Hudson Valley Magazine People to Watch 2012!

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(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.

Hering’s Law.

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:

The Psoric

Physical level:  Inflammation (fevers, rhinitis, cystitis), pain, spasm, constriction, sensitivity

Emotional level:  Anxiety, apprehension, irritability, anger, sensitivity, insecurity.

The Sycotic

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

The Syphilitic

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.

Exterior function:

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.

Physiological function:

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).

Spiritual function:

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.

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http://www.huffingtonpost.com/judith-acosta-lisw-cht/limit-setting-and-parenti_b_682565.html

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Everyone is different when it comes to their addictions.

There was one woman who needed surgery.

Se was in her 80's when he went to see a colleague of mine for an unrelated ailment. She had been beaten and cut by her husband for years. To deal with it, she took up drinking. She took it up so well, that she forgot about the abuse but became physically ill. She finally succumbed to the alcohol and had to go in for surgery for her gall bladder.

"They told me my liver was so soft, they almost couldn't do the surgery at all. So, I said to myself, 'Barbara Ann [name changed], you may not be very smart, but you ain't dumb enough to drink yourself to death neither.' So I just quit."

That was in 1981. She's been sober since.

Fear, as they say, can be a great motivator.

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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.

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No one over ten years of age would be terribly surprised by that sort of turn on a dramatic television show.

But Sweets, a psychiatrist whose job it is to support the people who face the most gruesome deaths on a regular basis, is utterly shocked and rattled.

And that interested me even though it was a droll stretch in the script. Because the truth is we are utterly unnerved by the Irony of the Universe. We come unhinged when someone we know has died. “He’s dead? What do you mean?!” we want to know.

Why are we so shocked by death? Why are we so stunned by suffering when it comes, finally knocking on our door? Why does the death of a young man unhinge us when we have lived in the world (in Sweet’s case for a few decades) and seen what the world is made of? Why—when we know there are NO exceptions to the bruising life gives us—do we still think happiness, good endings, and success is some sort of birthright?

I pondered this for a few hours and then it dawned on me: We forget the world is fallen. And it is fallen, all of it…all the time. I don't much like it and apparently I'd rather forget, too, but I keep getting reminders.

Once I had the misfortune of seeing a large hawk pick at a dying, but still-breathing rabbit underneath a juniper to the side of my garage. It was horrifying, but the deed was done and there was nothing I could do except weep as I walked away.

Sometimes, even years later, that image–that most intimate suffering–will pop up unbidden and unwanted while I’m driving or walking or resting. Every time, even now as I write this, I wince in pain.

As a psychotherapist and homeopath, I work with people whose lives are filled with undeserved misery, whose suffering sometimes boggles the mind and keeps me up at night. I have seen enough to know and it should be enough for me to remember what life is really like.

Yet, I’m no different than Dr. Sweets. I forget because I live in America where I can enjoy long periods of relative ease and comfort. I forget that things are fallen when all seems to be going well, the dogs are healthy, my husband is happy, and my family is at peace. I forget because I've been damned lucky.

Up until not too long ago (it embarrasses me to think just how not so long ago that was), I operated under the delusion that somehow everyone else would die, but I would just keep going. And that if I “just did this” or “just avoided that” or “just avoided flying” that somehow my ticket would never get punched. One can get very wrapped up (knotted, really) by this sort of thinking.

I know I’m not the only one, though. I think most of America operates under this delusion and because of it many, many people spend a great deal of their lives anxious—fearful, to be more accurate—and trying desperately yet vainly to control as much of their environment as they can.

Acknowledging the fallen nature of the universe does not mean we stop lamenting suffering, or stop praying for the recovery of a loved one, or ignore injustice or walk away from a wounded animal.

To the contrary.

At least for me, finally coming to terms with the nature of existence and my own mortality has set me free. I no longer have to struggle against the way it is. I no longer worry about “what ifs.” I no longer try to control the things that are uncontrollable. I know that there is little I can do about suffering (though I will never learn to shrug it off) and I accept its inevitability.

What I can do, though, is be truly present to those who are in its grip and I can give more of myself to the things I really can do something about. For instance, the other day my husband and I stopped by a wild bird supply store to pick up some seed. We got to talking with the shopkeeper and we asked her about the sudden disappearance of all the smaller song birds in the area. Where we used to get flocks of robins, finches, titmice, bluebirds and juncos, now we saw absolutely nothing. Not a one in the birdbath. No one on the feeder.

