Friday, January 12, 2018

Emotional and spiritual intelligence and its relevance to medicine.

Following is the text of the E M Wijerama Endowment lecture 2015,  of the
Sri Lanka Medical Association,  held at the inauguration of  Foundation Sessions held on 28th October 2015 at  Anuradhapura General Hospital Auditorium.

Dr. Sunil Seneviratne Epa
Consultant Physician , Past president of the Sri Lanka Medical Association

Emotional and spiritual intelligence and its relevance to medicine.
 Let me start by showing you a quotation from Albert Einstein.

“The intuitive mind is a sacred gift,   and rational mind a faithful servant.  We have created a society that honors the servant,   and forgotten the gift”. It is on  this  Intuitive mind or the forgotten gift that  that I am going to talk to you about  today. Purpose  of my  lecture is to show you the  vast potential of this intuitive mind and how best we can put it to good use. Emotional and  Spiritual Intelligence  is a function this intuitive mind.

Let me now show you few pictures. They are all about emotions in life. Emotions are a function of  this  Intuitive mind,  that Einstein spoke of. Some people refer to this intuitive mind,  as subconscious mind. According to some classifications, as much as 88% of our mind is  subconscious. What is Intelligence?.  A simple way to understand this abstract term,  is to think of it as an ability to  apply  Skills.  We now have a definition of Intelligence which is as follows.

“Intelligence is  the ability to apply appropriate skills,  at right time for right purpose.” We have different types of  intelligence

If we are to place different types of human intelligence as horizontal  layers or levels  in a pyramid, the bottom layer of this pyramid is the very basic level of intelligence,  the Physical Intelligence. All of us have this. When we are hungry,  we know we have to eat. When we are  sleepy, we go to sleep, as simple as that . Even animals have this basic  level of intelligence.

Above this basic  level is the Cognitive Intelligence, which we commonly refer to as IQ , or Intelligence Quotient . This is a measure of our cognitive abilities such as mathematical, analytical  or linguistic abilities.  Next level above this,   is the Emotional intelligence or EQ.  The highest level of intelligence or the peak  of the intelligence pyramid is called  Spiritual intelligence  or SQ.  In my today’s presentation,  I will be talking mainly, on these  last two types of intelligence, the EQ and SQ.

Traditionally,  the  Intelligence  Quotient or IQ    is what we have been referring to  as   intelligence,  at least  up to few decades ago.  Even today,  that is what many people think of as intelligence.  As a result,   IQ Score has been the basis of skills  assessment  – both in education and employment.  However this trend is now fast changing. Over the years,  we  have realized that after reaching a certain level of IQ, there is no direct correlation between  IQ level , and  the actual achievements or success in life.

What then is the secret of success in people with average IQ , over some  with very high IQ?  The concept of Emotional intelligence  or EQ, emerged as an answer to this question.  Emotional Intelligence ,  basically means how skilled you are,  in handling  emotions,  your own or other peoples’ emotions.  Daniel Goleman  was a pioneer  in popularizing  the  EQ concept by publishing his book on this topic in 1995. We now have a definition of EQ and it is as follows.

“Ability to make healthy choices based on the ability to recognize, understand and manage , your own feelings and  feelings  of the others”.

Emotions have played  a survival  function in us,  during evolution from primitive age.  At that stage  our thinking brain or neo cortex had not fully developed and as a result  we had to depend on our intuitive mind to a greater extent for  survival.  May be for this reason, our  emotions are still  a function of what is called   primitive brain, or the limbic system of our brain,  which includes Amygdala as the main body.  Neo cortex  or the thinking brain developed later on in evolution,  and therefore it  sits over and  above  this  primitive part of brain anatomically. This limbic system is also connected to the neo cortex, or the thinking brain,  in  prefrontal area of the brain, through neural circuits.  There seems to be a certain balance,  between the thinking  brain and the emotional brain,  and it is this balance that helps us  control our emotions. As a result we are not totally driven by emotions. It is believed that people with high EQ , have  a better balance between these two brains.

Customary thinking had been, to look upon   emotions as a kind  hindrance or a negative trait, to success in life. A classic example would be the case of  under performance of an artist when overwhelmed by anxiety in a public performance . So may be the exam performance of a kid in an examination hall.  However it was only in last  few decades, that we   realized,  we can use emotions  or at least handle  them,  to our own advantage in real life situations.   It is this skill,  that we are  talking of as EQ or emotional intelligence,  the ability  or the skill to handle emotions to our advantage. This could be our own emotions,  or other peoples’ emotions.

