Posts Tagged ‘Holistic Psychotherapy’
[This article recently appeared in The New Paltz Times, The Woodstock Times, and The Poughkeepsie Times. Courtesy of Ulster Publishing.]
It’s 1962. My brother, Bill, is 19 and his new girlfriend, Cheryl, is just 17. They decided to go for a drive in his new yellow Opel with the fuzzy dice hanging from the rear view mirror. They headed north from New York City towards New Paltz to take a hike in the Mohonk Preserve in the Shawngunk Mountains, a glacial ridge of sacred beauty filled with trails, wildlife and rock scrambles. Nestled in one corner of the mountains is a dirt path that leads up to the Mountain House, a historic hotel overlooking the Catskill Mountains. Behind it is a quarry lake so deep, the water so black, I imagine it as a nesting place for wishes, a portal to possibility, destiny, even magic, a holding space for lovers’ memories.
It was their first summer together and she can recall parking the car in a small lot and heading up a winding path toward the hotel. Sometimes they walked tandem over a narrow precipice, sometimes together holding hands.
At one point along the trail, Bill took out a pocket knife and carefully etched a heart with his and her initials into a tree.
Did he know then? Did she? That he wasn’t just another boyfriend, that she wasn’t another girlfriend? That it was a life-long love and could be engraved into an oak trunk that would bear witness to that walk and to those feelings for a hundred years?
It’s 1965, the year Cheryl and Bill were engaged. Right before he proposed, he sat down with our mother, who looked at him with uncharacteristic seriousness and asked him, “Are you sure?” And he said with uncharacteristic certitude, “Yes.”
It’s 2012 and Bill died three years ago. This week I went to find that tree and the hand-carved note he wrote into his future.
He and Cheryl were together for 47 years.
On The Trail of a Tree
Initials. How many initials carved into trees are a testament to too little judgment and too much moonshine? How many are a testament to loves lost and hearts still aching? How many are able to draw us a picture of two people on a trail, walking a little slower, perhaps, but still holding hands?
We used to see more of those hearts and letters years back. They used to be on trees or on park benches, occasionally you could see one on a bus, carved into a seat or scrawled onto an ad. Over time, instead of carvings, we saw spray paint splattered onto rocks and concrete bridges: “CS and CJ,” “I love Lane,” “Joey loves Marcy.”
Now, we see them rarely in any form. Instead of initials, you see graffiti celebrating the self or splattering rage. But it seems that fewer and fewer people are willing to make even the temporary commitment to paint. Carving initials into a tree that can last longer than we’d live? Never.
I asked Cheryl if she knew he was the one when she met him. “It wasn’t for me, but it was for him,” she laughed. “He talked about marriage from the beginning. He was open, honest. He poured out his whole life on our first date.”
And that communication proved to be the bedrock for the duration. “I could talk to him about anything. And there was nothing he wouldn’t do for me. I remember one time, it was snowing and he couldn’t drive to see me. But he was determined. So he started walking from Yonkers. He called when he reached the Whitestone Bridge to Queens. He walked miles in the snow. My mother had to tell him to go home, not to dare cross the bridge in a storm.”
Is that sort of love predictable? Chemical? Repeatable? Is it even noticeable? Can we tell the difference between lasting love and young lust? Is it a choice, a learned capacity, or a gift?
Schipani interviewed dozens of couples for an online article in The Ladies’ Home Journal (http://www.lhj.com/relationships/marriage/basics/long-lasting-love/). They were all married more than 20 years and reported themselves to be happy.
How did they do that? Each one had a different story. For Margaret C. it was about being satisfied with what was offered. For Russell S. a happy marriage was acceptance.
Cheryl thinks it may be generational. “A lot of the couples we grew up with are still married, but sometimes that meant keeping their heads in the sand. Our generation overlooked more than yours does. Yours says, ‘I’m outa here.’ And the women now, they have the jobs, the means to leave. It’s easier today. When it’s not that easy, you find ways to work it out. You make a conscious choice to not let a moment, a resentment, a fear take over the whole marriage.”
From Ladies’ Home Journal:
“If he helps around the house — washes the dishes, cooks, vacuums — and it’s not quite up to your standards, don’t complain. Be happy he is making an effort to help.” –Margaret C., married 45 years
“Accept that you can’t change someone. You have to learn to live with whatever annoys you, and remember that you have as many faults as your spouse does.”–Russell S., married 40 years
“When she gets mad, I just shut up, and she gets tired of talking. After a while, it’s over. In all our years being together, we have never had an argument!” –James P., married 56 years
But all of these comments, while making good sense, are retrospections not prescriptions. They are simple observations on what they have done over the years, not recipes. And they certainly don’t tell us how to know beforehand, if in fact there is a way to know. Although Bill showed little hesitation when he picked up his knife and started carving.
