Be still…It’s really such a simple request and such an impossibly difficult task for so many of us as we get older and more acculturated.  It certainly has been for me. I can barely talk on the phone for 15 minutes without washing the dishes or multi-tasking in some other way. America is a culture of action.  We do. We don’t sit.

The problem is that with constant busy-ness comes chronic spiritual insensibility. We can build things, accumulate things, and get from one point on a line to another faster than any other group of people on Earth. We are the cleverest, quickest, and most acquisitive culture in our planet’s history. But we see, feel, and understand less. We have collected data and sacrificed wisdom. We have built colossal glass cities and relinquished our sight.

By the time we are in high school, probably earlier, most of us are set into a rhythm of living. Our eyes are focused ahead and our peripheral vision shrinks with each passing year until we can barely see the tips on our own noses. And unless we can see not only ourselves but ourselves in context, the truth is that we can know very little. It becomes more and more difficult to see any evidence of God, no less know Him. Unless, of course, we’re in deep trouble and a sense of urgency is dramatically renewed.  As one Patriarch of the Russian Orthodox Church has said, “Unless there is thunder, people don’t make the sign of the cross.” The American equivalent: “Everyone believes in God in the trenches.”

Yet, we are continually surrounded by the evidence. We are in a world filled with miracles. Clues are in every corner of our lives. Amma, the Hugging Saint of India, exclaimed that God is everywhere: “If you ask me who is God, I tell you, you are my god. The lion is god. The flowers are god.” Yet most of us don’t see it. Or don’t recognize these clues as such if we do see them. Some of us just forget to look.  But miracles are not empirical. They do not present themselves in the linear, organized manner of double-blind studies. We try but we cannot collect miracle data to analyze. Most people think they will believe it when they see it, but the truth is that we see it when we believe it or are at least willing to entertain the possibility. This is what is meant in Mathew and why we must be as little children to see the truth in the evidence that is all around us.

Two experiences have illustrated to me the urgency of keeping my eyes and mind open.

The first experience occurred when I was 12 years old and I was allowed to take an after-school art class. It was a small, unpretentious event held in the backroom of an old woman’s apartment in the Bronx but it changed the way I saw everything. Instead of looking at a thing and seeing its function first (how it pertained to me, how I could use it, eat it, play with it), it now had a life and a charge all its own. I saw light, form, color, shade, placement in its surroundings. If I tilted my head this way or that, the thing—and all those aspects of it—also tilted. I was suddenly in relationship with the world in a new way.

The second was studying for nearly five years to become a homeopath after already being a psychotherapist for about ten years. Classes would not start until we had all closed our eyes and sat still for a period of time, sometimes for as much as a half-hour. Even as I write this some years later, it hardly sounds like much—what’s a half-hour? But for me sitting still and letting myself be quiet so that I could receive impressions from my patients without actually collecting them, without any judgment or interference on my part was initially as easy as teaching a puppy not to run after a rabbit.  But by my last year (and it was a struggle every time) I began to notice something odd—I started to see more. Information was not just more available, it was clearer and more understandable. This, I began to understand, was where the miracles were to be found.

But understanding was far from enough for me. Humans are a complex and mixed bag of needs, desires and defects. Poised precariously between good and evil, heaven and hell, life and death, dangling between light and dark, the human heart is by nature a busy place, a shifting ground where there is both endless dance and relentless battle.

Stillness does not come easy for me.

I do not sit with much grace.

I have had to find a way to be still of heart and let my body move as it will. So, I do yoga. I walk in meditation and I pray as I hike. Sometimes on those hikes I talk. Sometimes I listen. Sometimes I’m hurt and fearful. Sometimes I’m grateful and delighted. All I can do is bring myself—all of me—to Him, assuming that He can handle it, the awe, the anger, the confusion, the good, the indifferent, all of it, all of me, from the loftiest impulses to the darkest corners of my soul. And what I found was unexpectedly simple: Finding God was like being married. You have to show up for the relationship. All of you. Build it and they will come. The same is true of God.

Be there and He will come.

(This article is dedicated to R.M. who inspired it. Thank you for reminding me of what we are supposed to be doing.)

For some reason lately I have been seeing quite a number of brand new social workers for supervision, some of whom are still in graduate school. It has been a poignant and privileged rite of passage for me after all these years to be passing on what I’ve learned.

One in particular touched me. She worked some time ago in a hospital emergency department in another state. As you might imagine, she bore witness to countless tragedies and sorrows, the worst of which was one little girl who had been beaten so severely by her mother’s boyfriend that they didn’t know if she would make it.

