A RETURN TO THE POWER OF CARING

Created by Steven Warren & Wendy Mason.
Contributors Don & Anna Factor, Gill Edwards, Ruth Sewell.

Publication Date June 2016

 

You can listen to the recording of the seminar held in 1989 for free here on this website by simply visiting the dedicated recording page by clicking here.

When I met with Don and Anna through a mutual friend, Wendy Mason, in 1988 at their home here in England we sat and talked in the garden whilst we drank tea.

Wendy knew of my work with both the dying and those facing potentially life threatening illness. I had started working in primary care as a psychologist and counsellor at the beginning of the 1980's and, as a result of meeting Don and Anna they were able to consolidate the observations I had made in my clinical practice from their own heart warming experience of the power of caring in their lives as a result of Don's apparent terminal cancer diagnosis from which he recovered to full health.

There were many lessons which were explored and as the seminar progressed I was able to share my own clinical experience in psychotherapy and counselling with individuals, family members and friends growing awareness of another powerful and yet essential growing awareness.

Don and Anna had discovered that they needed to find who they really were and what they really wanted both from their own lives as well as the life that they 'shared' together in their marriage. That Don's health and recovery from illness was not just the doctor and medical teams responsibility and that in journeying through recovery both Don and Anna recognised the power of their caring for themselves and others if only we connect with our True Self.

For me there was an affirmation in exploring with Don and Anna their own personal journey. I had made similar journeys both with the clients I had been working with since 1980 as well as the journey I had progressed with my partner when they were diagnosed with lung cancer a year before and their death some four months after such a diagnosis.

As one colleague and contributor to the original seminar, Dr Sewell said to me 'Steven, you were twenty five years in advance. So now time to recreate what you so skillfully created back in 1989 to share with people once again.'

Now, in 2014, as I prepare to release the seminar content I reflect back over what is nearly 25 years or working at the next stage which we all focused on when we gathered for The Power of Caring in May 1989.

As with most 'truths' the core concepts remain and in the last twenty six years more doctors, healthcare practitioners as well as patients and their families know about the power of emotion and subsequent thoughts on both remaining healthy as well as recovery from illness.

 

I, by 1989, had worked for over seven years at this time with people who were dying, those who were bereaved and others facing both chronic as well as life threatening illness. Such work had shown Steven how the Power of Caring was the crucial factor in helping people to both recover from, cope with and in many cases prolong their lives.

Modern medicine contributed to their care but Steve had witnessed another important factor at work, the power stemming from a crisis in their lives to connect with their true self.

At this time modern scientific research was beginning to confirm what had been known from old wives stories, that the human mind and heart played an important role in releasing the individuals own healing potential but only as long as that individual was given the right circumstance, support, encouragement, care and love.

Don focuses on the often painful but illuminating process which he went through with the support of his wife Anna to reach a point where he could begin to go beyond the 'death sentence' he had received and progress to believing that he could heal from his diagnosis.

We hear from Anna as she explored a powerful journey within herself for as she said "The primary issue that I realised when Don was sick without knowing quite how sick was that whatever method he chose for healing he needed support with it and needed to trust himself that he had a clue what was going on and what was the best for him and we talked a great deal about what he might do'

For Don, as he says, "The one thought that I have come away with from this whole experience is a deep conviction of how the psychological come spiritual side of serious illness and in my case cancer is far far more important than is usually credited.

Don clearly expressed how what had been an academic study of psychology and the spiritual in his life before his diagnosis now became a heart felt understanding at every level of his being and that in some way he realised how a cancer diagnosis was for him the only turn key of sufficient power to enable him to move to the next stage of his life. He explored firstly his new found relationship with self and how this impacted on his relationship with his wife Anna and then to all the people who were important in his life. However, the emphasis had to be on his relationship with self and subsequent self expression from such a new found perspective.

In the afternoon session Steven invited his colleague and friend Gill Edwards to expanded on the medical and scientific viewpoints to rapidly include her work in the holistic field. Followed by Ruth Sewell who was, at the time, Marie Curie Foundation Nurse Tutor specialising in cancer management and in her session she focused on the key elements needed to be present in order to rehabilitate and maximize a persons potential as a result of illness and adjustment to their changed identity and status. In this book we explore the main factors to provide a foundation for such adjustment.

When someone is ill we support and empower them by 1- providing the power of choice which fulfills emotional needs and involves the power to make decisions, express who they are as an individual and choice over the life during this time period to express and demonstrate their abilities.
2 -
Love for the person with an illness to still be able to freely give and receive love as well as warmth and affection along with appreciation and support.
3 -
Control, to be able to exercise control in their lives at all levels which means feeling able to express what they do and not want and to see that people respect their wishes by fulfilling such wishes. For, if these key elements are not fulfilled then fear and stress may result which has been shown to compromise our natural healing and ultimately can influence the treatment in terms of such and eventual outcome.