Imagine a picture of a  floating iceberg in the sea, the bulk of which is not seen. Similarly, the bulk of our intelligence too  is not manifest, but remains only as  potential. Just like the iceberg – what we see at the top is the IQ and the rest is submerged and constitutes the bulk including EQ and SQ. Unfortunately,  the  conventional tools of measurement of intelligence,    test only the visible tip of this  intelligence , which is IQ. Research has revealed,  that it is this invisible  component of intelligence,   that is more important  for the success in life  in lot of people,  who otherwise have  just an  average IQ.  Good  EQ  means good  emotional  skills,  and is an  advantage in any situation in life.

Goleman   described 4 domains of EQ . According to him,  EQ is a collection of different emotional skills. It is not a single skill that we are talking about , rather a profile of skills. So one may be good at one skill, but may be poor at another. So if  we are to improve our EQ,  it is important for us to know  in which respect we are weak. Let me now briefly tell you   what these skills are. They  are categorized into  4 categories of skills. Two of them are  related to self or to  your own emotions. The other two relate to other peoples’ emotions. The two skills related to self are two fold, ie ability to recognize your own emotions and ability  to manage them well. The two emotional skills related to other people are also two fold, ie ability to recognize other peoples’ emotions ( we refer to this as  Empathy) and ability to manage them (this ability,  we refer to as social skills or soft skills). Ability to manage your own emotions is referred to as self control or impulse control and  is an important skill. Then the Empathy , the ability to recognize other peoples’ emotions too is an important skill in Emotional Intelligence.  Social  skills  or soft skills which come  under the ability to manage other peoples’ emotions  are very important aspect in leadership. So lot of leadership qualities such as  communication skills, motivational skills, conflict resolution, team work  etc.  come under this category. As much as 55% of our communication is non verbal  which includes communication through  emotions too. These are skills highly sought after in business world. So it is no surprise,  how business community embraced the  EQ concept,  when all these skills are  vital to their success. Studies have shown that  EQ of the top executives and of  business leaders  is directly related to,  how well they do in  businesses,  and also to the overall  business success. Research has shown that,  over 90% of  success  at CEO level is attributed to EQ,  rather than to  IQ.  In fact at that top  level,  EQ is twice as important as,  IQ plus technical skills put together. Traditionally, companies have been investing millions of Dollars in the US,  on enhancing the technical skills of their employees, but the trend now is changing, and they are spending more and more on  EQ Training as well,   of their employees.  Validated  EQ assessment tools have been developed. They are designed to test all four skill components of  EQ , and to give a rating. People vary in their skills in different components as already stated. One may be good at empathy but may be poor in impulse control or vice versa. This is why it is important to know in which aspects of EQ,  one is weak if his or her EQ is to be improved by training.  Studies have shown that  improvement in  EQ following  training  could be retained for  as long as five years on follow up. So  EQ coaching is now a big industry in developed world today. You may have seen  even  in local press , advertisements  for very costly corporate training programmes for EQ . If you want to know your own EQ rating ,  you may do so by logging into one of the  sites (there are many such sites)   in the internet offering free assessments of your EQ.

Judging from these success stories in business world it is not difficult for us  to imagine how important EQ could be for the practicing doctors who  deal with patients , a  category of  human beings with special emotional needs. Unfortunately  in Sri Lanka, medical profession  has lagged behind in  the  EQ concept, partly due to lack of awareness. We never had a formal   training on this concept when we were students or even thereafter, in spite of the fact that  EQ plays a major role in professional development . That is why we have now included an item called Personal Development as  one of the five objectives under professional development,  in the Portfolio for National CPD Certification programme by the SLMA. Personality  is a mix of both IQ and EQ . Sadly some   of my own colleagues have asked me-  what it is meant, by personal development.  It basically means  developing a good balance between  EQ and IQ.