Love Lost in the USA: Can Science Find It?
Currently the divorce rate is one in two, maybe higher in some regions of the country. It is so common, our culture so saturated with scandal and heartbreak, the statistic barely raises an eyebrow—even in more traditional and conservative circles.
One friend told us that he’d thought about getting married again but then he rethought it because he found out there was a fifty-fifty chance it might last. He is far from alone. Americans seem to have an issue with intimacy.
What raises eyebrows is longevity, love that does last, initials carved into a tree fifty years ago that could still be carved into a tree today.
While married couples tell only of their own experience, the “experts” talk about marriage and love as if either one were in fact a science, as if there were some way to predict, control, or warranty the outcome. On website after website, in book after book, they tell us what to do and what to look for.
The authors of Lasting Love: The 5 Secrets of Growing a Vital, Conscious Relationship, wrote:
“If you want a close vibrant love relationship, you need to become a master of commitment.” I could scarcely believe that a whole book had been dedicated to something so basic. Even though I had to grant that sometimes wisdom is a firm grasp of the obvious and there are clearly people who think they can have a good marriage without actually acting married or doing what it is that marriage requires, to me, it was like saying if you want to get wet, get water. Have we gotten to the point where we need that sort of elementary guidance?
Perhaps so. Scientific American Mind ran an article entitled “The Happy Couple.” In it, the author, Pileggi, states that how your mate responds to good news is as important, if not more important, than how well they support you when times are difficult. “In the past few years positive psychology researchers have discovered that thriving couples accentuate the positive in life more than those who stay together unhappily or split do. They not only cope well during hardship but also celebrate the happy moments and work to build more bright points into their lives.”
So people who have a good time together and have a good time having a good time stay together? Stunning.
One writer, Dee Anne Merriman, chose seven match areas to consider: Physical appearance, emotional maturity, lifestyle choices, financial style, value structure, marriage and sex, and intelligence. All of these make fine sense until you begin to notice the inherent problems: They are all presented as if, one, there were actually a sure-fire way to gauge or assess those match-areas, two, a way to centrifuge and separate a person as if he or she were a blood sample, and, three, even an idea of how to line those areas up between two complex beings to produce the perfect relationship.
I began to consider the possibility that this sort of pseudo-empiricism is part of the reason people experience such frustration with love and keep vainly trying to find the “perfect” match; Perhaps their confusion and resignation is due to the fact that they are told by the experts that if only they follow these simple steps, this or that proprietary program, everlasting happiness will be theirs. Of course, it rarely is.
The more I researched, the more I perused the so-called science of love, the more I was left wondering if it can ever be so well-planned or so conscious. I know I made my own “list” before I met my husband and, still, with as much “expertise” up my sleeve as anyone, my marriage certainly surprised me. It surprises me every day with its goodness, its fortitude, and the love that carries us forward—to no credit of my own, I am sure of that.
Did Cheryl and Bill ever think about things like that before they got married—match areas, accentuating the positive, lifestyles?
“We talked about goals—children, those things—but not like people do now. We were also very different. I was responsible and more grounded. Bill was…adventurous, impulsive. I was more restrained. He was an open book. I planned. He flew.”
And they were very different for as long as they were together. So are many of the people I know in long-term relationships or marriages. And not just superficially different—fundamentally so. Their marriages stand as a counterpoint to everything we are being told about how to find true love.
There is a debate deep at the heart of all this: Is love, in fact, a matter of the heart or the brain? Some would say it “depends” on what you mean by love. But I think for anyone who has actually loved another—whether that’s a child or a partner, a friend or a pet—there are no “depends.” While there is an element to it that is ineffable, inexplicable, eternal, when you feel it, there is simply no question as to its truth or meaning. It’s as solid as oak.
So that over the years as you move together through the first flush of Eros into friendship and familiarity, surf mighty high waves of irritation and frustration, it does not crash onto shore or ebb with the tide. It stays still. It digs in roots and holds strong.
C.S. Lewis wrote, “This is one of the miracles of love: It gives a power of seeing through its own enchantments and yet not being disenchanted.”
I would think of love as Lewis did, then: As a miracle, as an expression of something both lusciously earthy and other-worldly, as a glimpse at the promised Horizon through a field of waving tall grasses while tasting the juice of a single blade as you hold it in your teeth, as a Heavenly two-step, a delight of the Divine. It is not empirical. How can it be when it is a heart carved into a tree and a love that still stands, long after the tree itself has returned to the forest?
We started out on the trail full of childish hope: Maybe, just maybe there would be a trail of crumbs, a sign, something that would lead us to the tree in a mountainside full of trees. We walked for hours.
It took little time until we noticed that most of the growth along the trail was quite young, from saplings to trees perhaps a foot in diameter. The older trees were set far back or lying in enormous pieces on the ground.