Steven then concludes with a clear and detailed reflection on how this approach has progressed over the last twenty six years.

UPDATE By following this link you can listen to Don talking about his return to The Oasis of Hope Hospital - filmed in 2008, and his reflections over twenty years after his recovery from life threatening cancer.

 

Ebook Version ISBN 978-1-908587-53-1

 

Order through by following links to: Amazon UK Amazon USA Lulu Publishing Barnes & Noble Waterstones

Print Version ISBN 978-1-908587-53-4

Order through following links to: Amazon UK Amazon USA Lulu Publishing Barnes & Noble Waterstones

Audio Book Version - Release at the end of June 2016.

In addition you may be interested in contributors to the book which featured Don's case history entitled ' The Heart of the Healer'

Reclaiming the Spirit of Healing by His Royal Highness Charles, Prince of Wales

The Wounded Healer by Larry Dossey

 

Reclaiming the Spirit of Healing

by His Royal Highness Charles, Prince of Wales

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This chapter taken from 'The Heart of the Healer' *(1) (pages 9 to 13) is based on a speech given to the British Medical Association on the 14th of December 1982.

"I have often thought that one of the less attractive traits of various professional bodies and institutions is the deeply ingrained suspicion and outright hostility which can exist towards anything unorthodox or unconventional. I suppose it is inevitable that something which is different should arouse strong feelings on the part of the majority whose conventional wisdom is being challenged or, in a more social sense, whose way of life and customs are being insulted by something rather alien.

I suppose, too, that human nature is such that we are frequently prevented from seeing that what is taken for today's unorthodoxy is probably going to be tomorrow's convention. Perhaps we just have to accept it is Gods will that the unorthodox individual is doomed for years of frustration, ridicule and failure in order to act out his role in the scheme of things, until his day arrives and mankind is ready to receive his message: a message which he probably finds hard to explain, but which he knows comes from a far deeper source than conscious thought.

The renowned sixteenth century healer, Paracelsus, was just such an individual. He is probably remembered more for his fight against orthodoxy than for his achievements in the medical field. As a result of his unorthodox approach to medicine in his time he was equated with the damnable Dr. Faustus.

Of the barbers, surgeons and pharmacists, he complained that "they begrudge the honour I won healing Princes and noble-men and they say my powers come from the devil." And yet in his day and age he was criticising abuses among pharmacists and attacking the quack remedies - viper's blood, "mummy" powder, unicorn horn and so on.

In 1527, by an act of which I am sure today's younger doctors would be proud, he burnt the famous textbook of medieval medicine, the Canon of Avicenna, which became a symbol of rebellion against pedantry and unthinking acceptance of ancient doctrines.

But what kind of man was Paracelsus? A charlatan or a gifted healer? In my view he was far from being a charlatan. We could do worse than to look again briefly at the principles he so desperately believed in, for they have a message for our time: a time when science was tended to become estranged from nature and that is the moment when we should remember Paracelsus.

Above all, he maintained that there were four pillars on which the whole art of healing rested. The first was philosophy; the second astronomy (or what we might call psychology): the third alchemy (or bio-chemistry), and the fourth, virtue (in other words the professional skill of the doctor). He then went on to outline the basic qualifications for a doctor: "Like each plant and metallic remedy the doctor, too, must have a specific virtue. He must be intimate with nature. He must have the intuition which is necessary to understand the patient, his body, hid disease. He must have the 'feel' and the 'touch' which make it possible for him to be in sympathetic communication with the patient's spirits."

Paracelsus believed that the good doctor's therapeutic success largely depends on his ability to inspire the patient with confidence and to mobilize his will to health. By the way, he also recommended chastity and fasting to heighten diagnostic sensitiveness and to intensify one's hypnotic power.

I know that there are a considerable number of doctors, who operate by these kinds of basic principles, because several have written to me, but nevertheless the modern science of medicine still tends to be based, as George Engel writes. "…on the notion of the body as a machine, of disease as the consequence of breakdown of the machine." By concentrating on smaller and smaller fragments of the body, modern medicine perhaps loses sight of the patient as a whole human being, and by reducing health to mechanical functioning it is no longer able to deal with the phenomenon of healing.

And here I come back to my original point. The term "healer" is viewed with suspicion and the concepts of health and healing are probably not generally discussed in medical schools. But to reincorporate the notion of healing into the practice of medicine does not necessarily mean that medical science will have to be less scientific.

Through the centuries healing has been practiced by folk-healers who are guided by traditional wisdom that see illness as a disorder of the whole person, involving not only the patient's body, but also his mind, his self-image, his dependence on the physical and social environment, as well as his relation to the cosmos.

Paracelsus constantly repeated the old adage that "Nature heals, the doctor nurses" - and it is well to remember that these sorts of healers still treat the majority of patients throughout the world. Some of them, in the form of black Christian bishops in Africa, are subjected to the most appalling kind of misinformed abuse and censure, which so characterized the worst elements of missionary activity among populations whose childlike acceptance of the symbols of life and of nature is one of their most endearing qualities.