 Gut feeling ( also called Intuition)
This is the feeling based on perception rather than on rational thinking. Under normal circumstances, when it comes to making important decisions,  we tend to rely mostly on rational or thinking brain (ie  on prefrontal inputs.) However,  there are times we have  felt that something is not quite right with  such  decisions. That is the gut feeling.  This is a function of our  EQ. Our limbic system is a rich  repository of all our past  emotional experience. It is this experience that whispers us secretly and gives us the gut feeling.  Unfortunately,  not all of us get  this gut feeling because we have  what is called   Emotional deficiency or retardness in us. Emotional deficiency – a new terminology for us in medical profession, but it is the reality. People with high EQ have the ability to use this  vast pool of  emotional experience too in their  decision making.  Such people  have what is called good balance between the emotional and rational  minds. Often the gut feeling when you get ,  is more accurate than what you have deducted from rational mind  alone.  A  surgeon  may be guided by his Gut feeling ,  whether  to operate  or not on a bad  patient.  Steve Jobs of Apple fame once said he got his revolutionary ideas of innovation through intuition.  So was the story of Bill Gates who was a Harvard  drop out.

 We now come  to topic of  Science of Emotion. Conventional thinking has been,   that emotions are produced by  changes in neurochemistry of brain. So it was a chemistry that we talked of.  They are mediated by what are called emotional peptides – short chains of amino acids. When a peptide is  taken up by a receptor on the cell surfaces,  it triggers a chain reaction and produces a response.  A Classic example is Endorphine which is responsible for pleasure sensation.  Likewise, there are  many hundreds of such peptides in our body, allowing us to feel  different emotions.  There is however  now newer evidence, that these peptides once get attached to the cells, cause a vibration in the cell membranes, producing  energy waves with different frequencies.  So we are now talking of physics of emotions, producing  measurable energy waves with different frequencies.  This brings us to a totally new topic , Cell vibrations.  Each atom in our body is in a state of  constant  movement or vibration.  As a result, each molecule and  each cell of our body too is in vibration. This is not very  difficult to comprehend.  In fact the body is a bundle of energy in constant vibration producing a measurable energy frequencies. There is  a constant movement of subatomic particles causing vibrations. It is energy. Nikola Tesla , who is   considered to be  the father of electromagnetic engineering said “Everything is vibration and everything is energy”.  I am showing you here a   vibration  frequency  chart  of  different emotions. At the top of the chart  are the positive  emotions  like peace and  joy, and at the  bottom are the negative ones   like   fear anger shame etc. The frequency of vibrations increases from negative to positive emotions from 20 Hertz – 700 plus Hertz. This means,   we vibrate fast when we are happy and joyous.  The vibration pattern of sadness is much slower.

Empathy  is the ability to  perceive another persons emotions. Secret of empathy  my lie in the energy waves of emotions.  So it looks,  we now have a scientific basis for explaining  Empathy – the ability to perceive another person’s emotions-. How strange?  You may have heard of  people who can read other peoples’ minds. This may be the secret then. These emotional vibrations producing energy waves   may explain the mechanism of transfer of merit or blessings on to another person by us  performing spiritual activities. This is totally a new dimension connecting spirituality with science. Isn’t that strange again?

Spiritual Intelligence (SQ)
 Let me now talk on the other intelligence , the  spiritual intelligence or SQ  - a kind of extension of EQ. In the intelligence pyramid, spiritual intelligence  is at the top.  So it is basically the highest form of intelligence that we can aspire for. We have a definition  of Spiritual Intelligence too. “It is the ability or the skill  to behave with Compassion and Wisdom while maintaining  Inner and Outer peace regardless of circumstances”. How many of us have this skill or intelligence?  - the ability to be  calm and be able to  maintain our inner and  outer peace regardless of any situation.  

Yes, if you can do it then you have highest form of intelligence , the SQ. Unfortunately   not every one of us have this skill as much as we love to have . When we look at what is happening around us in the world today with so much hatred and war one may wonder if we have any spiritual intelligence at all.  If I ask you to think of one person who has these qualities utmost,  who would you think of?. This question was asked in a study and, majority of people  thought  of their respective  religious leaders. This shows that they consider such leaders,  as their  symbol  of Compassion and Wisdom. I think this is how,  the  term “spiritual” came to be  coined with this highest  form of intelligence . What are  the  traits of a  person with  high SQ.  They essentially have both,   inner and  outer peace.

This inner peace component is what distinguishes SQ from EQ. In EQ we are not talking so much about  inner peace.  A sales man may recognize an angry customer and may respond appropriately to calm him down and may succeed in  maintaining outer peace. But he may not feel inner peace in him self during this process. In fact he may be doing this at the expense of his own inner peace.

