Volume 11, Issue 5 (Sep & Oct 2021)                   J Research Health 2021, 11(5): 351-362 | Back to browse issues page

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Irani Z, Latifi Z, Soltanizadeh M. The Effectiveness of Self-healing Training (Healing Codes) on Psychological Capital and a Sense of Cohesion in Drug Addicts. J Research Health 2021; 11 (5) :351-362
URL: http://jrh.gmu.ac.ir/article-1-1925-en.html
1- Department of Counseling, Payam-e-Noor University, Iran.
2- Department of Psychology, Payam-e-Noor University, Tehran, Iran. , z_yalatif@yahoo.com
3- Department of Psychology, Payam-e-Noor University, Tehran, Iran.
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1. Introduction
ubstance abuse and addiction have become one of the major concerns of human societies today. This home-burning phenomenon has devastating effects on the physical, psychological, occupational, financial, and moral aspects of life and has adverse effects on family and the society and also can lead to the loss of young human capital and thinking brains [12]. This destructive social phenomenon has penetrated many Iranian families and has caused deep and comprehensive disorders in the functioning of families [3]. Substance abuse not only causes pain and suffering to the user but also imposes a lot of burden and damage on the family and society [45]. Substance use disorder is defined as a set of cognitive, behavioral, and physiological signs indicating that a person is experiencing substance-related problems despite significant problems. Substance dependence is seen in all professions, educational levels, and socio-economic classes and is not only limited to a specific individual or group [6].
Addiction makes people addicted to drugs and exposed to high stress and reduces their resilience and psychological capital in the face of problems [7] and this process greatly reduces the likelihood of quitting drugs. Positive psychological capital includes self-efficacy, optimism, hope, and resilience, which indicates a person’s positive assessment of the situation and the possibility of success based on effort and perseverance [8]. Studies show that optimism and positive thinking will lead to life expectancy and change of circumstances to create a positive mood and reduce the use of negative strategies, such as denying and giving up life responsibilities [9, 10]. Vanno et al. [11] reported that strengthening positive psychological capital, including self-efficacy, optimism, hope, and resilience, increases the ability to cope with difficult living conditions. 
On the other hand, sensitivity to cohesion is another psychological factor influencing the tendency to use drugs and can play a dangerous or protective role against substance use. A sense of cohesion leads to the formation of beliefs that make the internal and external stimuli of the life path predictable and explicable. This personality trait makes a person use his resources and abilities to face a set of these stimuli and feel valuable [12]. Thus, people with high levels of this personality structure experience more positive psychological symptoms and are likely to have a healthier lifestyle [13]. In contrast, feelings of low cohesion are significantly associated with psychological problems, such as anxiety and depression [1415]. Research has shown that therapies that increase the feeling of cohesion can be useful for managing stress and stress symptoms in people under treatment [5].
Self-healing is one of the new therapies of positive psychology that targets the management and control of physiological stress. This approach was formally introduced by Loyd (psychologist and complementary medicine therapist) and Johnson (cancer specialist) in 2011 in the United States under the heading of healing codes [1617]. The self-healing approach includes memory retrieval skills, recognizing problematic personality traits, reducing harmful actions, teaching self-healing skills, praying, and practicing healing codes. Loyd believes that 95% of all physical and non-physical problems are caused by stress [18]. Situational stresses are stresses that have a specific source and are mostly external and recognizable, but physiological stresses are internal, overt, and covert stresses that are created and evoked by destructive cellular memories. Physiological stress causes the autonomic nervous system to become out of balance, in which there is no balance between state, war, and flight in the nervous system with normal state or relaxation. Loyd [19] believes that the cause of physiological stress in the body is “destructive cellular memory”.
Destructive cellular memory is a memory that is stored in all cells of the body and reduces cellular energy and stress in the body. Loyd and Lipton [20] identify the causes of physiological stress as destructive cellular memories, negative emotions, unexplained fears, false images, and beliefs stored in the body and mind. These misconceptions in cellular memory cause people to mistakenly view their current situation as a threat, when in fact there is no threat, and this misinterpretation of the current situation triggers the unhealthy activation of the “war or “Escape” occurs in the brain. Persistent physiological stress can lead to mental disorders, and eventually a weakened immune system. Loyd believes that destructive cellular memories cause imbalance and aggravation of various mental disorders, such as resentment, narcissism, inability to control anger, irrational fears, depression, obsession, rejection and violence, low self-esteem, pessimism, idealism, disability in impulse control, procrastination, anxiety, detrimental actions, destructive communication, and reduced logical performance [21, 22]. 
The occurrence and increase of chronic physical disorders and the development of addiction and substance abuse, and the root of all the problems and destructive memories that people face in their lives, are related to one or more of the following reasons: resentment, harmful actions, misconceptions, and negative emotions, selfishness, sadness, anxiety, fear, anger, despair and intolerance (impatience), rejection and violence, feelings and inference are not good enough to control and create restrictions, unhealthy pride, arrogance, and deterrent image, and the loss of self-control [23]. The focus of this therapeutic approach is on the individual’s efforts to treat destructive cellular memories, or cache memory, and to trace the root causes of physiological stress. In this treatment, spiritual excellence, having a healthy lifestyle, correcting internal conversations, correcting unhealthy fears and beliefs, meditating, praying, and performing exercises for healing codes is emphasized [24]. 
Based on psychological studies, according to the cultural, traditional, and religious principles of Iran, the executive protocol was prepared in 14 stages and approved by Latifi et al. [24]. This protocol has been scientifically and practically discussed in several meetings by a group of psychologists and counselors, and its effectiveness has been practically confirmed by several psychologists based on clients’ reports. Accordingly, the present study was done to investigate the effectiveness of self-healing training (the healing codes) on psychological capital and a sense of cohesion in drug addicts.
2. Methods
This research was a quasi-experimental research with two groups (experimental and control) in three stages (pre-test, post-test, and follow-up). The statistical population of this study included addicted men who were referred to Isfahan addiction treatment centers in 2020. For implementation, after coordination with the provincial deputy of treatment and addiction treatment clinics in Isfahan, and obtaining the ethical code IR.PNU.REC.1398.157 from the National Committee of Ethics in Biomedical Research, invited addicts who had files in addiction treatment clinics who were willing to participate in the research, participated in the initial briefing session conducted by the researcher. Via convenience sampling, we selected 30 men and 15 participants were included in each group using the G*Power statistical software with an effect size of 1.8, a test power of 0.90, and α=0.05. 
The researcher carried out the randomization, and participants were allocated through selecting sealed opaque envelopes. Inclusion criteria were male gender, having a history of addiction for three years, the age range of 20 to 40 years, not receiving concomitant psychological treatment, having a minimum cycle degree, and completing the informed consent form. Exclusion criteria were having acute or chronic mental disorders (with the diagnosis of a clinical psychologist), taking medication, suffering from other physical illnesses, no cooperation during the training, not doing the homework presented in the sessions, and being absent for more than two sessions. After selecting the sample, the experimental group participated in a 14-session self-healing training course (once a week for 90 minutes) at the addiction treatment clinic. For ethical considerations, the conscious willingness to participate in the research, ensuring the confidentiality of the subjects’ information (the principle of confidentiality), and respect for the rights of the participants were considered. At the end of the study, to observe ethical considerations, the control group received an intensive course of self-healing training.
Research instruments 
Luthans Psychological Capital Questionnaire: This questionnaire was designed in 2007 by Luthans. This questionnaire has 24 questions and includes four subscales of hope, resilience, optimism, and self-efficacy, in which each subscale contains 6 items and the subject answers each item on a 6-point Likert scale (strongly disagree to strongly agree). The validity of the questionnaire has been confirmed in various studies [25]. Using factor analysis and structural equations, Luthans [25] reported the Chi-square ratio of this test as 24.6 and CFI (Comparative fit index) and RMSEA (Root mean square error of approximation) statistics of this model as 0.97 and 0.08, which confirmed the factor validity of the test. The reliability of the questionnaire in Iran has been reported by Bahadorikhosroshahi [26] based on Cronbach’s alpha of 0.85. In this study, Cronbach’s alpha of the questionnaire was equal to 0.79.
The Sense of Coherence Questionnaire: This is a 29-item self-report tool whose questions are scored on a seven-point Likert scale from 1: rarely or never to 7: often. Therefore, the total score of this scale is in the range of 29 to 203, and a higher score indicates a higher level of sense of cohesion. In addition to the total score, this scale consists of three subscales that include perceptibility, controllability, and significance. Summarizing the results of 26 studies on the psychometric properties of the Cohesion Sense Scale shows that this scale has a high validity of Cronbach’s alpha coefficients in the range of 0.82 to 0.95 [27]. Moeini et al. [5] reported the Cronbach’s alpha of the questionnaire as 0.91. In the present study, the reliability coefficient of this questionnaire was obtained 0.87 using Cronbach’s alpha.
The control group was considered on the waiting list for post-test. After the training sessions, a post-test was performed for the experimental and control groups. Follow-up was further conducted for both groups after 45 days. A summary of the training sessions is provided in Table 1.

