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
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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
Why
not share with a friend Mail Link to a Friend
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
Why
not share with a friend Mail Link to a Friend
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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