When she originally came on the ward she had been warned by the other professionals on staff to “watch her boundaries.” That’s a trigger point for social workers who, as a group, have been known to go the extra mile for patients and clients. This has become an “issue” for the profession as it has grown over the years and tried to maintain its status along with psychologists and physicians. What the well-meaning advisers meant was that she would be facing horror and that she needed to “detach” and “not bring it all home with her.” The real meaning: don’t get involved.

Those were their words. People warned me the same way when I started out.

I have been a psychotherapist and crisis counselor for nearly 30 years. I have worked with rape victims, survivors of war, children who had been abducted by drug lords, parents who were abused by their own offspring, addicts who had been lost and left to die on the street, and a full retinue of the mildly neurotic. I have stared into the abyss with friends and colleagues at Ground Zero and had to breathe the acrid smell of death.

But what I have learned is that there are boundaries and there are boundaries. Some should be zealously guarded and some not so much. And whenever I have made a real difference I have absolutely become involved though not in the way you may imagine or some may fear.

I will explain through her story.

As the baby was being treated, she called the proper authorities, as was legally required. She watched as the mother and boyfriend were carted away. And she stood nearby as the baby, broken and battered, moaning in pain, was gently set to rest in a small bed in PICU.

She was told to go home, that she’d had a hard day, and to have a glass of wine. There was nothing more to do.

But something inside her rebelled at that: there’s nothing more you can do.

And, against all the advice of authority, against all the warnings, she went into the PICU and sat with that little girl, breathing gently with her, resting her own fingers carefully in the child's small hands, smoothing the downy hair on the little girl's head, the one place that had gratefully been spared from the brute’s rant. She sat with her for hours until the little one was able to rest. She talked to her. She sang to her. She hoped for her. And then she reluctantly went home.

The case moved on from there and she doesn’t know what happened to her or the family. But there she was in my office, years later, wondering if she’d done something horrible by not letting go, by not listening to the advice of the nurses and administrators who told her to detach, to not take it home. “Did I make a terrible mistake?” she wanted to know.

Through tears as I listened to her and through tears as I write this, I said “No. You did everything right.”

She didn’t understand how she could be right and feel pain that way and disobey the warnings she’d been given. But I did. And I have found that when you do the right thing, there is often no way to sidestep the pain and sorrow that is common to us all. Nor should there be.

Suffering and Professional Boundaries

Social workers’ boundaries are important, but not in the way we might think.

I think there are actually two separate questions in this larger issue and it is a far more complicated topic than people might imagine.

Boundary Question One: How do we face suffering and not get lost in it? How do we help people in pain without absorbing it? How do we have empathy and compassion without becoming the patient? What do we do with suffering if we can't fix it?

Boundary Question Two: How do we treat people in a clinical setting and keep our focus on them rather than using the session or relationship as a way of working out our own lingering issues? How do we stay clear-sighted about the pathology and vigorous in our pursuit of  health and the well-being of our patients?

These are two separate issues and I believe that we often confuse them in clinical practice.

I hope I can answer them both briefly and simultaneously by drawing on my experience and explaining what I think is necessary in any healing relationship.

Over the years, despite accruing more and more “tools” for my clinical tool bag, despite learning more and more techniques and styles, I have actually simplified. One of my mentors in graduate school told me, “Learn them all well so you don't have to use any of them.” I didn’t know what she meant then, but I do now. She also told me, “Don’t for a second think it’s you doing the healing. It’s the love.”

So, the distillation is this:

• Presence and Pacing

• Compassion and empathy

• Seeing someone fully without bias and without projection

• Spiritual context

Presence and Pacing

Presence is paramount. It is foundational. The ability to be fully present in the moment with whomever is there, with whatever situation confronts you, is to be adaptable, available, and genuinely healing. It addresses both Question One and Question Two in that being in the moment (as opposed to the past or the future) allows you to feel fully, be ready to do what is needed, and then move on to the next moment. When you are in the moment truly, you will be more adept clinically. You will know the situation at hand is not about you and that it will not last. You can fully feel and know that when you go home you will be fully present to the joy and life that is there.

This is not easy and it has taken me many years to learn. Being present has a caveat. It means we are there for all of it—the pain, the glory, the defeat, the sorrow, the loss, and the redemption. All of it.

Pacing is a term coined by Milton Erickson, M.D., the greatest hypnotherapist in American history. It  is also a technique I focus on quite a bit when I teach Verbal First Aid to first responders, medical personnel and clinical professionals. It means to "move with" or "walk along." It can include mirroring (to some extent) but I use it mostly to stress the act of being with another person. When a person is in pain and we are hoping to move them to a state of greater comfort, we do what is called pacing and leading. We pace their pain (I can see your wound and your discomfort…) and then lead them, sometimes one tiny step at a time, to healing (…so as I hold your arm and apply this bandage, you can rest more comfortably and stop the bleeding). Without the pacing, there can be no proper leading.

