Twenty Years of Sangha
Community At Heart
“Don’t underestimate the importance of a group like this,” Dr. Alan Feren pulled me aside and gazed at me pointedly. “It’s the one place you absolutely feel safe.”
Dr Feren is one member of a group who gathers every Monday night in the kitchen and conference room of the Preventive Medicine Research Institute (PMRI), just steps from the Sausalito harbor, a few miles north of the Golden Gate Bridge. The group’s commitment is so strong that every week the members carpool from Berkeley, San Francisco and Marin County to eat together, meditate together and most importantly, serve as a support system for each other.
On the evening they welcomed us, the interlopers, as participant-observers (one behind a camera, the other poised with recorder and notebook), the kitchen bustled with people who were setting out salads festooned with just-out-of-the-garden rosemary, sharing the secrets of low-fat zucchini bread and discussing the merits of using fresh herbs to flavorfully reduce a recipe’s fat or salt content. Sharing a meal together was only the first item on the evening’s agenda; food has served as a focal point for their gatherings for more than twenty years.
The group’s genesis originated in Dr. Dean Ornish’s famous Lifestyle Heart Trial which began in 1986 to investigate the effect of comprehensive lifestyle changes by people with moderate to severe coronary artery disease, most of whom had heart attacks, or bypass surgery, before entering the trial. Some of the original research participants (RPs) continue the support group that was for years a formal part of the study and is now an informal, yet valued practice. We met original RPs Werner Hebenstreit, Hank and Phyllis Ginsberg and John and Phyllis Cardozo. The results they achieved proved that a comprehensive lifestyle program, including diet (low-fat, largely vegetarian), stress reduction (yoga, meditation, breathing techniques and guided imagery), moderate exercise and increased social support networks (including support groups) could actually reverse the progression of heart disease and reduce atherosclerosis, or the buildup of fatty plaques within the arteries. This reversal could occur in as little as a year and even in people with severe atherosclerosis.
Group Members
The program’s success led to the research participants being feted worldwide as ambassadors for the healing power of lifestyle, featured in: medical journals, Dean Ornish’s best-selling books, the New York Times and Newsweek and Time magazine, among others. They were stars on Bill Moyers’ Healing and the Mind. They have testified to convince lawmakers and insurance companies to offer the program as a cost-effective and efficacious benefit to members and even Medicare recipients. They were the centerpiece mentors in a number of week-long retreats, held at the Claremont Hotel in Oakland, to teach others a new way to interact with their bodies, their hearts, their families and their communities. They are role models and living examples of the power of the heart.
What Dr. Feren asked me not to underestimate was the feeling of safety experienced by the members as they shared their feelings – unconditionally, without being interrupted, without fear, without reprisal, even without advice. The benefit of this sense of safety is the reason why the original RPs, along with participants from the Claremont retreats (David and Sharon Strachan, Alan and Carol Feren and Miriam Leefe) and former Lifestyle Heart Trial Research Participant Coordinator Amy Gage and Amy’s husband John Gage continue to convene weekly. For Amy and John, participating is about cultivating sangha (spiritual community). Sangha may be a critical aspect of the success of the Lifestyle trial. In the introduction to his 1998 book, Love and Survival, Dean Ornish states: “Our survival depends on the healing power of love, intimacy, and relationships. Physically. Emotionally. Spiritually. As individuals. As communities. As a country. As a culture. Perhaps even as a species.”
Werner Hebenstreit
The heart, after all, is more than merely a mechanical pump, contracting and releasing. Numerous studies provide evidence of the deleterious effect of negative emotions such as anger, hostility, anxiety and depression on heart disease and the positive changes that can occur when those feelings are addressed, discussed or processed in some way. The power of the group can be part of this transformation. A research review published in the Canadian Journal of Cardiology that analyzed twenty years of studies of rehabilitation from coronary artery disease confirmed the importance of social support and social networks in the prevention of heart attacks as well as for long-term survival and quality of life for people with coronary artery disease.
As our heartfelt group mingled before and after eating, meditating and sharing, they all remarked on the conviviality of their Monday night gatherings and the importance of that safety net in their lives. These few hours a week are not the only component of their support network. The original studies and ongoing retreats included the spouses and partners in all the therapeutic activities of the lifestyle program, since the formation and sustenance of social connections were cornerstones of the comprehensive nature of the approach. Another aspect of support went beyond the social and emotional to include information about how people could change their lives through specific dietary coaching and instruction in the mechanics of actually implementing these positive habits. When they discovered the Lifestyle Heart Trial, or any one of the series of retreats, many of them were desperately searching for the necessary tools to change their – or their partners’ – lives.
Phyllis Ginsberg’s husband Hank was one of the original RPs. Hank joined the Lifestyle Heart Trial after visiting other doctors and centers, looking for something to heal his heart. Phyllis was looking for support. “After open-heart surgery,” she said, “they would send you home, and say, ‘Eat more vegetables,’ and that’s about it.” She knew there had to be more. After all, if you went home and went back to the same routine before the surgery, what would really change at the level of truly nourishing the heart? Through the Lifestyle Trial, participants learned how to understand the disease, how to do yoga, meditate, cook and order out for low-fat vegetarian food, and how to find a new connection with their hearts.
Not everyone was actively searching for answers. At the time, Werner Hebenstreit was a 71-year-old man who, as he describes it, was sitting around feeling sorry for himself after his second heart attack. “At 71, I was ready to give it up. I was an old, very sick man.”
