by Wayne Jonas
INTUITION
Mystics describe a state of total unity with the universe, where they see everything connected and have access to all knowledge and wisdom—what they call the mind of God. They also say this knowledge is not unique to them—it is available to all. I learned about this connectivity from my wife, who learned it from her illness and the wounds of her childhood. Susan had always had a spiritual bent and a keen intuition. She went to Yale Divinity School for one year before leaving to go to law school. After being diagnosed with breast cancer the first time at thirty-five years old she returned to spirituality with the hunger of one in mortal crisis and used this dimension to help her decide on treatment and healing. Her father had recently died of lung cancer, and the word cancer struck fear into her heart. She thought she would die soon. This drove her into deep introspection and prayer and further cultivated her already skilled intuition. When difficult decisions arose—like whether to do additional chemotherapy for which there was no good scientific evidence of benefit at the time—she would dive into deep thought and prayer until it became clear what to do. This enhanced intuition has served her well. After she was cured, she went back to school to get a pastoral counseling degree and then worked with military couples faced with deployment and war. It is there that we both—I as a doctor and she as a spiritual counselor—saw the kind of “soul loss” that so often impacts service members and veterans, and healing from the soul’s restoration. These veterans need spiritual guidance as much or more than medical treatment. Susan has an uncanny ability to know what they need and how to guide them—an intuition she developed out of her own suffering and wounds.
This sixth sense—this intuition—is a way the mind integrates complex information from many sources: from our body, sensory perceptions, relationships, memories, beliefs, and hopes. The response usually occurs below our awareness. Research led by Professor Gerard Hodgkinson, of the Centre for Organizational Strategy, Learning and Change at Leeds University, England, summarized findings from several decades of research on this process. They concluded that intuition is the brain drawing on this tsunami of signals to form a response and decision—but it is a decision made rapidly and unconsciously. That response occurs in the body first—thus the term gut feeling. Electrodermal responses—changes in the electrical charge on the skin—usually occur before we are consciously aware of the feeling. All we are usually aware of is a general feeling that something is right or wrong, or that we should turn right or left, go or stop, run or freeze. Often this feeling is right, but not always. Intuition can also mislead. I have had patients who blindly trusted their intuition and abandoned any science- or evidence-based medical treatment, only to suffer and die needlessly. In other words, intuition can be as uncertain as science. Says Professor Hodgkinson, “Humans clearly need both conscious and nonconscious thought processes, but it’s likely that neither is intrinsically ‘better’ than the other.” Intuition and science are both imperfect sources of knowledge. Healing requires the integration of both.
For centuries, healers from many cultures have claimed to be able to tap into these spiritual dimensions of healing. But does science show that we interact directly with the collective mind? Is there evidence for spiritual healing? To find out, I led a team in a massive critical summary of the research exploring this type of intuition. I was interested in whether spiritual reality—not just our mental beliefs and social rituals—interacted with material reality. Our goal was to see if there was rigorous evidence—as good as any evidence in modern biological science—that our intentions can interact with the world outside the normal boundaries of time and space: that is, nonlocally. The study was funded by the late Laurance S. Rockefeller three years before he died. It took more than five years to complete and involved dozens of prominent healers and scientists from around the world. We gathered and analyzed hundreds of studies, using state-of-the-art methods for detecting error or bias, and then discussed and synthesized the information in three meetings. The methods and results were published in a book called Healing, Intention, and Energy Medicine. We found that, as in other areas of medical research, when scientists tried to isolate the effects of spiritual healing there was uncertainty as to the magnitude of any single outcome. Most results, as in other areas of medicine, showed small effects, difficulty in replication, and bias in publication—all the challenges described by Stanford professor Dr. John Ioannidis in chapter 3 (see this page) for medical science in general. The best of this research, however, supports the claim by mystics that the connectivity underlying our gut feelings occurs continuously and everywhere. Like electrons, once they touch are always interacting, all living things are always touching. Everything is connected. Susan and many others who, like her, face serious illness, seem to use this mysterious connectivity to navigate the labyrinth of healing through time and space. From this inexplicable connection, the miracles of life arise.