Fifty years. The one they carved would have to be closer to 70 or 80 years old. A tree would grow and see quite a bit in that time—flooding rains, ice storms, winds, drought. The odds of us finding Bill and Cheryl’s tree looked worse as time went on.
Then we saw a tree that finally made me accept the fact that we’d be leaving there without the photo we wanted. On a relatively young beech were two sets of names. It was the only tree we found with anything carved on it at all. The interesting thing was that the letters had been growing with the tree and were starting to widen and callous, looking in some parts indistinguishable from the bark. The names were becoming the tree. The tree had made them part of itself.
As we left, I found a poetic justice in that. They, their young affection, that day, that moment, had become part of that whole forest.
Thinking of that tree, of those two kids climbing a mountain and opening their hearts for all the world to see, of the future that would bring both drought and abundance, of children and business, of their last years together and their utter devotion, presenting love as a science reveals at best a profound lack of imagination and, if true, would leave most of us without much hope. I have never seen a list work.
So, as I often do for my articles, I asked my husband what he thought of this whole journey, the initials, whether there is a way to know, whether love can last anymore without people going to experts for answers or techniques. And, in his usual Montanan manner, to respond to the question, he took me out to our backyard and carved our initials into a tree.
(this is an expanded version of the piece currently on Huffington Post)
I’ve been a psychotherapist for 25 years. I believe it’s an important part of my job to make my clients as comfortable as possible from the first phone contact. Despite all reasonable efforts, though, the first interview seems to still be somewhat awkward and difficult for new patients. Really, it’s very understandable. They don’t know me. They feel vulnerable and unsure because they don’t know exactly what’s expected. They’re sometimes not even fully clear about why they’re there except they know they want to feel better.
The homeopathic interview may be even more of an unknown for some people. Not only does it start with the same “unknowns” as the social work assessment, but it adds some new ones, like the simple but monumental fact that it turns allopathic or “standard” medical practice on its head. You may have called the homeopath to get rid of that recalcitrant psoriasis, but he or she keeps talking about whether you kick the covers off at night, how you feel about injustice, or whether your sadness is worse in the morning or at night.
Knowing what to expect of the process and what your homeopath is hoping to learn from you may make the experience more comfortable and more productive. The following is not a medical manual, but a primer for those looking to work with a classical homeopath. Hopefully, it will give you a good idea of what to expect and how to participate so you get the most out of it.
Preparing Yourself Philosophically
One of the fortunate aspects of my practice is that I see people more frequently because the primary focus of it is mental health treatment. Even though it also takes physical conditions into account, people almost always call me because they’re sad, anxious, grief-stricken, panicked, or in some way emotionally distressed.
Unless a person comes specifically to be treated homeopathically and has already had some experience with the philosophy and practice of classical homeopathy, I usually anticipate spending at least some time in the first or second session on education. I give material for reading, lead them to the National Center for Homeopathy website, and take as much time as he or she needs answering questions.
What you can do, then, to make the time you spend more efficient and effective when you are actively seeking treatment from a homeopath is to learn a little bit about it beforehand.
In my opinion, the best book for the starting patient is Impossible Cure by A. Lansky. It is written in clear, concise prose and doesn’t fall back on “homeospeak” so you can follow her all the way through. And hers is an amazing, personal story of hope.
The principles of classical homeopathy are the following:
Like cures like.
This is the manner of cure. It is also called the Law of Similars and it is the way all proper remedies are chosen. It means that the practitioner is going to ask you a host of questions intended to draw out information that will help him or her choose the remedy that is most “similar” to your totality of symptoms.
The simplest example of the Law of Similars is what we do when we get grease on our hands. We clean it with soap (or, if you’re out in the garage, Goop), which is little more than fat. The soap removes the grease because it is grease.
In a homeopathic case, it may look like this: A little boy suddenly gets a raging fever with a pounding headache, dilated pupils, cheeks so red they could be purple and becomes delirious. The remedy a homeopath would choose (and there would be a couple of contenders) would have to produce those symptoms in a healthy person. By giving the remedy that would generate that particular type of febrile state to a person with it, it is cured.
This is why quinine works curatively for malaria—because when it is given to a healthy person over and over, it creates symptoms similar to malaria. Like cures like. This principle goes back to Hippocrates and has been considered by homeopaths as the basis for all true healing.
This is the road of cure in homeopathy. In simplest terms it refers to the way and the order in which the pathology will be healed. Cure moves from top down, from present to past, and from in to out (from the spiritual-mental-emotional down through the organs from most to least important and finally out to discharge in a benign way, e.g., a runny nose, brief diarrhea, fever, or skin eruption).
One remedy at a time.
This is the technique of cure and it is an obvious but overlooked wisdom. If multiple remedies are given too frequently and in too rapid a succession (except in extreme and acute situations), the case can be lost. This is even more true with combination remedies (pharmacy concoctions that include multiple remedies, even those that antidote one another).