In all sessions, while emphasizing confidentiality, all members of the group were asked to take part actively in the discussion and share their personal experiences with others, which should be performed using various techniques and tailored to each individual’s taste. Participants were required to do the exercises individually in the session and in between sessions, and be sure to answer the instructor’s reflection questions. Having privacy and thinking about yourself was an essential part of the exercise. Participants were asked to start training their family members or two friends at the same time in order to better understand the content and to raise the challenges in the meeting. In each session, the topics of the previous sessions were reviewed and homework was emphasized. The sessions were very interesting for the participants because the course was strongly related to their personal lives and the lives of others, and all participants reviewed their own life stories. 
Statistical analyses
The repeated measures ANOVA was used to investigate the effectiveness of self-healing training on psychological capital and a sense of cohesion in drug addicts. SPSS Statistics version 24 was further used for analyzing the data.
3. Results
The sample size was 30 males with a mean age of 37.30 years with a standard deviation of 9.86 years in the experimental and control groups, respectively. Among the sample members, 30% had primary education, 40% had secondary education, 13.3% had a diploma, and 16.7% had a bachelor’s degree. Among the sample members, 10% had no children, 20% had only one child, 43.3% had two children, 20% had three children, and 6.7% of the sample members had four children. Among drug addicts, 43.3% have been using drugs for under 10 years, 26.7% for 11 to 15 years, 16.7% for 16 to 20 years, and 13.3% for more than 20 years. The mean duration of addiction in drug addicts was 11.80 years with a standard deviation of 6.67 years. The mean and standard deviation of the pre-test, post-test, and follow-up scores of psychological capital scales and sense of cohesion are given separately for the two experimental and control groups in Table 2.