I would suggest that the whole imposing edifice of modern medicine, for all its breathtakingly successes is, like the celebrated Tower of Pisa, slightly off balance. No one could be stupid enough to deny the enormous benefits which the advances of medical science in this century have conferred upon us all. To take only one example - penicillin administered in a case of infective heart disease leads to survival in an illness otherwise uniformly fatal. Anyone who has had this kind of experience is likely to be a powerful supporter of modern methods in medicine, but nevertheless the fact remains that contemporary medicine as a whole tends to be fascinated by the objective, statistical, computerised approach to the healing of the sick.

If disease is regarded as an objective problem, isolated from all personal factors, then surgery plus more and more powerful drugs must be the answer. Already the cost of drugs supplied to patients by the British National Health Service alone is well over £2,000 million [U.S. $3,500 million] a year. It is frightening how dependent on drugs we are all becoming and how easy it is for doctors to prescribe them as the universal panacea for our ills. Wonderful as many of them are, it should still be more widely stressed by doctors that the health of human beings is so often determined by their behaviour, their food and the nature of their environment.

The last word on this subject remains with Paracelsus, whose name should be synonymous with the common health. He hoped to show, above all, that the "light of Nature" was in the hearts of men, not in books. With all the conviction of a man who follows his inner voice he made a desperate supplication that "would we humans knew our hearts in truth, nothing on earth would be impossible for us."

REFERENCES

[1] The Heart of the Healer With Prince Charles, Norman Cousins, Richard Moss, Bernie Siegel & Others.
Edited by Dawson Church & Dr. Alan Sherr Aslan Publishing New York, New York Mickleton, England 1987 ISBN: 0-944031-12-9

The Wounded Healer by Larry Dossey

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This chapter taken from 'The Heart of the Healer' *(1) (pages 61 to 73) is based on a speech given to the British Medical Association on the 14th of December 1982.

*(2)


"Although life is an affair of light and shadows, we never accept it as such. We are always reaching towards the light and the high peaks. From childhood...we are given values which correspond only to an ideal world. The shadowy side of real life is ignored. Thus [we] are unable to deal with the mixture of light and shadow of which life really consists; [we] have no way of linking the facts of our existence to [our] preconceived notions of absolutes. The links connecting life with universal symbols are therefore broken, and disintegration sets in."

- Miguel Serrano C.G.Jung and Hermann Hesse: A Record of Two Friendships

"In the treatment process, something happens to the clinician as well as to the patient (e.g., fear, distancing, anger, frustration, joy, satisfaction, etc.) Frequently, [there occur] defensive maneuver's on the part of the clinician to avoid confronting the emotions and memories which the patient evokes...in the clinician. In shutting out a part of the patient, we also close off access to an important part of ourselves. We can grow emotionally (if painfully) with our patients...if we can see beyond surgical 'repair', patient 'compliance,' or drug 'efficacy.' Not that these latter are unimportant; but what whole are they a part of? What happens to us is as important as what happens to our patients. Indeed, what we allow ourselves to experience, both in ourselves and in our patients, decisively determines our diagnostic procedure, assessment of etiology, determination of prognosis, and formulation and implementation of a treatment plan. The philosophical and psychological question is not whether we will use ourselves in the clinical encounter, but how. This axiomatic in all medicine."

- Howard F.Stein

"To say 'Thou' to a patient, and mean it, one must be able to utter 'I' to oneself. One can then stand with his patient, because he can stand alone with himself. This is the essence of medicine, of therapeutic communication, of life.

- Howard F. Stein

"Eliade s

One of the greatest obstacles in understanding how health and illness form a unitary fact of our existence, how illness is as necessary as health in our lives, is our tendency to ignore life's darker side. In matters of health we focus only on the light and the high peaks, cringing from pain, suffering, and illness. We ignore these ignoble aspects of existence until we confront them in start and undeniable ways and can no longer run from them. They may surface as illness in our own particular life, or in the death of a friend. But following the anguish we continue to attempt the impossible, to banish them from existence, looking only to the light. Yet is a futile task.Deep within us we know we have a created a lie and that sooner or later the next confrontation with the shadowy side of life must inevitably occur.

I am not proposing that we renounce optimism about our own health and revert to a morbid disposition wherein we continually dwell on our inevitable decline and demise, for this is extreme is as one-sided as its opposite. I am not suggesting that physicians cease to hold out hope to those who are ill, assuring them instead that they must inevitably die - if not this time, then perhaps the next. I am proposing instead that we simply cannot have it the way we want it, for the simple and plain fact that light is not found without shadows, nor health without illness.

To suppose otherwise is to live a fantasy, a make-believe wolfed. And to fail to acknowledge the dark side of health actually diminishes the healthiness we do feel- for it takes energy to live a falsity; it is draining to attempt to keep the lid on the pot of grimness. We pay a penalty for supposing that there is only the light, and the penalty is that the intensity of the light, our healthiness, is diminished.