Pacing requires presence. Presence implies pacing. It is an emotional and spiritual partnership that may last anywhere from a few seconds at an accident scene or at an ER or go on for years in a psychotherapy setting.

Compassion & Empathy

This is not the same thing as taking on another’s pain. It is a communion, an experience of commonality, not a sympathy or an absorption. It is also NOT a projection of our own feelings onto them and this is where our skill must be honed and refined over and over again. Sometimes it means feeling what someone else is feeling, but that doesn’t mean it’s ours. It is a subtle difference, but an important one.

Many of the patients that come to social workers have been hurt terribly. We may in fact be the first person in their lives to genuinely feel them. (S.W. Recall: Winnicott’s “The Good Enough Mother.”) This can be in and of itself enormously healing.

What I have come to both believe is that feeling is not the problem. Over-interpreting and/or ignoring feelings is the problem. And that’s where we—as healers—can get into serious logjams.

In fact, it is the social worker’s ability to feel fully (and know what to do with those feelings) that is the hub of all clinical work. If we can’t do it, how do we expect our patients to do it?

Seeing Fully

When I was in school for classical homeopathy, my teacher used to warn us, “If you can’t see your patient, you can’t heal him.” He spent five years talking to us about the power to see.

I think this is true in any clinical setting. We open the door, a patient comes in and sits down. What do we see? What do we want to know? Can we see the hurt? What’s broken or bruised? What still works? How does it still manage to work?  These are the questions we want to ask and have answered.

Seeing someone truly may also entail some detachment, but not in the way it is used colloquially, which is to “not feel” what our patients are feeling. To see the truth means not get beguiled by façade. Most patients will come to us with a well-practiced façade in place, a mask they use to get through their lives—to hide pain, to forestall an accounting, to deceive and manipulate for one thing or another. We have to see past those deceptions, both conscious and unconscious. We have to see past the acquired skills and into the recesses of a person’s heart. We have to observe carefully. They may say they feel fine, but they can’t stop biting their nails. They protest over much about how calm they are, but their feet don’t stop tapping, they sigh repeatedly, or their eyes twitch.

As healers we are observers. Both of ourselves and our patients.

Spiritual Context

I cannot imagine doing this work at this point without two backups: One is the homeopathic philosophy and Materia Medica of Samuel Hahnemann and the second, most important one, is God. Suffering is intolerable (our own or anyone else’s) without some context within which we can hold it. Suffering or pain without meaning in a purposeless, random world is utterly intolerable. When there is meaning and purpose, even the worst pain becomes manageable.

Over the years, my work has become more about serving God (this is not about proselytizing by any means) than adhering to an agency code or a diagnostic manual, more about being present and truly healing than politically correct for the moment, more about truth and love than techniques.

I explained it to that young social worker that while others may not have understood what she did for that baby, God did. And the baby did. I am as sure of that as I am of the nose on my face. That baby heard her soothing voice, felt her calming breath and heartbeat, rested in her loving hands. Is there a better “technique” than that? I don’t think so. Those few hours she spent with that child may have changed the trajectory of her entire healing process.

I no longer aim for detachment, though I respect it. I no longer aim to fix every broken thing that is presented to me, though I very much want to alleviate suffering and disease. I no longer aim solely for technical skill, though I love learning.

What I am for is this: I aim to be present. I aim to see the truth. I aim to serve. Doing this work for so many years has required that I become more like a tube than a vessel. I do not “hold” other people’s pain, but I allow it flow through me and then up to God, Who can do with it what must be done, whatever that is so that peace and health and love are restored.

It's axiomatic that you get what you pay for. On observation, however, I believe that there are times we get more than we bargain for, not all of it good. In the case of current media-incitements, we get much more and we are rarely aware of it.

Viral fear, that generalized anxiety induced and spread by the media in all its forms, is evident not only in advertising but in most television programming. There's the famous It Could Happen Tomorrow series on the Weather Channel and that important reminder Armageddon Week on the History Channel. For the thoroughly inured and brain-injured there's also a 24-7 fear channel on cable in case someone needs to scare themselves to sleep. Of course, it's not enough to watch horrifying dramatizations of our last days on earth. Advertisers do their duty when they alert us to the more imminent dangers to life and limb if we don't buy their ________ (insert one or all of the following: security system, flu vaccine, dietary supplement, colon cleanser, or SUV).