It is terribly important to let each one reveal in its time what it must. Some remedies take longer than others. We all respond differently at different times to our environments. Remedies are no exception.
The Nature of Pathology: Layers
This is not a standard homeopathic “principle” but it’s one that leads me to ask of patients regularly: Patience. We are not out to just make a symptom disappear at the expense of your vitality and health. We want to get rid of the psoriasis but not at the expense of seeing you develop uterine fibroids or heart disease.
We want you to be healed. And that takes time. When patients ask me, “Well, how much time,” I have to say, “As long as your organism needs. You’ll tell me how much time.”
The reason for this is that there are layers to everything today. Including pathology.
Western practitioners often mistake the presenting problem for the only problem they need to cure, not having been trained to see the embedding of one pathology over the other or the inheritance one may have received from one’s ancestors.
These are levels of defense. We know this by what happens in our relationships. First bad joke, we get a giggle and a snort. Second bad joke, we get a “cut it out.” Third bad joke, we get kicked in the shins.
It is common knowledge that when an organism is injured, it inflames. It is a mechanism of repair. Homeopaths trace what happens if the injury is not healed (by itself, with proper medicine or the removal of inflammatory agent): the inflammation worsens, leading to induration (hardening). If that is not healed, then the organism resorts to its last defense to save the whole. Thus a cancerous tumor or an ulcer is a result of this process at the genetic level.
In homeopathy there are three basic levels:
Physical level: Inflammation (fevers, rhinitis, cystitis), pain, spasm, constriction, sensitivity
Emotional level: Anxiety, apprehension, irritability, anger, sensitivity, insecurity.
Physical level: Accumulation (calluses, warts), synthesis, deposition, and proliferation
Emotional level: Hyper-anxiety, fearfulness, hypervigilance, Super-vivaciousness, showmanship (most of American TV), boasting, rigidity, hardness (like calluses), precocity, collection (OCD). Also the opposite: too relaxed (a loss of collagen, dropped uterus), looseness in character, overly yielding, shame, frivolousness, bashfulness
Physical Level: Exaggeration, distortion (pointed teeth, curved spine), destruction (cancer), auto-immune diseases, mutations (scoliosis)
Emotional Level: perversion, cruelty, hysteria or mania, (borderline personality disorder, psychosis), distortion of reality and loss of connectedness, delusions, destruction, fearlessness, loss of will to live, loss of senses (smell, sight etc…).
Less Really is More
This concept is one of the major reasons why people have a hard time understanding and choosing homeopathy.
In homeopathy we do not use gross quantities of a substance. We use smaller doses, often below Avogadro’s number—meaning that if you looked at the medicine with an electron microscope you would see nothing. This is also called a “mole.” The mole, as defined by Wikipedia, “is a unit of measurement used in chemistry to express amounts of a chemical substance, defined as an amount of a substance that contains as many elementary entities (e.g., atoms, molecules, ions, electrons) as there are atoms in 12 grams of pure carbon-12 (12C), the isotope of carbon with atomic weight 12. This corresponds to a value of 6.02214179(30)×1023 elementary entities of that substance. It is one of the base units in the International System of Units, and has the unit symbol mol.” (http://en.wikipedia.org/wiki/Mole_%28unit%29)
The way I explain it to patients is this: Homeopathy is an energy delivery system, like a musical instrument or a beating heart or a scream of “fire” in an auditorium. So if the remedy is sulphur 30c, there are no molecules of sulphur in it. It acts on the vital force (and this is important!!!) by energetic resonance. It does not work on our bodies directly the same way that taking an aspirin or steroid does. It seems to work more along the lines of quantum physics than Newtonian law. (Poitevin, Bernard (2005). “Jacques Benveniste: a personal tribute”. Homeopathy 94 (2): 138–139. doi:10.1016/j.homp.2005.02.004.)
The rule of thumb is: The smaller the dose, the more potent.
How does this happen? According to one study, homeopathy works because water has memory.
(E. Dayenas; F. Beauvais, J. Amara , M. Oberbaum, B. Robinzon, A. Miadonna, A. Tedeschit, B. Pomeranz, P. Fortner, P. Belon, J. Sainte-Laudy, B. Poitevin and J. Benveniste (30 June 1988). “Human basophil degranulation triggered by very dilute antiserum against IgE” (PDF). Nature 333 (6176): 816–818. doi:10.1038/333816a0. PMID 2455231. http://www.nature.com/nature/journal/v333/n6176/pdf/333816a0.pdf.)
From Benveniste’s observations, it appears that what’s been in it has a resonant effect. It is similar to the way our bodies remember a trauma. We have body memory even when the trauma is long gone and resonate with similar states or situations, until that original traumatic injury is healed.
