Although this case was reported in a major medical journal, it was likely considered by most physicians as an interesting anomaly. This, despite the fact, that many similar reports can be found in the medical literature. It is ironic that we are so absorbed with miracles of another kind, modern technology, that we have lost trust, faith, and knowledge of the extraordinary healing powers of the human mind, body, and spirit. As we have invested in the miracle of technology, we have disinvested in the miracle of our humanness.
In this new age of scientific wonders, technology makes it possible for us to attain precise pictures of the inner workings of the human body, measure infinitesimal metabolic reactions, exchange organs from one person to another, grow babies in test tubes, and maintain physiologic life when all signs of human life are gone. Our approach to health and disease has resulted in diagnostic and therapeutic capacities that are unparalleled in human history. These achievements have enabled us to alter successfully the natural history of many diseases and to provide helpful treatment in others. Nothing can detract from these accomplishments. Yet scientific medicine is at its limits when confronting degenerative and stress-related diseases, which are more related to the way we think and live than to bacteria, viruses, and toxins. These problems of living cannot be analyzed under a microscope, cured with medicines, excised with a scalpel or eliminated through organ transplants. They cannot be reduced to biophysiology or comprehended by separate medical specialities.
Consider John's "medical problem." He is thirty-four years old. He came to my office with the understanding that I work with certain medical problems in a different way. For the past five years, he had been suffering with moderate symptoms from a disease called ulcerative colitis, a chronic, recurrent ulceration of the colon. He had been on a variety of medications, at times responding so that he was free of symptoms for many months at a time. Nevertheless, he continued to suffer with no permanent end to the problem in sight, even though he had received good medical care and was treated with proper medications.
The exacerbations and remissions of his illness were consistent with the medical understanding of this problem and with the acknowledged fact that there was no cure for his disease, only treatment. He had reached the limits of conventional medicine's capacity to improve his disease, and was instructed to use the medicines as needed and live with it as best as possible. That, however, was not good enough for John. He wanted to be healed.
In our meeting, I discussed with John the mind-body approach to illness and the effort it would require of him. I asked him if he would be willing to work with me in looking at his illness from a different perspective; a self-healing perspective that expands upon conventional treatment. He agreed. I explained to him that it would be helpful to use a relaxation technique, which clears the mind and allows access to hidden information stored in the mind, and mental imagery, which often assists in bringing this information to awareness. I instructed and guided John into deep relaxation. When I could observe through his breathing, complexion, and body posture that he had entered a relaxed state, I began the visual imagery.
I asked him to visualize an image of his colon as he imagined it would look.
"It is red, raw, and has ulcers scattered throughout," he stated.
Asking him to hold that image firmly in his mind, I then requested his patience as we began a magical, and, what may seem peculiar, conversation with his colon. "Ask your colon," I stated, "what it needs to tell you."
After several minutes he replied, "There is no answer."
I explained to him that talking to the colon in imagination is different from talking to a real live friend. He must wait quietly with patience, always in communion with this part of his body, awaiting the answer that may come in a verbal or nonverbal manner.
After several minutes of waiting, he stated, "It wants peace, quiet, and harmony." Anxiously, he then stated, "I am beginning to feel tense."
I asked him to stay with the feeling of tenseness and tightness and intensify it to increase his awareness of this feeling. "Ask your colon when all this tenseness began," I said.
His answer came surprisingly quickly. "Twenty five years ago."
I noted that his colon must have been very patient with him for all those years. Tearfully, he slowly began to access the important information hidden in his mind.
"We were not supposed to feel angry, express feelings, or disturb anyone. We were taught to be proper, pleasing.... I need to express my anger.... I need to be able to say no when I feel no.... I need to be able to express and care for my needs."
At this point, his agitation diminishing, he sighed with apparent relief, and slowly returned to a more relaxed state.
After several moments of quiet, I asked him to check with his colon to see if he had it correct.
"It says yes," he responded.
"Work out a contract with your colon," I told him, further explaining that this was a symbolic contract; a commitment to "listen" and respond to the physiologic needs of his body.
"I will work on these issues if my colon will be patient with me."
He opened his eyes, metaphorically as well as physically, and we planned the next few visits and the work ahead.
His disease could not be understood from either an exclusively physical or psychological perspective. An internist would have focused on his colon, a psychologist on his mind. Mind-body healing does not make this distinction. People do not come as parts.
John, intermittently disabled by his illness, had needed the treatment available through conventional medicine to reduce his symptoms and allow him to return to work and his daily activities. He wanted, however, more than treatment. He wanted to go beyond a reduction of his symptoms, he wanted to return to full health. As we will see later, John chose to begin a program of self-healing.