According to Table 2, the mean total score of the pre-test of psychological capital and sense of cohesion in the experimental group was 79.42 and 61.14, respectively, and for the control group was equal to 80.13 and 57.93. Also, the mean total score in the post-test stage in the experimental group was 97.00 and 47.57, respectively, and was 78.46 and 59.20 in the control group. In the follow-up, in the experimental group, it was reported to be equal to 98.00 and 46.57, respectively, and in the control group, was 80.20 and 26.59.
Assumptions of analysis of variance, including the normalization of pre-test and post-test distributions with Shapiro-Wilks test, complete lack of correlation between configuration variables, and homogeneity of variances with Levene’s test were confirmed. The results of this test are shown in Table 3.

As shown in Table 3 and considering the significance level of the scales, no value was less than 0.05, and the null hypothesis of Levene’s test based on homogeneity between the cohort and dependent groups was confirmed, and all these pairs of groups were homogeneous. As a result, another conditional assumption was provided for repeated measures ANOVA. Repeated measurement ANOVA was used to evaluate the effectiveness of self-healing training on psychological capital and sense of cohesion. One of the presuppositions of the statistical test is the repeated measurement of Mauchly’s sphericity test. The results of this test are presented in Table 4.

Due to the insignificance of Mauchly’s sphericity for psychological capital and sense of coherence, this hypothesis was confirmed (P<0.05). The values of Wilks’s lambda test are given in Table 5.

According to Table 5 and values of 0.35, 0.25, and 0.19 for intergroup, intragroup, and interactive effects, respectively, self-healing training was effective on at least one of the scales of psychological capital and sense of cohesion. The results of intragroup and intragroup ANOVA for the effect of self-healing training on psychological capital and sense of coherence with three measurements of pre-test, post-test, and follow-up are shown in Table 6