The Myth of the All-powerful Physician

One of the most curious traditions that has persisted in modern medicine is the tradition of the all-powerful physician. This belief is pathological because it is a distortion to the grossest degree. It is a belief that endures because it fills a need - the need of the patient to deify his healer and to imbue him with superhuman abilities, and the need of certain physicians whose egos need the fantasy to continue. As long as the patient has a god-like figure looking after his welfare. Things are safe. Any self-responsibility he might need to invoke on his own behalf to be healthy is minimized, for with an all-powerful physician at hand he is secure. After all, gods can "fix" anything. No matter the degree to which my health might fail, my physician-as-god can set it straight. And it is not surprising that many physicians do little to disavow the show to go on rather than acknowledge their own limitations and ignorance.

This mutual participation by both doctors and patients in the myth of the all-powerful physician is one way in which we hide from the shadows. We need not acknowledge the dark side of illness and suffering as long as we have a god-healer at our disposal. True, illness will one day occur; but the mythological, god-like healers will summarily sweep it aside when it does supervene as if it were little more than a nuisance and a bother. With gods as our healers there is nothing but the light. The valleys and the shadows can be ignored.

The greatest healers, however, do not participate in this myth. They sense their own limitations as surely as they know their strengths. They know, too, the necessity of illness in human life and its dynamic interrelatedness with health. For them the light and shadows are both essential ingredients of healthiness, and they do not attempt to ignore one in favour of the other.

The Myth of Chiron

Nowhere is the intrinsic fusion of health and wellness more vividly illustrated than in the Greek mythological figure of Chiron, whom the birlliant contemporary mythologist Carl Kerenyi calls the wounded healer. Chiron was a centaur, half man and half horse. According to myth, the hero Heracles was received by the centaur Pholos at his cave. He was presented with a jar of rich wine, the scnet of which attracted the other centaurs. Unaccustomed to the wine, the centaurs began to fight; and in the battle which followed, one of the arrows shot by Heracles wounded Chiron in the knee. Following the instructions of Chrion, Heracles tended to the wound, but because the arrow's tip bore the poison of the hydra the wound was incurable. Chiron thus could not be cured nor could he die, since he was immortal. He is an enigmatic figure: immortal but wounded, carrying within himself te godlike and the mortal at the same time.

From Mount Pelion, the site of his cave, he received and taught heroes their craft. Among them was Asclepius, who learned from Chrion the knowledge of herbs and power of the snake. Yet Chiron, the greatest teacher of medicine, ironically could not heal himself. This was part of the widsom which Chiron passed to Asclepius, the wisdom embodied in the wounding of the great healer.

Physician and Teacher: An Intimate Relationship

The etymological meaning of the word 'physician 'is' teacher and association symbolised powerfully in the relationship between Chiron and Asclepius. Robert J. Sardello, the psychologist and writer, has drawn attention to the similar role of the teacher and the healer. In his penetrating treatise, "Teaching as Myth," his observations about teaching have the strongest relevance to the role of the physician:

"Our teaching often does not resemble that of this greatest of mythical teachers, Chiron. As long as a teacher stands totally in the light, stands as one who knows, facing those who do not know, the teacher remains unaware of his own woundedness and does not participate in the learning enterprise. An original and originating image of teaching is split radically into two parts as long as the teacher imagines himself as one who knows and the student as one in need of instruction. The student must stand in total darkness if the teacher stands totally in the light. Such a split image identifying teaching with knowledge and learning with ignorance can be maintained only through power. This attitude is like that of the physician who believe that he does the curing rather than being the occasion through which curing comes as a gift. And like a physician, such power so maintained by authority, by speaking in jargon, presenting oneself as a specialist and seeking professional status." (3)

This is a grotesque view of teaching, a dehumanizing, in-human scenario which places on human in a domination over another who becomes the inferior supplicant. It is the role all too often enacted in the doctor-patient relationship. The physician forgets his own woundedness, his own imminent or potential sickness, his own inexorable death. He is willing to be elevated by the patient to the role of the god0like. The error occurs on both the parts of the physician, renouncing his own fallibility and woundedness in favour of deification, and the patient, who creates a god and claims him for his own private healer.

It is frequently supposed that this type of relationship is actually desirable, for from his position of ultimate respect and admiration the physician can motivate the patient to make certain changes, to follow advice, to have surgery, to take medications, etc. Nothing is lost if the all-powerful, glorified, and edified physician uses his power benevolently. If the patient's best interests are kept in the foreground, this type of relationship can be tremendously therapeutic, it is alleged. It does no good in this scenario to remind the physician of his own woundedness, for it is power that counts in this relationship, not weakness. Why, if the patient actually felt his physician to be 'wounded' he would lose respect. After all, who wants his physician to be compromised in some way? It is best to let the concept of the wounded healer remain in mythical lore.