There are statistics that suggest that while our diets are no good (by in large, they're awful), they're not the sole culprits in our poor health. While our intake of alcohol is high, that too is not the bullet that hit the artery. Same with cigarettes.

The Europeans eat and drink and smoke and suffer fewer heart attacks and less cancer. The Japanese eat very little fat and suffer fewer heart attacks than us but the Mexicans eat a lot of fat and suffer fewer heart attacks than us. The Chinese drink very little red wine and suffer fewer heart attacks than us.The Italians drink a lot of red wine and suffer fewer heart attacks than us.The Germans drink a lot of beer and eat lots of  sausages and fats and suffer fewer heart attacks than us.

Something else is at work, then.

I've been a psychotherapist for 25 years. Licensed in five states at one point. Seen hundreds, if not thousands of people. The one thing that seems to be the most prevalent and devastating to the most people is the constant fear, the unrelenting stress to perform to some impossible standard, and the agonizing inability to meet those standards and resulting inadequacy. This is just observation, not analysis.

But I did have a question or a thought on the topic. Is it possible that part of our cultural nature as adventurers and conquerers has something to do with it? When we are not scaling sheer cliffs, jumping out of planes, or conquering the west, where does that energy go?

There's a truism in Homeopathy that a remedy exists on a polar spectrum. It can be bright red (for instance) with heat or appear to be so white it looks cold. It can be enraged or as silent and coiled as a snake. It can be delighted or deranged. Each one existing within the same remedy state.

Could the same be true for Americans? That when we're not engaged in the extremes of conquest, we're trapped by our televisions? That the kissing cousin of adventure–fear–grabs us as soon as we stop leaping off of cliffs. And one thing I DO know is that fear kills us faster than anything else I've seen.

Just a thought to consider.

]]> http://www.wordsaremedicine.com/2010/01/10/the-wages-of-fear/feed/ 1 http://www.wordsaremedicine.com/2009/09/08/a-real-resistance-to-the-swine-flu/ http://www.wordsaremedicine.com/2009/09/08/a-real-resistance-to-the-swine-flu/#comments Tue, 08 Sep 2009 16:19:13 +0000 Judith Acosta http://www.wordsaremedicine.com/?p=677 Some people are finally just saying "no." One-third of the nurses in Britain have refused the vaccine even though it might mean losing their jobs. The internet is literally buzzing with resistance of the right kind–finally. And people are getting smart.

More on A Real Resistance to The Swine Flu

She was seeing a therapist and a psychiatrist who both agreed her anxiety was a symptom of her depression. So, even though she's an adolescent, she was put on Lexapro. Within 28 days her symptoms of anxiety spiraled into massive agitation, self-mutilation, delusions, and auditory hallucinations.  She was placed in an allopathic hospital.

What did they do?

They doubled her dosage. So now she was clawing at herself with her own fingernails and threatening to kill herself.

What was the next step?

Leave her on the Lexapro and give her thorazine as a chaser.

Her symptoms have not only not abated, they have worsened and become life-threatening.

This is not the first time I have heard or seen a patient unravel this way because of allopathic dosing. It is frightening in and of itself, but it is much worse when the parent is pleading with the doctors to take her child off the medication that has clearly exacerbated the situation and they will not listen. To make matters even more desperate, if the mother were to take the child out of the hospital and bring her to a healer of her own choice, in their state she could be incarcerated.

Thankfully for this Albuquerque psychotherapist, New Mexico has passed the Healthcare Freedom of Choice Act, which allows individuals to choose their own medical care, whether they follow the advice of their tribal shaman or choose to use the chemotherapies of western medicine.

Happily, the young lady's story doesn't end there. The mother, armed with the literature that demonstrates how ill-advised it is to use an SSRI on an adolescent female, has finally gotten one reasonable physician to agree with her and, while titrating her off the Lexapro, substituting it with Resperdal, an anti-psychotic.

When she is stabilized from this episode, they will be seeking out homeopathic treatment in their area, where finally she will be heard.

And what they might find out is that what they were calling "depression" may not have been  a standard depression at all, but either a borderline personality disorder or a prodromal psychotic state with agitation and some delusions (or perhaps both). In such cases it is highly INadvisable to give SSRI's, which tend  to do exactly what they did to this young woman.

When your doctors don't listen to you, be sure you listen to yourself.

The other day was a case in point. Angie, as some of you know, is my eldest dog. She has bilateral cardiomyopathy, metastasized carcinoma, cataracts, spinal arthritis and dysplasia. She is 15 years old. She has had an amazingly rich and happy life with us–traveled across the country, sniffed through woods in Montana, New Mexico, Colorado, and New York, chased down critters she was too cumbersome to catch, buried bones in caches so secret they are still there, dug 3 foot deep holes under azaleas to keep herself cool, then at the end of the day had a warm home, a good meal and a belly rub waiting for her.