As a psychotherapist, I think the tendency of trauma victims to unconsciously set themselves in traumatizing situations again and again is a desire to self-heal in some ways…they are searching for the similar agent. Freud was close to this when he talked about the repetition compulsion. People are often horrified (and not unreasonably) when they engage in unhealthy behavior time and again. They rightly want it to stop. But when it is framed this way and they can see that they have only been seeking resolution, it becomes not only easier to understand but to actually resolve. They feel less guilty with unconscious complicity, less victimized by their pasts and more empowered to move towards change. I’ve seen this understanding alone start to bring about healing even before a remedy has been delivered.
Yegads! No Coffee???
Perhaps the hardest thing for some patients is the need to temporarily give up coffee. I’ve seen patients give up vicodin, birth control pills, marijuana, and essential oils quicker than their daily java joy. I can absolutely understand it, too. I love coffee. But it is an unavoidable part of the homeopath’s process.
Although I’ve met some homeopaths who do not worry about coffee or other known antidotes (steroids, marijuana, camphor) very much, many of us do take the more conservative path. In general, it’s best to be prepared to have your homeopath ask you to leave the java (and the camphor) aside until you’ve reached a solid plateau of good health. It doesn’t antidote everyone or every remedy, but for most homeopaths it isn’t worth the risk of complicated the case.
What Do They Need to Know THAT For?
Come to the interview ready for a lot of unusual questions. It will not be enough for us to just “name that disease.”
What is important when we look at a patient and what are we going to ask you? We will generally work along the following areas even though we all have different styles and personalities.
Interior function (most important):
Creativity, compassion, forgiveness, centeredness, relatedness, empathy, adaptability, consistency in relationships, integrity/honesty, and consistency between intention and behavior.
This may not coincide exactly with interior function. However, I believe and have found that our pathologies normally express themselves poetically or holographically. You may recall the expression, “as above, so below.” It is true for us, as well. So we will ask you about situations that reveal your capacity for appropriate behavior (clothing, responsiveness to social cues), money management, job status, time management, socialization, housing.
Parents’ medical history, personal medical history, current disease state (psoric, sycotic, syphilitic), diet (especially cravings and aversions), exercise, chronicity (how long the problem has persisted), periodicity (how often it occurs and whether there are specific cycles), and modalities (what makes it better or worse).
Rigidity, belief system, presence, judgment, fear.
The Art of the Interview
When I teach clinicians and medical personnel (Verbal First Aid, crisis protocols, and alternative healing principles, etc…), I always remind them that questions, no matter how clever or how technically astute, are no substitute for the therapeutic relationship. There is an art to homeopathy that is not “technical” and cannot be acquired solely by accumulating knowledge. I’ve met people who could recite remedies and their exact properties by memory, but could not see a patient in his totality and could not, therefore, come up with the right remedy.
Part of what makes a homeopathic interview successful is the synergy between you, the patient, and your homeopath. There must be a give and take, a relationship of trust, and an open dialogue. If you have questions, ask them. If you have fears, share them. The homeopath must observe and listen, but no one can see what you do not present.
If in fact there is as much art as science to a good case-taking, then you are as much a part of that creative process as your homeopath. Be as open and as honest as you can and you will reap the rewards in the health, vitality and freedom you have always longed for.
About a year ago I heard a sermon about two brothers, Cosmas and Damian, both of whom were doctors. Trained in Syria they practiced as physicians in the seaport Ægea, now Ayash, on the Gulf of Iskandrun in Cilica.
Through their work, they attained great status as healers. They were revered as the “anargyroi,” the Unmercenary physician,s because they decided to stop charging for their services and to offer the gift of healing purely out of their devotion to God.
They never starved or lacked for anything, although they were brutally tortured and beheaded in 287AD during the persecution under Diocletian for not recanting their beliefs.
After I heard their story–despite their unfortunate ending–I made a decision about my practice as a holistic psychotherapist. From that point on, I would slide my fee scale and that if someone truly wanted help and I could honestly help them, I would. Period. No forms. No hidden agendas. God gave me the tools. I give them to you.
This is not easy in a world where standards of care are generated by committees composed of people from pharmaceutical conglomerates and insurance companies. Or where doctors get sued for malpractice when diabetics won’t stop drinking alcohol. The tort laws in NM have scared most medical practitioners to Texas.
When I was being interviewed and had a site visit conducted by NM medicaid, in order to become a provider I had to post exit signs over what were clearly doors AND have a map of my house drawn according to scale and post it where patients could see it. It had to have a “YOU ARE HERE” mark and show them the way out.
Mind you, my private office is in my home and the office has a separate entrance. There’s no mistaking it.
At one point in the interview, the insurance rep was so adamant about it I had to ask, “If there’s a fire, do you think I’m going to run out and leave my patient here?” He, by the way, was sitting right next to the door!