I believe that this kind of relationship, in spite of the fact that it is frequently preferred by both doctors and patients, is sadly off base. It perpetuates the idea that woundedness is abhorrent; we especially must not speak of it in healers; it is only power and health that count. The interconnectedness of health and illness in human lives goes unnoticed. It might be argued that we hold onto object to this sort of doctor-patient relationship if it were highly effective. But here is the point on which it most miserably fails: it simply does not work therapeutically as it outhit. We must now see why.

The Doctor-Patient Relationship: A Living Archetype

The Jungian psychiatrist Adolf Guggenbuhl-Craig has described the doctor-patient relationship in a provocative way. In his book, Power in the Helping Professions, he states:

"The 'healer-patient' relationship is as fundamental as is that of man-woman, father-son, mother-child. It is archetypal, in the sense expounded by C.G. Jung; i.e., it is an inherent, potential form of human behaviour. In archetypal situations the individual perceives and acts in accordance with a basic schema inherent in himself, but which in principle is the same for all men." (3)

The doctor-patient relationship, then, is contained within nature. It is primordial, something inborn, an innate behaviour seeking expression in the appropriate circumstance. It is called forth when we are sick, injured, or about to die. At those times we look to healers as much as a mother looks to her child. At such times we are duplicating behaviour of countless members of our species who have looked to their own healers, persons who have had names other than 'doctor': shaman, curandero, witch doctor. To look to the healer during times of affliction is as natural as seeking food or water.

On the surface, archetypal behaviour seems simpler than it is. It seems as if, for example, the mother is simply reacting to her child, an object 'out there.' A woman responds to a man, who is himself an object apart from her. Patients respond to healers who, too, are objects possessing some fundamental status of their own distinct from that of the patient. But the basic situation is more complex. Every archetypal situation contains a polarity - that is, both poles are contained within the same individual. To reiterate, as Guggenbuhl-Craig says, "Each of us is born with poles of the archetype within us." And, "...in human psychology as we know it, both poles are contained within the same individual." [4]

This is a crucial point because it flies in the face of our ordinary concept of the doctor-patient relationship. We suppose that on the one hand there is the healer, and that on the other stands the patient, who is little more than a passive object to whom and for whom certain things are done. But the concept of archetype tells us that this way of thinking is misconstrued. It suggests that a polarity exists within both individuals that constitute the archetype, the healer and the patient. It suggests in no uncertain terms that the patient contains something of the healer within his being, and that the healer is simultaneously the patient as well -- containing, as it were, his own woundedness.

Guggenbuhl-Craig clarifies how the polarity of the archetype operates:

"A child awakes maternal behaviour in its mother. In the psyche of every woman there is the inborn personality of motherly behaviour within the mother-child situation, which in some mysterious way must mean that the child is already contained within the mother, somewhat in Goethe's sense when he wrote: 'Did our eye not contain sun's power, how could it perceive the sun at all?" Perhaps we should not speak of a mother archetype, a child archetype or a father archetype. It might be better to talk of a mother-child or a father-child archetype." [5]

Extending these analogies to the doctor-patient relationship there is, then, something of each in both: the polarity of the healer and the one-to-be-healed are contained within the healer and the patient, and there is, in fact, only a single archetype which embraces both doctor and patient, not a different archetype for each.

Why bother to struggle with formulations such as these? What difference does it make what ancient mythology has contended about 'wounded healers,' or what Jungian psychological theory asserts about arcane constructions such as archetypes and polarities? It is my belief that there are a few things more important in modern medicine than that we get these issues straight -- far more important than, for example, setting up a Manhattan-type Project to search for 'the cure' for cancer, heart disease, or any malady whatever. Unless we understand such basic notions as how we ourselves, patients and physicians, are constituted at heart, all subsequent attempts at healing will, in some sense, fall short, and all apparent cures will be nothing more than counterfeit. We will continue to flail about in medical research and in clinical medicine in our endless attempts to banish the shadows and retain only the light, or attempt to fill in all the valleys in our lives while retaining the peaks. It will not matter greatly whether we actually do find 'the cure' for whatever affliction, for, without a sure knowledge of how we are constellated, we will never know even who it is that has been cured, not who it was that did the curing.

Yet what does it mean to say that both poles of the archetype exist within the physician and the patient? The statement need not be defended simply through metaphor or psychological theory. It can be taken literally, and it can be described in strictly scientific terms. Let us consider that the sick person contains his own healer. What is the proof?