According to Table 6 and the significance of the factors within the groups, the existence of a significant difference between the three measurements of pre-test, post-test, and follow-up for the dimensions of self-efficacy, hope, resilience, optimism, and sense of coherence was confirmed (P<0.01). Also, considering the significance of the group source among the groups, there was a significant difference between the experimental and the control groups for the dimensions of self-efficacy, hope, resilience, and sense of cohesion at the level of P<0.05, but the group source was not significant for optimism. Therefore, self-healing training was effective on self-efficacy, hope, resilience, and sense of cohesion and was not effective on optimism.
4. Discussion
The present study tried to examine the effectiveness of self-healing training (the healing codes) on psychological capital and sensitivity to cohesion in drug addicts within the framework of a valid trial-based methodology. The results showed a significant difference between the three measurements of pre-test, post-test, and follow-up and the effectiveness of self-healing training on increasing psychological capital and sense of cohesion among participants. The results of this study showed that this intervention could significantly increase psychological capital in the dimensions of self-efficacy, resilience, and hope, and improve the sense of cohesion among participants.
According to the researcher’s studies on the effect of the self-healing method on the psychological capital of drug addicts in Iran, only a few studies have been done so far, but similar research has been done in this field, including the results of Sadeghi and Karimi [28] in the field of improving the variables of psychological capital and about the feeling of cohesion. Also, Froehlich et al. [29] assessed the effect of self-healing on reducing alcohol use and improving anxiety and depression, and increasing quality of life as well as abuse of other drugs. Latifi et al. [24] evaluated self-compassion, concern about body image, and the process of recovery in patients with skin cancer. Zarean et al. [8] assessed psychological capital, enduring anxiety, and headaches of spouses of drug addicts. Latifi et al. [30] reported the improvement of hypertension, psychological well-being, and impatience in patients. Latifi et al. [31] assessed burnout, quality of life, and emotional resilience of social emergency personnel, based on the effect of self-healing training on psychological problems. 
Regarding the effect of self-healing on increasing self-efficacy, it seems that people who are addicted to drugs gradually feel inefficient, helpless, and helpless after a period of inability to quit and their efforts to manage and improve their lives. Participating in self-healing sessions by emphasizing the ways to increase self-esteem, correcting bad habits and harmful actions, recognizing unnecessary fears, lies, and unhealthy thoughts, emphasizing the methods of strengthening the will (decision, care, evaluation, punishment, and reward), and teaching a balanced lifestyle and reflection to improve the quality of life in the areas of health, increased intimacy and communication (parents, spouse, children, relatives, and others) and useful social activities with an emphasis on continuous self-care against physical and mental injuries and emotion and communication management It probably caused the person to increase their sense of self-efficacy while establishing better communication and doing more useful activities. Concerning the strategies with a positive effect on increasing the resilience of addicts, humility and self-control can be mentioned because one of the important training in this course was to create and strengthen nine healing codes, including love, happiness, peace, patience, kindness, and trust. It seems that strengthening the healing codes and emphasizing the teaching of techniques of spiritual transcendence, deepening belief in God (an infinite power), trust and surrender (entrusting to God and letting go of troubles that one cannot solve) continuous prayer and supplication at least three times a day were effective in increasing resilience against hardships and problems.
On the one hand, considering that the feeling of cohesion is a general orientation and belief towards understandable, manageable, and meaningful life path events, and on the other hand, each person’s beliefs and personality traits are among the factors that make him perform in stressful situations when a person develops beliefs that he or she can predict and understand what is going on in his or her life and that he or she can cope with what lies ahead, he or she feels valued. Thompson et al. [32] also reported that self-acceptance, self-friendliness, and sense of agency increased in depressed patients after training and correcting self-blame based on self-blame, inadequacy, and devaluation.
Regarding the reason for the effectiveness of self-healing on increasing the sense of cohesion, emphasizing the spiritual purpose of life and increasing the inner richness (being useful and caring for oneself and others), introspection, explaining the creation of a triangular relationship instead of a linear relationship with self-esteem and planning for eternity, along with increasing communication with God, praying, and having a thoughtful solitude about values and the meaning of life were found to increase a sense of cohesion. Concerning the increase of the hope, it can be said that investigating the role of my poor syndrome in destructive habits, recording the successes and skills used in the three deterrent groups, practicing forgiveness, letting go of resentment, and recognizing the inner puzzle of positive and negative emotions, learning to manage situational stress were effective in improving this factor. Chopra and Tanzi [33] argued that it is necessary in the world where human beings at all times face many problems, such as chronic diseases, like high blood pressure and diabetes, problems and psychosocial pressures, such as possible epidemics to maintain existence, optimism, and psychological and social well-being, learn self-healing as a method of self-care and use it over time so that as a habitual method, he or she can face the recurring challenges of today’s world, especially for vulnerable people, such as addicts.
5. Conclusion
Self-healing training can be effective in improving psychological capital and a sense of cohesion in drug addicts. Therefore, the psychological problems in drug addicts can decrease by this training at different stages of treatment or after it. It is suggested to hold a self-healing training course in workshops of addiction treatment centers and consider this training in executive programs for consultants of universities, especially rehabilitation centers to help solve physical and psychological problems in patients.
One of the limitations of this study is the gender of the sample members because all were male. It is suggested that in future research, other therapeutic approaches along with a self-healing therapeutic approach be used to compare and evaluate the effectiveness of different therapeutic approaches. Also, considering the emphasis of this approach on reducing physiological stress and increasing the immune system, as well as the prevalence of psychiatric diseases, it is suggested that in future research, the effectiveness of this method on other diseases with physical symptoms be investigated. It is also suggested that the training course of this intervention be used to train the required therapists in counseling and guidance centers in clinics or hospitals, and then, this treatment for drug addicts who have high levels of generalized anxiety and lack of emotional regulation.

Ethical Considerations
Compliance with ethical guidelines

This study was approved by the Ethics Committee of Payam-e-Noor, Tehran (Code: IR.PNU.REC.1398.157).

The paper was extracted from the MSc. thesis of the third author at the Department of Psychology, University of Payam-e-Noor.

Authors' contributions
Study design: Zahra Irani, Zohreh Latifi; Data collection and analysis: Zahra Irani; Manuscript preparation: All authors.

Conflict of interest
The authors declared no conflict of interest.

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Type of Study: Orginal Article | Subject: ● International Health
Received: 2020/12/13 | Accepted: 2021/04/3 | Published: 2021/10/1

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