Now a youthful 93, Werner keeps an autographed copy of one of Dean Ornish’s books on his living room table. While a strong advocate now, it was not his idea initially to enroll himself in the study. Through a recommendation from Werner’s family
physician, Dr. Ornish called his house. “Out of this developed a long conversation between Eva [Werner’s late wife] and Dr. Ornish.” But when Werner got on the phone with Dr. Ornish, he was clear with the then-barely known physician, “Whatever you are selling; I don’t buy it.”
John & Phyllis Cardozo
“At the time I was very aggressive, not a pleasant character….Eventually, I learned to recognize that I was my own greatest enemy; I was doing everything the wrong way.” The tests given to study participants confirmed that Werner had a Type A personality, maybe even an A+. There was hope, and as Werner says, leaning forward while sitting on his sofa, “changing this behavior pattern could change the likelihood of a heart attack.”
For Werner, something clicked as a result of the combined effect of the lifestyle components, including the regular meditation practice (he still sits een my heart and talk about my feelings not only changed my entire personality, but my marriage, the way I handled my former Type A behavior as well as stress and so on.”
very morning), the vegetarian diet (to which he still adheres) and the originally twice-weekly support groups presided over by a psychologist. “The newly acquired ability to op
Now Werner’s wry sense of humor is a feature of his storytelling and the poems he reads while sitting in a circle in the group or entertaining visitors in his living room. Although he’s lightened up a bit since his Type A grade, Werner still brings a sense of seriousness and commitment to the Lifestyle program. Werner speaks about the program’s components while on Elderhostel trips worldwide and has been instrumental in changing the dietary offerings available at the retirement home where he lives. He’s given official talks about the program in Europe, on the East Coast, providing testimonials for the transformation that can occur in practice.
Werner is the timekeeper who signals the start and finish of the weekly meditation practice that’s sandwiched between sharing dinner and sharing feelings. Meditation is a practice to which the community – as individuals and as a group – is fully committed, even if they didn’t give it much consideration before their participation in the program.
Amy Gage has participated in the group process as a coordinator, yoga teacher, stress management director and now participant; she has watched the evolution over twenty-plus years. “It’s been interesting over the years to watch what has happened: what’s dropped out is everything except the meditation when we get together. If we didn’t do the meditation, I don’t think we’d be so clear. From that, the quality of everything else is enhanced.”
Phyllis Cardozo’s husband, John, claims the title of RP. He heard about Dr. Ornish’s work in 1986, when John was looking for something to address the ongoing angina (chest pain) that was becoming progressively worse. The couple shares the study’s community building component through facilitating groups aside from their Monday night mainstay. Phyllis confirms Amy’s feelings about the cement of collective meditation: “In all the three groups we have, we do the meditation first. I can’t imagine it without it.”
Along with meditation, yoga is one of the integral components of the Lifestyle Program, one that was a new introduction to many of the participants. Yet it took on. “I used to have backaches all the time, and once I did yoga, that was gone,” Phyllis Ginsberg stated while looking at newspaper photos of the group doing yoga. “They would always photograph us doing yoga.” Yoga is, after all, photogenic.
After two bypass surgeries and subsequently begging to be included in the study, original RP Hank Ginsberg attributes his life today, his ability to be with his wife Phyllis and play host in this moment, to his ongoing participation in the Lifestyle program, yoga and all. “I was told by my doctor to go home, and take care of your insurance, and don’t expect to be an older person. That was 22 years ago.” He’s 82 now. When asked what advice he would give for how to live a healthy life when you’re older, he retorted, “Who’s older? The truth is, I don’t feel old, seriously. I’m young here; in my head, I’m still young.”
When speaking about the study, and the continued impact on this life today, Hank insisted, “The combination of the yoga, the support group, and the food, all of them were very important, I don’t know if there is one that was more important than the other.” Amy, listening intently to his answer, quickly queried him with: “Hank, what about the meditation?” He replied, “I consider that part of the yoga; I don’t really separate that.”
He still meditates daily, and it was an activity Phyllis reports he unknowingly engaged in even before the study. “It relaxes you to a degree that calms you down and puts you in another place where you don’t have the stress of your daily life that is going on around you.”
The couple echoes the beliefs of the other participants who emphasize the role of the group in their lives. “It’s the only group I’ve ever belonged to,” Phyllis mused. Hank identified the reason for their continued participation. “It’s the idea that there is a place to be whoever you are and not worrying about what people think. And feeling comfortable in saying whatever your problems are and being accepted for who you are and not who you want to be.”
By Felicia M. Tomasko, RN
Photos by Tai Kerbs, www.almomentophotography.com
Felicia Tomasko has spent more of her life practicing Yoga and Ayurveda than not. She first became introduced to the teachings through the writings of the Transcendentalists, through meditation, and using asana to cross-train for her practice of cross-country running. Between beginning her commitment to Yoga and Ayurveda and today, she earned degrees in environmental biology and anthropology and nursing, and certifications in the practice and teaching of yoga, yoga therapy, and Ayurveda while working in fields including cognitive neuroscience and plant biochemistry. Her commitment to writing is at least as long as her commitment to yoga. Working on everything related to the written word from newspapers to magazines to websites to books, Felicia has been writing and editing professionally since college. In order to feel like a teenager again, Felicia has pulled out her running shoes for regular interval sessions throughout Southern California. Since the very first issue of LA YOGA, Felicia has been part of the team and the growth and development of the Bliss Network.