She said, “That’s odd. Maybe you have a predator?” I hadn’t seen anything, but I yielded the possibility. We are, after all, in the foothills of a large mountain and federal land.

The next day while driving home I saw something bizarre: a young hawk standing in front of our house by the edge of the road. I thought it was a hawk, anyway. I stopped the car and the bird looked at me with utter indignation and tried to fly away.

Instead he flopped. His wing was broken. I ran into the house, yelled for my husband to come out with a towel and leather gloves. I said, “Don’t ask, just hurry.”

It was getting dark and I knew if we let him stay there, by morning the coyotes would have found him. Or he would soon die of the pain, an infection or starvation.

We ran after him a little while and finally managed to throw the towel over him. My husband picked him up and we held him in one of the dog crates, covered, until we got in touch with a friend who’s not only a medic but a top-notch expert on raising birds of prey. When we brought the bird to him, he looked at it and exclaimed, “It’s not a hawk. It’s a kestrel. He’s a full grown falcon!”

It was a joyous relief to learn the next day that he’d been handed over to a rehab, Talking Talons, for surgery and hopefully release back into the wild. So, the birds have started returning.

But it is all such a frail thing; it all hangs in so precarious a balance. For them to come back, one kestrel had to be severely wounded.

I am no great mystic. I understand relatively little about how things are the way they are. But I have learned a few things that help me to observe truly and keep my center. The most important one is the simple knowing that if the world is indeed fallen, there was a fall. And if there was a fall, there was a place, a higher place from which it fell. That means that it was created to be quite different than the way it actually is and that it can—and will—be restored to its proper condition, as God intended.

This I do believe—we all, the falcon, the small birds, the Boy on the Train, and all that suffer will one day be redeemed and made new. There will be no balance beam to totter along, no “ironies” of natural law, no struggle to make palatable that which is intrinsically intolerable, no need for philosophical pockets big enough to hold the suffering of the innocent.

One day, the debate will be over. The train will be made to set right on the tracks again. In my mind I hear some of the last words of the last book of the Narnia series when the battles are all over and Lucy, Edmund and Peter stand at the end of all they have known, before all they have ever hoped to know: “Welcome, in the Lion’s name. Come further up and further in!”

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(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.

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It happens with Hummers, with houses, with degrees of “handsome” and with holiness. People will even huddle around their own humility, if you can wrap your mind around that one. I know at least one person who not only announces how humble she is, but attests to the humility of all those she associates with.

When we “huddle” like that or use a quality or item as a source of pride and superiority, we are simultaneously shaming others, whether we intend to or not, whether we are even conscious of it or not. When I googled "snob" I was rather surprised to see how many websites (millions) were snob sites. There were cigar snobs, brew snobs, bag snobs, pot snobs, coffee snobs, and beauty snobs. There were snob snobs, which I took to mean people who were snobs about being snobs. There were so many levels of elitism, I lost count.

But the essence of it goes like this:

I have a Hummer. Hummers mean success. Success means I’m favored. Being favored means I’m better. Better than who? Better than you. Why? Because you don’t have a Hummer. (And if you do, I’ll find a way to make my Hummer bigger, better, and badder.) This can be done alone or in a group. Just take out the “I” and substitute a “We.” It’s the way most problems are started in the world as much as in the playground.

So…speaking of playgrounds…

My colleague came in to the office the other day shocked and dismayed by what he heard transpire between his young granddaughter and an older, obviously way more sophisticated nine-year-old girl.

“Look at what my grandpa got me,” the little one said, happy to be in her soft, fuzz-lined boots.

The nine-year old looked her up and down. (Can nine-year-olds watch Desperate Housewives?)

“My grandpa got it for me for Christmas!!!” Her joy was palpable. There was no pride, just a fuzzy delight. “They’re UGGS!”

The nine-year-old pursed her lips in disapproval and said, “Those aren’t real UGGS. I’ve got real UGGS. Yours are fakes.”

Then she pivoted and walked away, leaving a little girl confused and deflated.

Why did the nine-year-old do that? Because someone had shown her how important it was to have the “right” label. Someone had instructed her already—by the ripe old age of nine—how to have pride in a thing that meant literally nothing. Someone had given her the ability to attach her sense of self to an article of clothing, a pair of boots, to make her image more important than her integrity, rightness of being, her compassion, or her relationships.

My husband is a musician and he sees a fair cross-section of people when he plays in clubs and public forums. Recently, after a gig in another state, he told me about a group of 20-something men and women who had paid fairly good money to be seated at a table near the stage. Every single one of them had their face lit up green by their palm pilots (or whatever they’re calling them this week). Not one of them was listening to the music. Not one of them was in actual communion with anyone else.

