About Us

Established as Intercontinental Open University in 2009, and restructured as the Institute for Open Understanding in 2018, the Institute focuses on the improvement and advancement of palliative communication through the elimination of Pilate Syndrome™ . Exemplifying the World Health Organization's definition of palliative care , thus addressing the future of health care , the Institute offers a Certificate in Palliative Communication and the honoris causa Higher Doctorate in Palliative Communication . Acknowledged  by top-ranked  Duke University School of Medicine , the Institute ia an institutional member of the U.K.-based Worldwide Hospice Palliative Care Alliance , and its Director an individual member of the U.S.-based Global Palliative Care Quality Alliance .

From the Director

Welcome to the Institute for Open Understanding of the Society for Spirituality, Theology and Health.

According to the National Institute on Aging, end-of-life care "is the term used to describe the support and medical care given during the time surrounding death.” . This implies a delineated perimeter outside of which support and medical care are given during what supposely is "surrounding" it. Yet time does not surround death. It exists alongside death. Not subject to time, end-of-life care is not an experience constrained by some fixed duration. As time is timeless, so too is end-of-life care timeless. Only in terms of timelessness can end-of-life care be defined correctly, be engaged appropriately, and be understood for what it is: an undying presence among the dying. What is this timelessness that an end-of-life caregiver is to personify? How is it to be expressed? How is it to be communicated?

In answering these questions, our Certificate and honoris causa Higher Doctorate programs prepare future caregivers to act upon those answers. Is your calling to be there for those dying and alone? I invite you to learn from us. Is your calling to be there for those having that calling but unable to respond to it because of financial difficulties? Then I ask that you please consider offering a monetary gift to help them. Thank you.

With best wishes,
Rev. Fr. Constantine A. Constantopoulos, Ph.D.
Director and Distinguished Clinical Professor of Communication


The Institute for Open Understanding operates exclusively in the person of its Director, both an Orthodox priest, ordained under spiritual aegis of the Ecumenical Patriarchate, and an inaugural member of the Society for Spirituality, Theology and Health , established by the Center for Spirituality, Theology and Health  based in the Center for the Study of Aging and Human Development  at the Duke University School of Medicine, accredited regionally by the Southern Association of Colleges and Schools Commission on Colleges and professionally by the Liaison Committee on Medical Education .

Clinical Perspective

Jewish historian, Flavius Josephus, portrays Pontius Pilate, Roman military governor, or procurator, of the imperial province of Judea from 26 to 36, as a harsh administrator who fails to understand the religious convictions and national pride of the Jews. Though he had complete judicial authority over all non-Roman citizens, many cases, particularly those relating to religious matters, were decided by the Sanhedrin, the Jewish supreme council and tribunal. Gospel accounts relate that after the Sanhedrin, lacking authority to impose the death penalty, finds Jesus guilty of blasphemy, it commits Him to the Roman court. Pilate refuses to approve the judgment without an investigation. The Jewish priests further accuse Jesus, and Pilate questions Him privately. Impressed with the dignity and frankness of Jesus' answers, Pilate tries to save Him but succumbs to two blind spots: Failure to understand his constituency, and fear of an uprising within it. He accedes to the demands of the populace, and Jesus is executed.

Pilate Syndrome™, an anxiety disorder, affects one's ability to communicate, and is marked by two blind spots: failure and fear. For the caregiver, "failure to understand" a patient, and "fear of an uprising" in that patient, undermine end-of-life care by disabling palliative communication, causing it to become dysfunctional, as opposed to enabling it and empowering it to become functional. With Constantopoulos (1999, p. vi, vii, 2, 22 and 99  [cf. Gardner  ] ) having laid the initial groundwork for assessment of such a risk, and with Bachner and Carmel (2009, p. 530  ) having drawn attention to that risk, Pilate Syndrome™ now can be identified in terms of style and assessed in terms of that risk by using the paired comparison equivalent of a global positioning system, created and developed by the former, presented by him in 2008 at the 1st Annual Meeting of the Society for Spirituality, Theology and Health at the Duke University School of Medicine, and both alpha-tested by him in primary care facilities for five years, then beta-tested by him in a wide variety of diverse pastoral settings for ten years.

Diagnostic Approach

Predisposed to underlying conditions outlined by the Duke Health Profile , and externalized as a communicator style (cf. Norton and Pettegrew, 1977  ), Pilate Syndrome™ is diagnosed using the Style Designation Index™, allowing for instinctive end-user reactions to forced-choice, biaxial, dependent variable alternatives of varied light intensity, originally examined from the perspective of biological chemistry by Constantopoulos and Bloch (1967  ), each option signifying a fractional inclination for conveying palliative communication relationality, overviewed by O'Connor, Davis and Abernethy (2010  ), to an immanent exigent situation, examined by Bitzer (1968, p. 6  ), he having dovetailed it off of Aristotle (350 BCE  , Part 2, Sentence 1), thereby reconfirming systemic interdependence of vision and hearing to be the key to preparation and readness, observed by Duke University neuroscientists . If, after risk assessment using the Risk Vulnerability Scale™, allowing for instinctive end-user reactions to forced-choice, independent variable alternatives, that style, given a high factor to relationship ratio, is anticipated to result in disabled palliative communication, then the disorder can be reordered in the appropriate manner . Thus, with a structure and a metabolism that are, so Palade (1963, p. 614  ) emphasizes, two aspects of the same set of phenomenon, Pilate Syndrome™ proves to be not as much a "response" to them as it is a reaction to them, one that can be relieved and reversed.

Programs & Tuition

The Institute's flagship, and its sole academic, program is the honoris causa Higher Doctorate in Palliative Communication. The Doctor of Humane Arts (D.H.A.) for creative work, the Doctor of Letters (Litt.D.) for scholarly work, or the Doctor of Science (Sc.D.) for scientific work is conferred throughout the calendar year subsequent to double-blind peer review. Tuition is €2,580, payable in euro only, half of which is payable within ten days of acceptance into the program, and the remaining half of which is payable thirty days prior the scheduled date of the double-blind peer review. Tuition is all-inclusive and non-refundable.

The Institute's sole vocational program is the Certificate in Palliative Communication, following one calendar quarter of monitored candidate interaction with patients or residents at an approved medical facility or in a home environment, and further requiring, at the candidate's choice, a 120-question, 30-minute multiple-choice test, or a 2-hour, single-question, comprehensive written examination, or a 90-minute, peer-reviewed, face-to-face capstone encounter. Tuition is €645, payable in euro only, and payable in three equal monthly installments, with the first installment due within ten days of acceptance into the program, and the second and third installments due within thirty and sixty days, respectively, from the date of payment of the first installment. Tuition is all-inclusive and non-refundable.


The Institute is led by multi-award-winning Constantine A. Constantopoulos, Ph.D.   , Distinguished Clinical Professor of Communication at the Institute. From 2011 to 2018, founding director, George C. Constantopoulos (1923-2018), Ph.D., of the National Institute of Neurological Disorders and Stroke (Retired), and lead author  for 1964 Nobel Laureate, Konrad E. Bloch, served as President (honoris causa), with Nickas C. Constant (1926-2007), A.D., having served as Director Emeritus of Grants and Scholarships .

Congratulations to the newest leaders among us: Linda Elaine Vogt Turner from Vancouver, British Columbia (Canada), awarded the Doctor of Humane Arts degree on June 27, 2017, and Michael Frangogiannis from Galatas, Peloponnese (Greece), awarded the Doctor of Science degree on October 1, 2017.

Contact Us

Institute for Open Understanding
Androu 5
190 13 Saronida

+30 22910 55815