Treatment or Healing?
My medical school teachers never raised this question. I learned to treat illness: to match the right drug to a set of symptoms; to expect patients to comply with instructions and behave passively; to measure success by reduction in symptoms, results of laboratory tests, or duration of hospital stay. This was a technology of treatment using external agents or interventions, drugs, surgery, radiation, or physical therapy. There was no instruction in stress management, nutrition, or exercise— techniques for healing that use our natural capabilities; nor did it include the art of listening and learning about the individual being treated. Most notably, our instruction completely lacked any reference to the capacity of the human mind and body to self-heal.
As a young physician, I began my career at a large HMO. I soon became proficient at seeing many patients each day. As I gained experience practicing medicine, I discovered that conventional treatment, what I was taught in medical school, was ineffective at permanently relieving the symptoms I was treating. My patients were frequently returning with the same or related problems, most often resulting from stress and unhealthy life-styles. After several years, I began to feel overwhelmed, stressed, and fatigued from practicing a treatment oriented medicine that was working for neither my patients nor myself. So, I began to explore alternatives to the treatment model and soon discovered that treatment and healing were not the same. Attempting to sort through these issues, I began by clarifying the difference be between the two approaches.
Treatment is the use of an outside agent, or power, usually in the form of medication, surgery, radiation, or physical therapy, to manipulate the physical body with the goal of reducing or eliminating the signs and symptoms of disease. Healing is the use of the inner power and resources of our mind and body to restore our own unique balance and harmony. It is this balance and harmony that results in full health and gives us the ability to live lives of vitality and joy.
The sophisticated hard technology of treatment is a sharp contrast to the soft technology of mind-body healing. Consider the setting in which each occurs. Treatment is based in the doctor's office or a hospital, usually busy, loud, and intrusive environments. Healing requires solitude, a natural, comfortable, peaceful setting, and nonurgent time for self-reflection, learning, gradual change, and the experience of balance and harmony.
By emphasizing the expertise of the physician in matters pertaining to health the treatment model delegitimizes the essential role of the individual in his or her own healing. This results in the loss of selfhealing skills and, even worse, a lack of awareness that there is more to health than the absence of the signs or symptoms of illness. In this manner, the treatment model may at times, in the long term, place the individual at an increased risk for illness. In contrast, the healing model views the individual as central to his or her healing, and aspires to a broader vision of health and well-being.
Treatment is expensive, invasive, and often rife with side effects that, at times, may be worse than the disease being treated. Healing requires the commitment and willingness to allocate time to oneself and to give priority to full health. It is self-directed, natural rather than imposed, and, unlike some effects of treatment, the effects of healing can only be positive.
As treatment is directed at the reduction and elimination of symptoms, and infrequently at actual cure, healing is directed at mobilizing the mind and body to enhance the natural defenses, accelerate recovery from illness, and promote full health. It is directed at the early, subtle, and fundamental sources of distress that lend themselves to selfregulation. This includes the following: 1) emotional distress resulting from unresolved and unhealthy feelings of powerlessness, deprivation, loneliness, and inadequacy and 2) unhealthy behaviors and life-styles. These early warning signs of imbalance are precursors of mind-body stress that, inevitably, when unheeded, lead to overt disease.
These are not exciting and dramatic issues that call upon trauma centers, intensive care, and the technological mastery of organ transplantation. These are soft issues that, when unabated over time, can be the cause of profound physiologic disturbances that may set the stage for the future breakthrough of illness. Yet, even though waiting until illness presents itself at a late stage is the most expensive form of medical care, crisis care continues to be our exclusive approach to health and disease.
The urgency of crisis, when illness has reached a level of severe mind-body imbalance, requires treatment. This is not a time for subtle, long-term self-healing that requires a consciousness and presence that is possible for very few individuals at a time of great pain and distress. Instead, crisis is usually a time to choose available treatment technologies and to allow a physician to assume the role of expert and, with sensitivity and skill, direct therapy for the malfunctioning organ or system until the immediate crisis is over and self-healing practices can be initiated.
The differences in these two approaches to health and disease are dramatic, and yet they are complementary:
Used in crisis
Goal is the absence of signs
or symptoms of disease
Goal is experiencing
full health, wholeness
Expanding on treatment to include healing, shifting from professional direction to self-regulation, from an emphasis on the absence of symptoms to a focus on full health is as revolutionary to contemporary medicine as was the introduction of antibiotics in the 1940s. Change, however, is certain as new research findings substantiate the age-old knowledge of the self-healing powers of the mind andbody.