I have been a psychotherapist treating trauma and anxiety for more than 25 years. I have been teaching Verbal First Aid and therapeutic communication for almost 20. I have seen many forms of emotional fragmentation. I have seen pained children and lost parents, angry spouses and lonely ones. The world is no stranger to suffering.

But something that is happening now has not happened before. While we are physically closer in proximity than ever before, we are less—far less—connected to one another. The trend is a disturbing one: It is as if our own manifest destiny were a version of a microcosmic “big bang.” Post-boom, western culture is moving out like a speeding centrifuge, pushing itself further out to the edges, farther away from each part of itself, leaving its center empty.

If, as it’s said, nature abhors a vacuum, that emptiness has to be filled by something. If we are wise, that emptiness gets filled by God and we are released back into communion, re-centered, and freed. If we are unwise, we buy more and more Uggs so we can lord it over little girls who wear other-than-Uggs and buy into the delusion that it somehow makes us better. We are then pulled by those forces farther and farther away from the only things that really will make us better. Each other and God.

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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.

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Husband of Deanna

21 Roadrunner Trail

December 25, 2009, Christmas Day

Yesterday, Christmas Eve, at around 9:30 in the morning, my husband, Dave, went to go run some errands. At around 9:35 he called from down the road, his voice thick. He was weeping. “Burt died,” was all he could say.

Burt lived across the street. He was 59. He was a master gardener, a kind soul who really did look like Santa Claus, a biker with a heart as big as his Harley, and a classically good neighbor.

We were not close friends, but something about his sudden passing hit us both hard, particularly my husband. He came back to the house and we spoke for a little while outside.

He told me that he’d met Vinnie and his wife, neighbors from down the street, who had told him that Burt had a heart attack and died on Christmas Eve morning at around 4:30 a.m. I'm a psychotherapist and I hear an awful lot of difficult and often very sad things. But this left me speechless and stunned.

“I was up at 4:30,” Dave said vaguely. “I couldn’t sleep.”

“Did you hear something?” I asked.

“No, more like felt something,” he said.

Over the years, I’d come to respect his “feelings” that way. He was uncannily sensitive. When we spoke later, we tried to understand what had upset us so much. And we came to see that it was not about what will be missed as much as what was missed.

“I lost a friendship that was in the bank,” Dave said. “He was a friend that I never really enjoyed. There was always something that got in the way, some work, some errand, some weather, something. The ride we were gonna take together was always pending. And then it was gone.”

We had just gone to a neighborhood Christmas party together. Burt approached Dave in the room set aside for the bar and had, in typically generous fashion, offered some help with a kiva problem we’d been having. He had been thinking about it (without even being asked) and believed he had found a solution to putting in the grill we’d been struggling with. Dave was fielding another conversation and felt bad separating himself from the other fellow. So, noticing that Dave was a bit socially torn, Burt graciously said, “Well, I can see you’re involved in another conversation. We can talk about it later.”

He died within a few days. There was no later. We never got to hear his ideas. Burt was a clever, industrious, kind-hearted man who would do anything to help a neighbor. He was also very humble. He had the most beautifully sculpted Southwestern garden we’d ever seen and every day as we walked our dogs past his house, there he’d be, hip deep in sand and prickly pear, turning something ordinary into something unique. And every time we told him so, he’d just laugh and say, “I just like playing in the dirt.”

Burt, we would like to have said many more things to you, heard many more things from you, seen what you would have created with that garden in the next few years, watched what you did with that beard as it reached your belt buckle, taken a ride or two with you and your wife and seen where we would’ve wound up. We can’t pretend to know the grief and sorrow your family must be feeling right now and  we can’t imagine how big the hole your passing has left in the lives of those who knew you well and loved you deeply.

We don’t know the divine plan, but in our time you were taken too soon, way too soon.

I think most eulogies, most deaths, most losses are about that—opportunities or conversations missed, things not said, times not had. They are often reminders that the clock is ticking, the hour is near and the opportunities are passing as we sit, busy with things that we think we must get done at the expense of the only things that count.

We salute you, Burt, as you ride down the ever-winding road to pastures more perfect than any garden we can ever create here, to conversations more illuminated than any we can conceive on this earth, to opportunities always fulfilled and a soul always satisfied. You—and all those rides we might have taken together—will be sincerely missed.

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