The Inner Healer: More Than Myth

Examples could be endlessly produced, one of which is the careful study of Jerome Frank, at Johns Hopkins Medical School. [6] Frank studies the speed of healing of surgical wounds in the immediate post-operative period. He found that those patients healed fastest who had faith, trust and confidence in the surgeon and the nursing staff. On the other hand, slower wound healing occurred in those patients who did not trust their physicians, and who were reluctant and afraid. This type of study goes beyond the metaphorical use of the term inner healer, and relates the concept to something as concrete as the healing of actual surgical wounds. The end point is measurable: The inner healer is something inward, who effects are quantifiable. As such, it is not just a topic that must be dealt with by mystics and philosophers, but it is a fit concern for bio scientists as well. It is important to point out, for we must constantly remind ourselves that we are not just speaking psychologically or poetically, but physiologically as well.

The polar expression, then, of the wounded healer who is mythically represented by Chiron, the centaur-teacher of Asclepius, is that of 'the healthy wounded.' The healthy wounded are all of us, for we all have within us the inner healing potential demonstrated in Frank's study. It is not for us to create, for it is there, existing inwardly as a force for healing as surely as there exists within us the capacity to fall ill. This is the polarity of the archetype which all men contain.

It is becoming recognised, through the best of medical research, that patients do have self-corrective, innate, inward, self-healing capacities. In a variety of disease states these so called 'factor of consciousness' - emotions, attitudes, feeling states of various sorts - have emerged as potent factors in healing. [6]

The Inner Patient

But the sword of the archetype polarity cuts both ways:

"It is not very difficult to imagine the healing factor in the patient. But what about the physician? Here we encounter the archetype of the 'wounded healer.' Chiron, the centaur who taught Asclepius the healing arts, himself suffered from incurable wounds. In Babylon there was a dog-goddess with two names: as Gula she was death and as Labartu, healing. In India Kali is the goddess of the pox and at the same time its curer. The mythological image of the wounded healer is very widespread. Psychologically this means not only that the patient has a physician within himself, but also there is a patient in the doctor" [7]

It is this concept that is much harder for healers to swallow, for it is an admission of an integral, inescapable weakness. The recognition of fallibility comes hard for many modern healers. And, not surprisingly, we physicians expend ingenious efforts to conceal this external fact. This dilemma, however, has been faced by healers of all times, not just our own, and is expressed by Guggenbuhl-Craig:

"It is not easy for human psyche to bear the tension of polarities. The ego loves clarity and tries to eradicate inner ambivalence. This need for the unequivocal can bring about a certain splitting of polar archetypes. One polarity may be repressed and continue operating in the unconscious, possibly causing psychic disturbances. The repressed part of the archetype can be projected onto the outer world." [8]

One of the most difficult admissions for many modern physicians, who have been schooled in an era when the medical credo is to do, to act, and to cure, is that of woundedness. It becomes more expedient to do something, sometimes anything, for which the doctor is frequently praised ("He was willing to take her case when no other doctor would: he was willing to operate in spite of overwhelming odds; no matter that Mother died, the doctor tried!"). It has become extraordinarily difficult in modern clinical medicine to do nothing. Doing nothing is taken too frequently as an expression of impotence, of fallibility. It is a reminder to the physician of something he'd rather forget: the fact of his own woundedness.

There are many physicians to whom the fact of their own woundedness is apparent, and they handle this knowledge with a grace that empowers them as healers. Yet others do not. And the unfortunate way that the inner fact of woundedness is too often dealt with is through projecting it onto the external world in an attempt to rid oneself of something painful. Far better that someone else should be wounded, weak, or fallible than I, so the rationalisation goes. And the object of the physician's projected weakness is all too often the patient, as the following incident illustrates.

The Story of Tom B.

Tom B. was taken to the coronary care unit of a major hospital after collapsing with chest pain and shortness of breath at home.

He was seventy-eight years old, had already sustained two heart attacks, and suffered from high blood pressure. Although he took his prescription medications religiously, he had been unable to stop smoking and lose weight, a fact which always irritated his doctor who never failed to remind Tom about it.

Tom's wife had called an ambulance immediately and then called Dr. Ponder, who said he would meet his patient in the emergency room. Upon arrival of both patient and physician at the hospital's emergency room, resuscitation efforts were continued, having been initiated by the paramedics who found Tom without any detectable blood pressure and with an erratic, ineffective heart rhythm. Finally, with intravenous tubing streaming from both arms, Tom was moved to the coronary care unit of the hospital with the diagnosis of acute myocardial infarction and congestive heart failure.

Tom's elderly wife remained in the background all the while: she didn't want to interfere. After all, Dr Ponder had rescued Tom on two previous occasions following heart attacks, and she had to believe he would do so again. Even though she was burning with a desire to hear from the doctor about how her husband was doing, she remained ubobtrusive, getting second hand bits of information from the nurses who were scurrying in and out of the room. She thought it odd, though, that Dr. Ponder has not time for her. After all, he had to know she was there, for it was she who had placed the call, telling him she was en route to the hospital with her husband.

An hour later, following her husband's transfer to the coronary care unit, she stood weeping outside the swinging doors that guarded its entry. Still no word. Then without warning both doors burst open and Dr. Ponder emerged, obviously very angry. My God, she thought,, why is he angry? Any emotion, she allowed herself to think, would be more appropriate than anger.