Progression from EQ to SQ.
As one progresses to SQ , the  person   becomes skilled in maintaining   inner peace too. How  do you recognize people  with high  SQ?. Essentially , they are  Calm,  peaceful, compassionate  people.  Such people have less stress and conflict both at work and at home.  They have better health and better output of work  at work places.  This is how SQ also  came to be recognized in business world as a positive trait to be encouraged among  employees.  So it looks,  a new trend is now emerging on the  application of  SQ too in business world.

Let me show you this  advertisement,  which appeared recently in a local newspaper. It has been inserted by a corporate company and says,  all their branches island wide will be closed  for business to enable the employees to engage in religious activities. One may have thought,  spirituality is the last thing they would  be  talking  of in business world. But things seem to be changing now. Can one  improve  spiritual intelligence or  skills ?. Answer is,   Yes. It is a skill that can be acquired and developed,  though genetics too may  play a role. This is what the British Medical Journal, one of the most prestigious medical journals,  said about Spiritual Skills in relation to medical practice, in a leader some time ago  “Spiritual values and skills are being increasingly recognized as necessary aspects of clinical care”.

SQ is like a two winged bird. One wing is Compassion , the other one is Wisdom. The result is universal love. Can you think of any other human qualities surpassing these two? That is why we consider SQ as the highest form of human intelligence. One way to learn  compassion is to follow the teachings of the religious leaders.  They all have preached compassion. Wisdom is a state of  heightened  awareness of  yourself  - a state of inner peace and tranquility of mind. It is some thing you need to develop and acquire on  your own,  with  your own effort.  How can we do that?. Our inner awareness and inner peace  is often disturbed by thoughts,  arising from rational or cognitive brain.  So if we are to enhance  our inner awareness and inner peace,  we need to block such thoughts arising from rational mind. Meditation is one way of doing that. There is  now enough scientific evidence to suggest that meditation  calms down   the conscious brain.  Why do we  lose our inner peace in a conflict situation? Let us take an example.  If some body shouts  at you , you react because of what is called   Ego or self centeredness.  You may not react in the same way if shouting was at another person, and not at you.  So it is this   ego that  causes loss of our inner peace. Ego is a function of emotional brain or limbic system. Ego in fact,  has  served a survival function in our evolution. Meditation is one way to reduce ego. Let me show you  a video clip from a BBC documentary of a functional MRI (f- MRI)  of brain during meditation.  In this video, you will  that  the front part of brain including limbic area  becoming   less brighter during meditation -  an indication,  that   Ego too  is  getting   less during meditation.  So now ,  Ego  is something demonstrable on f MRI. It is no wonder that people who meditate are calm and  have more of  inner peace  as a result . As the ego element gets thinner and thinner , the person begins  to question the true meaning  or purpose  of life.  What am I here for in this world? Where do I go from here? –  has  this type of questions  ever come up in your mind? If  so you are seeing the  dawn of wisdom- searching for the true meaning or purpose of life.

 Let me now digress a little from my topic. Abraham Maslow, a great American psychologist,   classified human needs  into 5 categories in hierarchial   order and put as layers or levels  of a pyramid. Bottom layer  is the most basic  physical or physiological needs like food, shelter clothing etc. Next layer   is security and then come social needs.  Above that  is the  need for self esteem,  and then  at the top of the pyramid is   what is called  self actualization- the ultimate need of a human being. According to him, the human nature is such that,  when we reach one level we try to reach the next higher level.   Try to compare the two pyramids. How similar is Maslow’s self actualization (at the top) to the Spiritual intelligence ( at the top of intelligence pyramid)?

At the time Maslow descried his needs pyramid, the concept of spiritual intelligence was not much known. What Maslow meant by self actualization should be the  equivalent  of  SQ in human  intelligence - the highest form of intelligence. Isn’t that bit strange?  Both seem to be the ultimate aim or the need   of a human being.  Yes , SQ  is the highest  state of mind one can think of and one needs to reach. This  probably is  what all religions have defined as their ultimate goal.   Ultimate aim  of any human being should be to  reach the peak of intelligence pyramid  before death.  How do we do that? This is a difficult task  to achieve , of course. We need to change the way we think. Let me  conclude by repeating what  Einstein said

“The intuitive mind is a sacred gift  and rational mind a faithful servant. We have created a society that honors the servant  and forgotten the gift”.

 I leave you pondering  how apt,  what Einstein said  over 100 years ago,   in our present context today.


  1. Thank you Ruwan for this. It is good that prominent doctors are talking about these things. I think the westerners are a few decades ahead of us on these concepts.


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