Braving heart problems together

The Braveheart Project was started in Scotland during the middle 1990s by a group of coronary heart disease health-care professionals who were concerned that their patients were losing valuable information as they were being referred from one expert in the field to another. Once they focused upon their patients’ situation, the reason was quite plain: Their patients were not experts in the field, were in a foreign and stressful environment, and were almost always scared. So all of these conditions tended to result in a lack of attention and loss of memory.

To counteract this problem, these caring professionals formed a mentoring program led by non-professional, volunteer lay people, and preferably ones who had a history of coronary heart disease. Then they set up group sessions with the current coronary patients in non-clinical environments, with the added provision that health professionals would never be invited. The purpose was to see if this approach would result in the valuable information being better retained, and more motivation being generated for the patients to take control and do what was needed to improve their overall quality of life.

Two pilot programs were set up, each with a fully-trained but non-professional health mentor, and 10 to 12 cardiac patients were referred to each program. The groups determined their own agenda and met for two-hour sessions, three times per week, in non-clinical locations like community halls or schools. But the core of each program included a discussion about the basic nature of coronary disease, various risk factors, and the importance of medications, exercise and diet. Each program also drew up a code of conduct that would govern each person’s behavior during the meetings.

The results of each of these two programs were dramatic. Almost without exception, each patient became part of a support group for every other patient, and each also tried to live up to the positive expectations of the group. Thus each patient became much more motivated to learn about the disease and possible remedies, and many were amazed to learn first hand how much personal control they actually had over their own situation.

Specifically the two programs resulted in significant improvements in exercise scores, such that the average time spent walking per week was increased by a full 72 minutes. There was also an increase in adherence to medication regimens, a slight but important reduction in the intake of saturated and other fat, and reduced necessities to return to doctors, clinics and hospitals.

This approach can be extended to almost anything in life. For example, a similar study found that encouraging nursing home residents without dementia faithfully to share mealtimes with each other resulted in a noticeable increase of motivation, quality of life, physical performance and healthful body weight.

None of this should be surprising, because inherently we are all social animals, and are better adjusted and happier when we can share our challenges and feelings with our fellow human beings. Thus any time people with mutual problems or challenges can be grouped together, and the leaders or mentors can focus upon ownership of and responsibility for whatever their problems may be, good things are likely to happen. Of course, this is the principle behind groups like Alcoholics Anonymous, drug treatment programs and other group therapy, and even support groups for people recently released from prison.

In fact, speaking of prisons, when I was in my first year of law school at USC, our contracts professor formed us into study groups, and required us to discuss the cases and respond to different problems as a group. This approach was so successful that four of us grouped together when we studied for the bar examination after graduation.

Similar approaches have increased success in running, weight lifting and other exercise programs. Why are they almost unfailingly successful? Because there is a natural human inclination to please or at least not to disappoint one’s partners, and that results in more motivation and successful compliance.

To take this one step farther, when I was growing up, my family had the tradition of eating meals together — with the television turned off! Looking back, this tradition tangibly fostered a much greater interest in each other’s activities and feelings, a better and more loving and lasting relationship among us, and also more of a motivation generally to succeed. Many families do not seem to follow that tradition today, and that is unfortunate. In fact, if this column encourages even one family to spend their meals quietly discussing the events of the day with each other and sharing their feelings, I will consider it to be a success.

The same thing is true about friends meeting together on a regular basis to share their feelings and problems, and just “be” together. It almost always is great therapy. Women are typically better at this than men, but as women have increased their involvement in the workplace, even many of them have regressed.

So take a lesson from the Braveheart Project, and take time regularly to gather your family and friends together, or any people who face the same problems and challenges that you do, and learn from and support them as we all face and take ownership of whatever life has thrown our way. This will help all of us better to meet and resolve our challenges in life, and to reap the benefits — not to mention fun — of what some good camaraderie and human sharing can provide.

Judge Jim Gray (Ret.)