He just shrugged, “Those are the rules.”
I shrugged, too, and decided after two months that I wanted the exit signs off my walls and that I would not leave my patients to burn.
So, now to a more pointed story of modern medicine under the thumb of big business:
Someone I know who was injured on the job was sent by the Worker’s Compensation insurance underwriter to one of their approved rehabilitation physicians.
The patient was examined and at first it revealed nothing, so they said it was a muscle injury and pushed pain killers, particularly vicodin, which is a known hazard (tendency for addiction, narcotic bowel syndrome, irritability and mood disturbance, motor function disturbance and so on and so forth). The patient refused all of their suggestions but took a bottle of ibuprofen.
Finally, after much complaining and only after the 90 days for a lawsuit had passed, the insurance company begrudgingly ordered an MRI which found several bulging discs including an impinged S1. They also found moderate to severe neuropathy along one leg, hip and buttock.
Nothing worked to help except one thing: physical therapy. So what did the modern doctors do?
They discontinued treatment, declared the patient MMI (at “maximum medical improvement”) and told him he really should “reconsider the vicodin because it was never going to get better.” He was told he was permanently disabled.
The patient couldn’t believe what he’d heard. They were taking away the only treatment that had helped? “But that was the only thing that worked. How can you do this?”
“Yeah,” the doctor said, “but you had your 8 weeks.”
“But you’re a DOCTOR!” the patient leaned forward, raising his voice.
“I know. But that’s the system.”
The patient was furious. He pointed his finger, “No. YOU’RE the system.”
The doctor went on to earn a lot of money and live very comfortably. So far he has not been beheaded.
For the rest of this article on the choices involved in becoming a healer, on the amazing healers I have known, and what insurance companies have done to the practice of medicine, please take just a short click to: http://www.opednews.com/articles/Modern-Medicine-Healing-o-by-Judith-Acosta-100715-534.html. It’s worth the trip. We have some serious thinking to do about medicine and what we expect from our physicians. And, practitioners: we have some serious, serious work ahead of us if we’re going to get back to the real business of healing.
In one of my talks on Verbal First Aid™, I make a point of bringing up the stethoscope as one of the inventions that truly changed medicine and the art of healing. Because where once the physician had to lay his or her ear on the patient’s chest to hear the heart beating, now there was over a foot of distance between them. We need to rethink this.
Holistic Psychotherapy With A Heart
The other day a patient told a story of how she got her first kitten. It wasn’t anything like what one might expect—found a litter in the alley behind the house, or a stray wound up on their porch. Her family doctor was over for dinner with his wife and he had found a kitten.
“Your doctor came over for dinner?” I asked.
“Yeah, he always did. He was like part of our family,” she sat back.
“He was your doctor and your parents’ doctor?” I asked stupidly.
The last time I heard about a doctor visiting a patient’s house to celebrate a socialoccasion was the last time I watched Little House on the Prairie.
When I went to graduate school and in every agency I’ve worked since, those boundary crossings were utterly verboten. I know of one social worker (who’s really an administrator, not a therapist) who won’t even acknowledge a patient in public unless the patient comes up to him first.
There are rules and regulations about these things now, privacy laws and confidentiality acts that can put a therapist or doctor in jail for saying the wrong thing at the wrong time.
So, the caution is understandable.
But it’s also lamentable.
Because this past week I left the cloister and went to see a client graduate. She invited me to do so and there was no doubt it meant the world to her. In my mind and heart it was the healing and loving thing to do. I could have said no, that the regulations strictly interpreted limit our interaction to the office setting and that leaving those four walls could pollute the therapeutic relationship. But I didn’t. I went. And we both wept.
To be fair, there are some good reasons for people being careful about leaving a traditional and “safe” setting. Many “healers” have taken terrible advantage of people by forcing unprofessional relationships on them with highly improper dynamics. And I don’t just mean sexual ones. I mean ones in which the therapist is the needy one. And people like that sincerely do need lines drawn around them that read: “so far and no farther.” But I suspect that we may have gone too far in our tentativeness and become fearful. In so doing we may be losing something truly precious—the healing relationship.
My father is a doctor. He no longer practices, but he is and always will be a doctor. When I was growing up it was not unexpected for the phone to ring and it would be his answering service. I distinctly remember more than a couple of occasions when the call came in the wee hours of the morning and he picked up his leather medical bag (just like in the Jimmy Stewart movies) and left the house not to return until 4 or 5 in the morning.
In fact, one of our family’s closest friends—Aunt Irene and Uncle Harry, we called them—were his patients. It was winter when I was an infant and Harry had contracted a bad flu which took a turn for the worse one night. They called in, my father went to their apartment on Decatur Avenue in the Bronx, where he sat with Harry as Irene paced until the fever broke. He sat there all night. Harry lived. Irene never stopped pacing, but she was eternally grateful and thought my father walked on water.