Fuming Dr. Ponder exploded, "Your husband is making this very difficult! He refused to cooperate with anything I do!"

Dr. Ponder stood there, glowering at her, his face flushed and diaphoretic, gripping a stethoscope in one hand. Mrs.B. she had to say something, anything, and through her tears she stammered, "Oh Dr. Ponder, please forgive Tom, I know he doesn't mean it!"

Dr. Ponder did not acknowledge the apology, but wheeled abruptly, disappearing through the double doors, still streaming anger behind him. Mrs.B never saw her husband alive again. Within an hour he was dead.

I fortunately do not believe most physicians behave in crucial situations like Dr.Ponder; this incident is related only as a classic example of how healers repress part of their own archetype (their woundedness, their weakness, their fallibility, their helplessness) and project it onto the external world where it frequently becomes the patient's weakness, not the doctor's ("He refuses to cooperate with anything I do!"). But the healer may project his own wounds in a more subtle way that did Dr. Ponder. For instance, it may not be the poor patient himself onto whom the physician projects his weakness, but the disease itself ("This is the worst case of high blood pressure I have ever seen in my career as a physician!"). In this case the patient does not answer for the doctor's weaknesses, but some impersonal entity called disease. This disease-as-enemy approach is very common. The doctor-patient relationship can constellate strongly around this common foe without either having to admit to the shadows within ourselves.

Another variation on the theme of how the healer avoids the recognition and admission of his own woundedness is by projecting the failure onto 'the system' - "We just don't have a cure for this problem yet." Here the scapegoat becomes the entire medical edifice itself, which has so far failed to produce a suitable remedy. It is not the physician who is weak. He is simply making-do the best he can, working with the tools at hand.

The Harm In Denying the Inner Polarity

I am not suggesting that there is not some justification to the occasional use of statement such as these. It is when patient and doctor actually begin to believe that these represent reality that great harm occurs. For when each denies the inner polarity of his own archetype, certain events predictably follow: for the physician, his own inner psychic processes are blocked; he sees a distorted view of himself and may begin to live a lie to his patients. As long as he persists in denying his own woundedness he cuts off from himself an essential part of his healing power, preferring to assuage his own ego rather than confront the shadowy elements that are a part of himself. He glues together this distorted view of himself with the element of power - personal power, his imagined notion of what healers should be like. He becomes a doer, for it is only through doing that he believes power can be wielded. This strategy transforms his patients into the recipients of his doing; and it is on 'the doing of the doctor' that cure and healing must hinge. He becomes a peddler of techniques; no matter that they are sophisticated expressions of biotechnology, they are techniques nonetheless. And not matter that they occasionally seem to work, as they indeed do. What has occurred is that a deeper, more profound potential for healing and wholeness has been sacrificed.

How? The patient becomes the sacrifice - for in projecting his own wounds onto the patient, the patient is further crippled. It is only the healer now who can save him through the incessant round of doing, of the endless wielding of techniques. The stage is set for the "fix it" mode of medicine that has become the hallmark of our day.

The physician is an easy target in our time, but we should not forget that this scenario could not go on but for the complicity of the patient. It is the patient who allows for doctor's strategy to be enacted. After all, it fulfils a need for himself, too - for by repressing his own power, his own 'inner healer,' the polarity of his own archetype, he escapes having to acknowledge that he is 'the healthy wounded.' He can project his own inner healing power onto the physician, whose job it then becomes to do all the work. It is an escape of responsibility that the patient has engineered. He has become the genuine article: the helpless, woeful, innocent person who is stricken down by illness which he cannot possibly control, and who must, therefore, look to the source of power, the physician, to cure.

Most doctor-patient relationships are constituted along these lines. When a physician and a patient come together who have repressed, respectively, their woundedness and healthiness, a silent bargain is struck. The physician unconsciously agrees to de-emphasize the inner power of the patient in bringing about his own healing ( he must reserve the power for himself, for it is only through this mechanism that he can disguise the fact of his own woundedness); and the patient silently agrees to not acknowledge his own power (to do so would create a responsibility for himself in getting well), not to point out the wounds of his healer(this would constitute such a threat that the entire relationship might crumble). In the context of such an agreement the average doctor-patient relationship limps along - sometimes working, sometimes not.

An Alternative Approach to Transform the Doctor-Patient Relationship

What is the way out? The admission by the physician and the patient of the murky shadows within each - the woundedeness of the healer and latent healthiness of the patient. Such a recognition would create the atmosphere wherein a new kind of healing could flower. It would entail no less than a radical transformation of the doctor-patient relationship.

"The image of the wounded healer symbolizes an acute and painful awareness of sickness as the counterpole to the physician's health, a lasting and hurtful certainty of the degeneration of his own body and mind. This sort of experience makes the doctor the patient's brother rather than his master...

