we all face. Measures of Sense of Coherence have
been developed and tested in more than 30 countries.

The SOC is defined as: “The extent to which one has a pervasive, enduring though dynamic, feeling of confidence that one’s environment is predictable and that things will work out as well as can reasonably be expected.”

So it tries to capture our sense of optimism and control.

SOC has three components:

• Comprehensibility
• Manageability
• Meaningfulness

Comprehensibility is the extent to which events are perceived as making logical sense, that they are ordered, consistent, and structured. Manageability is the extent to which a person feels they can cope. Meaningfulness is how much one feels that life makes sense, and challenges are worthy of commitment.

Professor Antonovsky believed that a person with a strong SOC is more likely to feel less stress and tension, and to have confidence that he or she can meet the demand placed upon them. The SOC was developed to apply across cultures, and versions of the questionnaire have been used in over 30 countries.

The SOC is not the only factor in a predicting outcomes in a person’s life: it interacts with a person’s natural coping style, upbringing, financial assets, mood and social support. The strength and availability of each is a major determinant in the development of a strong or weak SOC.

Research in the growing field of psychoneuroimmunology
has supported many of the basic assertions of the relationship between
emotions and health contained in Antonovsky’s theory of Salutogenesis.

I saw some research (NR691) at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California last month that was based on a sample of 976 working people in Denmark, found that people with a high sense of coherence perceive less stress and experience less psychological disturbance in the work place.

This all makes very good sense, and it also gives us yet another line of approach for helping people deal with the stresses of life and gain personal mastery.

I shall talk about using this information in the future.

Regular readers will know that I have been collecting wise words from around the globe for many years, and I now have almost 40,000 of them broken down into more than 500 topics. It has taken years not just to collect them, but to try to check the sources and wording. But if you find errors, please let me know!

Here are 23 of my favorites comments about enlightenment.

I do hope that you find them as useful and inspiring as I have.

“One does not become enlightened by imagining figures of light, but by making the darkness conscious.”   
–Carl G. Jung (Swiss Psychologist and Psychiatrist, 1875-1961)

“Be a lamp unto your own feet; do not seek outside yourself.”   
–Buddha (a.k.a. “The Awakened”, a.k.a. Siddhartha Gautama, Indian Religious Figure and Founder of Buddhism, c.563 B.C.E. – c.483 B.C.E.)

“When the divine vision is attained, all appear equal; and there remains no distinction of good and bad, or of high and low.”   
–Sri Ramakrishna (a.k.a. Sri Ramakrishna Paramahansa, Indian Hindu Mystic and Promoter of Universal Religion, 1836-1886)

“We loosely talk of Self-realization, for lack of a better term.  But how can one realize or make real that which alone is real? All we need to do is to give up our habit of regarding as real that which is unreal. All religious practices are meant solely to help us do this. When we stop regarding the unreal as real, then reality alone will remain, and we will be that.”   
–Ramana Maharshi (Indian Hindu Mystic and Spiritual Teacher, 1879-1950)

“We attain enlightenment when we love truth for the sake of truth, and not for the sake of self-promotion or worldly gain.”   
–Emanuel Swedenborg (Swedish Scientist, Mystic and Philosopher, 1688-1772)

“Once and for all, dedicate yourself to the service of a high ideal, to the coming of the kingdom of God, and do not be concerned with what will become of you. This ideal will bring you everything."
–Omraam Mikhaël Aïvanhov (Bulgarian Spiritual Master, 1900-1986)

“The holy instant is the recognition that all minds are in communication. Every thought you would keep hidden shuts off communication.”
–A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

“If you are enlightened, you are not free, as some people say, but you are freedom itself. Not like a bird in the sky, but like the sky itself.”
–Wolter A. Keers (Dutch Advaita Teacher and Editor, 1923-1985)

“The reason why so few people find enlightenment is because they have free will and punish themselves by making wrong choices. Constantly, enlightenment is being offered to them, but they refuse to accept it. Therefore they refuse to accept it. Therefore they are being taught problems that are set before them, since they refuse to make choices voluntarily.”
–“Peace Pilgrim” (a.k.a. Mildred Norman, American Peace Activist, 1908-1981)

“All the riches of this world are too less a price for a single word which enlightens the soul.”    
–Hazrat Inayat Khan (Founder of the Sufi Order of the West, 1882-1927)

“To the dull mind all nature is leaden. To the enlightened mind the whole world sparkles and burns”   
–Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

“Enlightenment must come little by little, otherwise it would overwhelm.”   
–Idries Shah (Afghan-born Sufi Philosopher and Writer, 1924-1996)

“Out of compassion I destroy the darkness of their ignorance. From within them I light the lamp of wisdom and dispel all darkness from their lives.”   
–Bhagavad Gita (Ancient and Sacred Sanskrit Poem Incorporated into the Mahabharata)

“If these little sparks of holy fire which I have thus heaped together do not give life to your prepared and already enkindled spirit, yet they will sometimes help to entertain a thought, to actuate a passion, to employ and hallow a fancy.”
–Jeremy Taylor (English Anglican Clergyman, Writer and Bishop, 1613-1667)

“The great beacon light God sets in all, the conscience of each bosom.”
–Robert Browning (English Poet, 1812-1889)

“God reveals himself unfailingly to the thoughtful seeker.”
–Honoré de Balzac (French Novelist, 1799-1850)

“There is no difference between an enlightened man and an ignorant one. What makes the difference is that the one realizes it, while the other is kept in ignorance of it.”
–Hui-Neng (a.k.a. Daikan Eno, Chinese Chan Monk, A.D. 638-713)

