Lifestyle Counseling

Changes in the Brain During Repentance

April 19, 2017

I read a chapter in a medical textbook that seemed to describe the brain changes during repentance. But let me first start with some context.

When we look at Christ’s medical ministry we see that he was constantly looking to bring people to the point of repentance. To repent means “to turn away from” or to completely change direction. This is not done on our own but by the Holy Spirit.

As Christian medical providers we are also seeking repentance in our patients.

Repentance is used in the broad sense of the word and not limited to its religious meaning. When we see a patient dependent on tobacco or alcohol or drugs, we work to “turn them away” from those destructive habits. We want them to repent.

We seek to turn patients away from addiction to food leading to poor health. We seek for patients to turn away from anxiety and fear and learn to surrender their challenges to God. When a patient is in despair, we seek to turn them to hope.

How the Brain Changes

I read a chapter in a medical textbook that seemed to describe the neuronal process of repentance. Researchers actually called this insight. However, I find the neurological description of insight and our theological understanding of repentance strikingly similar.

The left side of our brain is primarily involved with computational and linear thinking. The right side of the brain concerns itself more with depth of meaning, color, character and pattern recognition. For instance, with language, the left side of the brain tells you the exact meaning of a word. But the right side of the brain concerns itself with more connotation or shaded meaning of the word.

The neurons on the right side of the brain are more broadly turned with longer dendrites or spines covering a wider cortical space. This lends itself less to precision and more to pattern recognition.[i]

During the moment prior to insight, there seems to be unusually intense activity on the right side of the brain, specifically near the anterior superior temporal gyrus.

The author describes the following:

The activation is described as sudden and intense, a surge of electricity leading to a rush of blood…

The adult brain is an infinite library of associations, a cacophony of competing ideas, and yet, as soon as the right association appears, we know. The new thought which is represented by that rush of gamma waves in the right hemisphere, immediately grabs our attention. As soon as the insight happens, it seems so obvious. People can’t believe they didn’t see it before.

Insight researchers call the “aha” experience the moment of categorical insight. This moment of epiphany registers as a new pattern of neural activity in the prefrontal cortex. The brain cells have been altered by the breakthrough. An insight is a restructuring of information – it’s seeing the same old thing in a completely new way. Once that restructuring occurs, you never go back.[ii]

Connecting Insight and Repentance

The words reminded me of words of the author Ellen White when she described the experience of conversion:

The wind is heard among the branches of the trees, rustling the leaves and flowers; yet it is invisible, and no man knows whence it comes or whither it goes. So with the work of the Holy Spirit upon the heart. It can no more be explained than can the movements of the wind. A person may not be able to tell the exact time or place, or to trace all the circumstances in the process of conversion; but this does not prove him to be unconverted. By an agency as unseen as the wind, Christ is constantly working upon the heart. Little by little, perhaps unconsciously to the receiver, impressions are made that tend to draw the soul to Christ. These may be received through meditating upon Him, through reading the Scriptures, or through hearing the word from the living preacher. Suddenly, as the Spirit comes with more direct appeal, the soul gladly surrenders itself to Jesus. By many this is called sudden conversion; but it is the result of long wooing by the Spirit of God,–a patient, protracted process (emphasis mine) – Desire of Ages, page 173.

As with the description of insight, the moment of conversion is described as sudden. It is something that seems to come all at once, in a moment. And after that moment, life can never be viewed the same. A long lasting change has occurred and one can never look back. I believe the studies on insight also describe the same activity that goes on in the brain during repentance.

Medicine is mostly a left-brained activity. We listen for clues pointing us to a specific organ. Afterward a differential diagnosis is developed. Then a plan is targeted toward the most likely diagnosis. It has a very linear logical flow.

However, medical ministry does not merely seek a diagnosis and treatment plan. It strives for repentance or the transformation of the patient. In other words it seeks to generate moments of insight. As such, it is a model of medicine that engages both the right and left hemispheres of the brain.

 

Understanding the neurological process of insight has profound consequences for how we do medical ministry. Here are 4 implications.

1. Partnering with the patient generates insight.

In order to partner with the patient, doctors need to listen. Asking a computational question may trigger left brain function at the expense of right brain activity. One study pointed out how the average doctor interrupts the patient within 12-18 seconds of speaking.[iii] This causes the patient to shift from right brain activity to left brain thinking and distracts the patient from generating insight.[iv] Allowing the patient to express their story increases the likelihood of the aha moment leading to lifestyle change.

2. Partnering with the Holy Spirit generates patient insight.

We must recognize a force beyond the patient or physician generates the insight. We cannot manually tinker with the human brain to initiate the neuronal activity leading to transformation. But we know God can. He is working with each patient and we trust that he can use our interaction to result in transformed patient lives.

3. Exploring emotional and meaningful areas generates patient insight.

While the left brain detects the exact meanings of words, the right brain is picking up the emotional charge of the sentence. By willing to explore areas of emotions and meaning, we set up the possibility for patient transformation. Just the other day I had a patient eager to meet me in the hallway even though he didn’t have an appointment. “I just want to you thank you, Doc. You told me to think about my kids when it came to my smoking. I want you to know that I’ve totally quit. Thanks for putting a bug in my ear.” When we explore emotion and meaning with patients we are engaging the right side of the brain, the area where insight occurs.

4. Our own authenticity generates patient insight.

I had a patient with depression who did not want to do counseling. While I also prescribed medications for him I knew he also needed something else. In the beginning of the visit the patient was against receiving counseling. But as I shared my own experience of how counseling had benefited my own life, he suddenly changed his mind. My own authentic experience helped generate a moment of insight for the patient.

Have you had any patients in your office experience a moment of insight? How can we make this a reproducible experience?

 

[i] Jones DS, Laurie H, Quinn, Sheila. 21st Century Medicine: A New Model for Medical Education and Practice, page 58

[ii] Ibid.

[iii] Rhoades DR, McFarland KF, Finch WH, Johnson AO. Speaking and interruptions during primary care office visits. Fam Med. 2001, Jul-Aug;33(7):528-32.

[iv] Jones DS, Laurie H, Quinn, Sheila. 21st Century Medicine: A New Model for Medical Education and Practice, page 57-58

 

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7 Comments

  • Reply Placido Roquiz MD April 19, 2017 at 4:00 pm

    Very interesting explanation of the left and right brain function and the development of insight and repentance .

  • Reply Nathan April 19, 2017 at 5:42 pm

    As you mentioned, I have found sharing my own experience with patients to be of great benefit in inspiring change, providing reassurance, or just simply planting a bug. The approach you present here has a much better chance at leading to change then telling a patient over again at every visit, “you need to quit smoking” or “you really need to eat a healthier diet”.

    • Reply Andrew Roquiz April 20, 2017 at 4:20 am

      Interestingly, I don’t think that the sharing of personal experiences by providers is something that is necessarily common. More often than not the culture seems to be to maintain a sort of “professional distance.” Yet authenticity leads to connection which ultimately leads to healing.

  • Reply Dulce April 21, 2017 at 1:40 am

    Quite interesting ! we happen to be studying repentance in our early morning devotional group in church so this article was very enlightening.

    • Reply Andrew Roquiz April 21, 2017 at 4:15 am

      Thanks Mama. I’m thankful it was a blessing.

  • Reply Susan Stilwell June 25, 2017 at 6:26 am

    I enjoyed very much reading this explanation of the similarity between repentance and insight! Sharing with my daughters! God bless you Dr. Andrew and the work that your office is doing!

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