She was diagnosed  in June 2008  by a doctor in Montana with congestive heart failure and was given 1 month to live. I called Dr. Stephen Tobin, our homeopathic vet in Connecticut, and we gave her lachesis, CoQ10, and a diuretic to help her eliminate the extra fluids. Within a week she was walking more comfortably. Within the month she had rallied herself so beautifully I thought perhaps our troubles were really over.

But then, some time in the fall of 2008 she suddenly developed a hard lump on the back of her left hip. It grew fast. One day it was there and the next day it wasn't. Something about it made me concerned and I took her in for a biopsy, which confirmed that it was a carcinoma. The doctor in New Mexico gave her two months.

Angie's always been dominant. We have called her "your highness" and Madame Angeline more than once. The dominance that had been so difficult and irritating in her youth now seemed to be the springboard for another recovery, because apparently she was having none of that nonsense with limitations. Her expression seemed to say to us, "I shall decide when and where I am to go."

So, we proceeded as always–CoQ10, a few supplements, a remedy as indicated. She had made it a year past their deadlines and once again, we thought we were clear.

But, that was our own foolishness, perhaps. She is 15 and regardless of medical approach, we are all limited and mortal.

Two weeks ago, she took a turn for the worse. She began panting, pacing, cramping with diarrhea. She was terribly anxious. It was worse at soon as the sun set. She was thirsty and drank huge drafts of cold water. She was ravenous. At first we thought phosphorous. We gave her a 30c, then a 200c. It seemed to me that it made it worse. We spent a week night-watching and by the end of that week my husband and I both needed our own remedies. It was exhausting.

So, I took a close look at her again and felt for sure that she was moving into her last stages. I worried that she was suffering. I worried that I was keeping her around for my own benefit. My husband and I talked for hours about euthanasia and when–if–how we would know it was the right time. (See blog "Words Are Medicine".)

Then I remembered that Arsenicum (among a few other remedies) in high potencies was often used to ease the transition in a dying patient. It would not "euthanize" or kill anyone, but if the vital force was already too ill to be healed, it would smooth the passage. If the vital force, however, were still strong, the patient could be rallied.

I took the case again: pacing, restless with the pains, panting, cancerous affections, anxiety, diarrhea (especially at night). It was all arsenicum. I gave 10M. One dose. And then I waited, half-expecting to find her gone in the morning.

What I got was quite different. We had two days of bloody diarrhea, but an instant calming of her spirit. The panting stopped. The pacing was gone. She was able to get up and walk around with us as we moved through the house. She kept up with the other dogs.

She's rallied.

I know we all come into the world with a time-stamp. And lengthening her days was not the objective, even if it was one sweet outcome. Giving her comfort and peace for however long she was her with us was. And–once again–homeopathy came through in a way that surprised and relieved and delighted us.

Thank you, Samuel Hahnemann.

People in this culture tend to think of health as an absence of cellulite, a nose that never runs, and a great sex life. This is terribly and dangerously misleading. As the current protocol stands, symptoms are to be eradicated as soon as they appear.

Recently, I'd taken a bad fall and went to a doctor for an exam to make sure nothing was broken. Without taking an x-ray or an MRI he offered three forms of potent pain killers. I said "no, thank you" to each offer. He raised his eyebrows in both surprise and disapproval. I added, "I need to know what's happening. Pain is communication. If I'm feeling pain in more than a week, something is still wrong. Don't you want to know that?" He was quiet and handed me 800mg Motrin. "You'll need this."

Unfortunately, the standard of care is suppression. Got a pimple? There's a cream and a pill for that. Got a cold? There's a tonic to wring out that nose and squash that cough.

This does not heal or cure, though. As homeopathy has been teaching us for hundreds of years, all this does is drive the disease up and inward. So, while the nose may not run, an infection ensues. Or while the cough disappears, asthma may develop. Or worse, an emotional downturn may take hold.

A teacher of mine once told me, "There are no side effects to drugs. There are only effects."

I heard a commercial the other day for an anti-arthritis drug. I don't remember the name of it, but it listed its "effects", I was stunned. I could not believe the drug had been released onto the market. Among the dangers: lymphoma, increased infection, tuberculosis, pneumonia. And that's just what I remembered. Half the commercial was dedicated to warnings.

Thus, in exchange for arthritis, we are given the serious risk of cancer.

What are we thinking? Particularly when there is such an elegant alternative in homeopathy?