First they came to major family events—birthdays, funerals, the like. But then they started coming over just to come over. He still took care of them medically. And they lived into their 90’s, hale and happy.
It never occurred to anyone in my family–immediate or extended–that there was anything untoward or unethical about it. In fact, if that question had even been raised, they would have heard a resounding “Are you CRAZY?” from all of us.
I think the patient who got her first cat from her family internist would have said the same.
Doctors, therapists, priests, rabbis, pastors—healers and helpers of all sorts—used to be part of the community and a part of the lives of the people whom they served. Doctors didn’t have to find different churches to attend because one of the congregants came to see them for a yeast infection. It was confidential, the relationship was sacred, yes. But there was other life to live, too. And people did.
In one of my talks on Verbal First Aid, I make a point of bringing up the stethoscope as one of the inventions that truly changed medicine and the art of healing. Because where once the physician had to lay his or her ear on the patient’s chest to hear the heart beating, now there was over a foot of distance between them.
In our zealousness and fear, we have substituted machines for people and strict rules for sensible relationships. We have literally taken the heart out of healing. I think that is something we cannot afford to do.
The Source of All Good Healing
Psychology and fundamentalism at best have been polite opponents. In recent history, say the last 50 years, this opposition has become vigorous and often less than polite. Many churches, such as Calvary, completely eschew all mental health practitioners (whether social workers, psychiatrists or counselors) and staunchly maintain that all healing comes directly from God or prayer and that all you need in order to develop and maintain a robust mental health may be found in Scripture or a prayer session.
This rejection of psychotherapy may have been a reaction to the “I’m okay, you’re okay” generation of therapists who did very little for most people except to allay the anxieties of narcissists and sociopaths by telling them “if it feels good, it is good.” In the eyes of both Orthodox Jews and Christians, the field of humanistic psychology took the whole program of self-improvement one giant step too far, putting man in the center of the universe, particularly his own.
Their objections were not wrong. And I say this as a holistic psychotherapist with almost 25 years of experience in the field.
I have seen far too many well-meaning therapists do little more for their patients than make them feel better about being sick. They are loath to challenge or confront negative behavior or unhealthy thinking because they fear being seen as judgmental. As a result of their tentative relationships with the truth, they fail in their relationships with their patients. They do not see what needs to be healed so the patient is left unhealed. This is truly a disservice to the patient because what it ultimately does is feed the pathology and starve the essence of the person.
I think all good and true healing flows from the same Source which means that there can be an alliance—and an important one—between the Biblical and Mental Health communities.
But only if we have an understanding of our terms and are actually seeking the same results.
(More on this topic to come.)
On August 17th at 5:45, I held my eldest dog, Angie, as she took her last breath. I rubbed her gently behind the ears and kissed her forehead, taking in as much of her as I could before I let the technicians take her away. In the 36 hours since I let them lift her out of my arms, I’ve been wandering around the house looking for things she might have left around–clumps of hair, a toy, a half-chewed bone, a hidden towel. There was nothing. Absolutely nothing. It was the first time in my life I lamented my own neatness. She was really gone.
She was 15 and had been sick for a year. Homeopathy had kept her miraculously vital and calm throughout that time even though she had been diagnosed with both bilateral cardiomyopathy and metastasized carcinoma. I knew it was coming. I thought I was prepared. In these last few weeks as I had to help lift her up to go outside so she could urinate, I tried to tell myself–as so many others were telling me–that when the time came I would be relieved. I would know it was the right time and it would be okay.
I know they meant well, truly. But I was not relieved. And it did not feel right. It was not okay.
When the doctors gave me the news more than a year ago, I made a committment to myself and to her that I would see her through it all. I would minister to her while she was here and when it was time for her to die, I would be fully present. It was the least I could do. She had been my truly faithful companion for more than 11 years since I’d rescued her. She was my first dog, my mentor, and my trusted guardian. So when the time came I did what I promised I would do. I held her and I watched her die.
In the back of my mind I held out hope that the people who’d talked to me about the “naturalness” of death were right. I had prayed for comfort in the way they had promised. But I didn’t feel it at all. I know that when I let go of her body, limp and without any of the fight she had in life, the Angie I loved and trusted and trained and struggled with for all those years was simply not there anymore.
As I held her and felt her chin go limp against my thigh, the strangest though popped into my mind: I’d heard people speak of dead weight before, but she seemed terribly light, nearly weightless to me as if the greatest part of her, her ballast, had departed with her last heartbeat. She–Angie–was not there anymore. Just a brief moment ago she had been there. But then she wasn’t. It was stunning. And I do not understand it. I find that no matter what I do or how I appeal to reason and the modern, scientific schema I cannot understand that disappearance. Where is she? Where did she go? She was just here. The first night I paced the house like a child as I whined a mantra, “I want my dog back.”