“You may have expected that enlightenment would come Zap! Instantaneous and permanent. This is unlikely. After the first "ah ha" experience, it can be thought of as the thinning of a layer of clouds…”   
–Ram Dass (a.k.a. Richard Alpert, American Spiritual Teacher, Author and Lecturer, 1931-)

“God realization does not begin in a cave high atop the Himalayas. It begins in the pots and pans of the kitchen. Treat all your tasks, however small, as opportunities to see God and serve him.”
Sri Swami Sivananda (Indian Physician and Spiritual Teacher, 1887-1963)

“Enlightenment is not an attainment: it is a realization. When you wake up, everything changes and nothing changes. If a blind man realizes that he can see, has the world changed?”   
–Dan Millman (American Writer, Philosopher and Former World Class Trampolinist, 1947-)

“Enlightenment is the highest good. Once you have it, nobody can take it away from you.”   
–Siddharameshwar Maharaj (Indian Spiritual Teacher, 1888-1936)

“Is enlightenment really possible for the average person? Yes. Big Yes. Enlightenment is very possible for the ordinary individual. Actually it is easier than for some one who thinks that they are special…. whenever someone is ordinary, simple, innocent and natural, that is enlightenment.”   
–Sri Sri Ravishankar (Indian Spiritual Teacher and Founder of the Art of Living Foundation and the International Association for Human Values, 1956-)

For centuries, people in cultures throughout the world have believed that increasing age is associated with increasing wisdom. Not just knowledge and experience, but wisdom. Is this an old wives’ tale, or is there something to it?

There is growing evidence that as we age our brains actually become stronger. Everyone missed it, because the emphasis was on memory, concentration and thinking speed, and those may all deteriorate with age. What changes is that as we age we become more efficient at making associations rather than thinking linearly. we also recruit regions of the brain that may have lain dormant for years. At the same time, different types of mental training, including meditation, can improve many aspects of our cognitive abilities, and may also enrich and even grow appropriate regions of the brain.

Some new data from a study being conducted at Wake Forest University Baptist Medical Center in North Carolina suggests that it is possible to use a fitness program for your brain that can improve thinking skills, attention and concentration as reliably as lifting weights can increase muscle strength.

Preliminary findings from the study, which used functional magnetic resonance imaging (fMRI) to record brain activity, were presented last week at the Organization for Human Brain Mapping conference in Chicago.

As we age, we do experience changes in how we perceive the information that our senses gather from the environment. As I mentioned older adults combine information from the different senses more readily than do younger adults. This is known as sensory integration, and the down side is that it can lead to difficulties in blocking out distracting sights and sounds while still maintaining focus on important information. You are probably familiar with the “Cocktail Party Phenomenon.” You are in a loud room, but because someone is saying something interesting, you are able to block out uninteresting information. This technical term for this is cortricofugal inhibition. As we get older it gets more difficult to do the inhibiting.

The Brain Fitness in Older Adults (B-fit) study has been designed to establish whether eight hours of brain exercise can improve the ability of healthy older adults, ages 65 to 75 years, to filter out unwanted sights and sounds.

The B-fit study uses fMRI to visualize blood flow and brain activity to determine how attention training affects brain function. The training involves either a structured one-on-one mental work-out program or a group brain exercise program. During the one-on-one sessions, the volunteers were asked to ignore distracting information and tasks get harder as the eight-week training progresses. For the group sessions, participants learn new information relevant to healthy aging and are then tested on their ability to apply the new information.

All participants had an fMRI scan during a distraction task. They had to look for target words or numbers while ignoring distracting sounds. The scans showed brain activity in areas related to both sight and sound. Follow-up fMRIs showed that in the group receiving the one-on-one training, activity related to sight was increased, while activity related to sound was decreased. In addition, performance on the task was improved.

So the data do indeed suggest that attention training is a way to reduce
older adults’ susceptibility to distracting stimuli and therefore help improve
concentration.

And what about wisdom?

I have written in Healing, Meaning and Purpose that “Wisdom is the integration of understanding:” making more new associations and drawing conclusions based on a new perspective is a gift of aging. The training enables us to make sense of and communicate our conclusions.

When it comes to the brain, use it or lose!

Here is yet another possible problem associated with poor quality sleep and breathing problems during sleep.

Research from the University of Michigan that was presented at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies in Minneapolis this week, suggests a link with aggression.

Aggressive behavior and bullying are common amongst schoolchildren and are likely to have multiple causes. But a new one, and one which may be an undiagnosed, is sleep-related breathing disorder (SRBD).

The study focused on children in the second through fifth grades who attended school in an urban public school district. Parents completed two well-validated rating instruments: the Conners’ Parent Rating ScalePediatric Sleep Questionnaire SDB Scale. Teachers completed the Conners’ Teacher Rating Scale (CPRS) the  (CTRS). The numbers of discipline referrals in the previous 12 months were obtained from the six elementary schools.

A total of 345 CPRS’s and 245 corresponding CTRS’s were completed. The main finding was that schoolchildren who bully may be more likely to have an SRBD than their peers.

An SRBD may be a problem in more than 10 percent of children. It occurs when the airway is partially blocked during sleep. The most common example is snoring. The most severe form of an SRBD is obstructive sleep apnea. It occurs in about one percent to two percent of children.

If you suspect that your child or grandchild might be suffering from an SRBD or, for that matter, any type of sleep disorder, it is a really good idea to consult with your child’s pediatrician, who can see of he or she needs to be referred to a sleep specialist.

We already know that treatment of an SRBD may improve other mood, attention and behaviors in
children. We do not know if treatment might reduce aggression and bullying, and that will be the next research project.