In the final analysis [the physician] must always strive to constellate the healing factor in the patient. Without this he can accomplish nothing. And he can only truly activate this healing factor if he bears sickness as an existential possibility within himself. He is less effective when he tries to unite the two poles of the archetype through petty power." [9]

Thus a new vision of the doctor-patient relationship begins to take shape as both doctor and patient becomes attuned to the two poles of their archetype. The traditional hierarchical stratification wherein the physician is seen as a powerful master directing the inner workings of the body of the subservient patient is transcended. This does not mean that in admitting his own woundedness the physician must actually take on the illness, for this would be a sentimental perversion of the recognition of weakness. And it does not mean that the patient, secure with the awareness of his own inner potential for healthiness, must now seek out a healer. For this, too, is an improper and shallow conclusion. The healing relationship goes beyond hierarchy, wherein neither healer not the one to be healed stands about the other.

In the new context a basic humanism emerges, a quality that in the ordinary doctor-patient relationship is decidedly supressed. Robert J. Sardello has described the flowering of this humanistic quality in speaking of the proper relationship between teacher and student. Bearing in mind that the root meaning of the words "physician" and "teacher" is the same, Sadello's observations are keenly applicable to the doctor-patient relationship:

"When teaching and learning are imagined as a single action occurring for both teacher and student, a model of teaching more closely corresponding to the perennial pattern of the teacher is enacted. The teacher admits to being a student and students experience the desire to know awakened in their relationship with teachers. The teacher is touched by certain vulnerability, is reminded over and over again that there is much that he does not know. He is deeply touched by students, excited, frightened, shaken by them only when the teacher is a perpetual learner does a learner desire knowledge. Like Chiron, whose very name refers to the hand and has connotation of touching with the hand, working by hand, practicing a handcraft or art, the teacher who allows himself to be touched, touches in turn." [10]

As Sardello has described the teaching-learning experience, the new version of healing is that it is a 'single action.' Hierarchical differences, contingent on the wielding of power by one person over another, take a back seat. Power can be brought into play, but it does not flow only from the doctor to the patient. In full knowledge of the polarities within himself, the patient also uses power - this time on his own behalf, not content to let the doctor do it all. The appeal of the patient to the physician of "Fix it!" dissolves in the 'single action' of mutual effort.

This mode of interaction will suggest to some the impossible. How can healing possible occur as a "single action" unless a single person is involved? This sounds suspiciously like the mushy appeal to 'oneness' and 'sharing' and 'uniting' of the transpersonalist, who would have us, in effect, forget who we are, dissolving into some featureless relationship wherein one cannot tell doctor from patient or patient from doctor. We can't forget who we are and what we are, and this 'single action' mode of healing is nothing but words.

Yes the 'singleness' that we are speaking of is not a featureless blending of identities, a fusion of disparate qualities into some unrecognizable blur, but exactly the opposite. It is a mode of bringing about healing not through forgetting all the various qualities that make us who we are, but in acknowledging them. It is a new way of doing and being that becomes possible because we know all that we are. Because, we now sense within us the shadows as well as the light, we are empowered into a new existential set of premises which say something entirely different about how healers and patients can interact and about how healing can come about.

Lewis Thomas once observed that, instead of always emphasizing what we actually know in science, it would be enormously fruitful to focus alternatively on what we do not know. For it is here that the wonders lie. The known is the domain that is safe, where risk-taking is no longer necessary. to dwell in it forever is not only to never advance, it is also to promote a deceptive and false view of ourselves as knowing more than we do - of being more powerful than we really are.

I can conceive, too, that one day medical schools will emphasize not entirely the known, but a healthy dose of the unknown as well. It might give us not only a true picture of medical science, but also a truer vision of ourselves as well. It might remind us of something we have almost forgotten as modern physicians, and which we desperately need to remember: that first, and finally, and without exception, we are wounded healers.


REFERENCES

[1] The Heart of the Healer

With Prince Charles, Norman Cousins, Richard Moss, Bernie Siegel & Others.
Edited by Dawson Church & Dr. Alan Sherr Aslan Publishing New York, New York Mickleton, England 1987 ISBN: 0-944031-12-9

[2] This chapter is taken from Beyond Illness by Larry Dossey, (c) 1984. Reprinted by arrangement with Shambhala Publications, Inc.., 300 Massachusetts Ave., Boston, MA 02115

[3] Adolf Guggenbuhl - Craig, The Power in Helping Professions, Spring Publications, Inc., Dallas, 1982, p.89

[4] ibid. page 89

[5] ibid page 90

[6] Jerome Frank, "Mind-Boyd Relatioships in Illness and Healing," Journal of the International Academy of Preventative Medicine, 2:3 (1975), pp. 46-59

[7] Power in the Helping Professions, p.91.

[8] ibid.

[9] Power in the Helping Professions, pp. 97, 100-101.

[10] Teaching as Myth

 

 

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