It must sound awfully naive for a therapist and homeopath to be so surprised by death. I have seen death before, though luckily not very much. But I don’t think the exposure has helped me understand or accept it much better any more than the platitudes about the cycle of life have helped to ease the pain.
When I was a very young psychotherapist, not two weeks out of graduate school, I worked at a hospital in New Rochelle on the med/surg unit. There were 30 some-odd beds and all of them were filled all the time with very sick people. I was only there for two months, but I watched several people get covered in sheets and rolled away by stretcher. It was a hospital. I was saddened by it, but I expected it.
There was one woman who was different. She never had a visitor, not a family member or a friend. She was a quiet person with short, brown hair who always asked for books to read. Most people got in and out of the unit within a week or so. But she was in her room a long time, always propped up in bed, never in a chair or walking around. She was not assigned to my caseload, but I spent time with her anyway. She seemed so lonely. She didn’t talk much when I visited because she found it difficult to breath, but she seemed to like it when I read to her or talked to her about the news, offering her some connection back to the world outside the window.
Once when I sat by her, she lifted her fingers straight up, though her arm remained flat on the bed. Because she was suffering with terminal lung cancer, I thought she was restless or uncomfortable and offered to move her pillows or adjust her bedding. She shook her head until I realized she just wanted me to hold her hand.
It only took a few days from the time I first held her hand to the last time. Her spiral downward was quick, as if she could leave now that she had company. Or maybe she needed a witness. I don’t know. I never really got to know her. But I came to care about her and never forgot her. I still think about the changes in her breathing as her time approached, how the muscles in her hand would occasionally contract as if to make sure I was still there, how thin she looked but how firmly her jaw was set as she finally let go. I stayed with her till the end but I can’t even remember her name. In my mind now, she was more than any name or any identity that could have ever been assigned to her.
Mostly what I remember now is what I didn’t understand and what I still don’t.
Peter Kreeft, one of the brightest and best when it comes to writing about the great mysteries, said, “We are shocked at the irreversibility of death although it is utterly familiar, utterly universal, utterly natural. We find the natural unnatural. Why? Let us be shocked at our shock…’This is our natural state and yet the state most contrary to our inclinations.’”
I AM shocked. I am stunned by its finality, its emptiness, its contrariness–not only to everything my senses can fathom but to what my heart holds truest, that He has “put eternity” in us and no matter how we try to rationalize, empiricize, or explain it away with, “well, that’s the cycle of life,” it never, ever feels right. And I, like Kreeft and many others, believe that it can’t feel right because that is not what our souls–or our hearts–were created for. There is something in us, or to be more precise, we are made of something which is not temporal, which does not bow its head in acceptance to the last breath, which does not feel at home in the mortal, time-bound world and never will.
It is why, no matter how many times I hear from people “it’s the way of nature”, it will never feel natural to me. And if Kreeft is right, then that gives me the most hope of all.
“Quietly they go, the intelligent, the witty, the brave. I know. But I do not approve. And I am not resigned.” (Edna St. Vincent Millay)
A patient came in the other day having difficulty breathing, anxious. She had just taken a couple of puffs on her inhaler, but still felt uneasy. Having known her a while I was able to ask, “What happened?” It had become clear to both of us that her asthma was as much the result of feelings as it was of pollen.
Her daughter had been expelled from school and she was in danger of losing custody to her ex-husband. Her anxiety was bulging out from her sides. She was terrified.
Having both suffered from asthma (years ago) and worked with asthmatic patients for quite some time, it has been my clinical observation that it is a “poetic” pathology, often expressing a grief, a panic, or a worry that has not been expressed in other, more productive ways. Even in cases where there is a clear physical etiology (smoke inhalation, chemical burns, and the like), it may be ameliorated by understanding the way the human organism works and the power of both imagery and emotions.
The research has shown that Verbal First Aid. techniques are being used successfully with children who suffer from asthma. In one pediatric study measuring the effects of guided imagery and hypnosis the results were dramatic: 80% of the children had improvement that was measurable, none of the children’s symptoms worsened, and, best of all, some patient’s symptoms resolved after one hypnosis session (Anbar, 2002).
In an article entitled “Applying hypnosis in a preschool family asthma education program: uses of storytelling, imagery and relaxation,” author D.P. Kohen found that combining those modalities helped the children both physically (they needed fewer office visits) and emotionally (with greater self-confidence as marked by both the parents and the children).
Helping an asthma patient was the experience that changed one paramedic’s way of thinking after I taught Verbal First Aid to his team in NY. He used the techniques of pacing and leading, utilizing both imagery and the rhythm of his own breath to calm the patient. “By the time she was at the hospital,” he recalled later, “she was fine. It was amazing.”