PRAYER
But does this mean that direct spiritual healing—like laying-on-of-hands and prayer—works? It seems it does. And their effects are often about the same magnitude as that of drugs. So far, our understanding of these phenomena remains in the realm of mystery. We do know, however, that the miracles—those unexplained events of healing—probably arise from this mystery and can be tapped if we look for them and use them. Prayer is one tool from the spiritual dimension of healing used by billions. But like other specific approaches to healing, when research attempts to isolate its effects from the other dimensions—the effects shrink and often vanish. Physician and author Dr. Larry Dossey is one of the world’s best thinkers and writers about research on healing prayer. He notes the robust but small effects of prayer when studied in randomized controlled trials. In general, he recommends that the spiritual dimensions of healing be left to professional clergy and the physical dimension of healing to physicians. However, he says, just because it does not seem to be as effective as we might wish, it still works and so there are reasons to explore prayer in healing. If prayer works to help us feel whole and loved, it has value. If it contributes to healing, so much the better. As Dossey notes in his book on prayer, Healing Words, “The most important reasons for examining the effects of prayer, however, has little to do with its healing effects in illness. The fact that prayer works says something incalculably important about our nature, and how we may be connected with the Absolute.” Like any of the dimensions of healing described in this book, the power of specific components of the mind and spirit lies not in their isolated use, but in the meaning response that can be generated with them in our life. Like the other dimensions of healing, mind and spirit provide us with another set of tools for integrative health.
CHAPTER 9
Integrative Health
The balance of curing and healing.
For millennia, the fundamental nature of the therapeutic encounter has remained largely the same: a person who had been functioning normally and without giving a thought to her health now notices that something is wrong—she doesn’t feel well. She seeks someone to help, usually a person with specialized knowledge. In various cultures and eras, this “practitioner” may have been called a shaman, a barber, a priest, or a physician. The ill person hopes the practitioner can help restore her previously normal function. Usually the practitioner does an assessment and makes recommendations, often suggests behavioral change, and then does something to the patient—gives her potions or pills, sticks her with needles or manipulates her body structure, cuts her, or conducts some other ritual. The practitioner administers the healing agent.
The details of this transaction and its rationale have varied from culture to culture and over time. Ancient Greek physicians thought they were manipulating “humors” within the body. Ayurvedic practitioners used the idea of consciousness and doshas as the basis for applying their treatments. Ancient Chinese practitioners framed their interventions around the manipulation of “chi” or energy. Shamans and priests sought to divine a spiritual malady and drive out demon
s or evil spirits.
Then, around the turn of the nineteenth century, about 200 years ago, a new idea arose—a radically different way of understanding the human being and its treatment in health and disease. That new understanding was that all things were made up of small physical substances and parts—chemicals, cells, and other elements that comprise organs and people—and this was best studied with a new approach to knowledge called the scientific process. Modern biomedical science emerged and began breaking the body down into smaller parts and manipulating these, creating theories about how the parts fit together and testing those theories for accuracy. The science of the small and particular—sometimes called “reductionism”—was born. With this came the concept of the human being as a set of mechanical and chemical processes. All biological and psychological processes arose from these chemical interactions, organizing themselves into increasingly complex arrays and manifestations that peaked in the human being. We are, in this view, literately a bag of chemicals elegantly organized to survive and reproduce. Thinking, feeling, and even our very souls are epiphenomena of these chemical interactions. It was a powerful concept.
The value of this thinking soon proved itself in profound and practical ways. The chemical and cellular model of life controlled infectious disease—the number-one killer of humans two hundred years ago. Over time, chemistry produced antiseptics, antibiotics, and analgesic approaches that dramatically alleviated pain and suffering. The physician finally had some tools that were based on more than just magical incantations and historical knowledge. The impact of these discoveries was so dramatic that many of the old ways of thinking—the more holistic views of a person—were discarded. A medical treatment industry grew up around chemistry and physiology and the mechanical manipulation of the body. The pharmaceutical and surgical industries were born. Today, those who have access to this curative approach when they need it are grateful. Those who do not have it want it. The science of the small and particular has been a resounding success—until recently.
By discarding the more holistic, health-promoting, and nonphysical dimensions of what we are as humans, we have lost something essential in health care. While we improved our science and certainty for managing acute disease, we sacrificed what most people value about being alive, and we lost how healing works in chronic illness. Our improvements in health waned. The costs of medical care soared. The value of the mechanical and reductionist model has reached its limits. But by attending to the whole person and integrating this with the scientific process and curative medicine, we can unleash the power of healing and well-being in ways that humanity has never experienced before. In this chapter, I will describe how you can access healing and curing and bring them both into your health care and your life with integrative health. Trevor taught me what can happen when we do not integrate these aspects of healing. Mandy taught me what happens when we do.
TREVOR
Trevor began to pray. He was at the end, as far as he knew. He was now back for his fifth visit to the hospital and waiting for a possible kidney transplant. It looked like the possible kidney would not come through again. This was the third time that year and second time in three months that he had been hospitalized to seek a kidney and it had fallen through. It was now 7 AM and his wife was packing up to go home. He had a strong feeling that if he did go home now he would never return.
Almost two years to the day he had been in this same hospital after a failed kidney transplant; his body had rejected his wife’s donated kidney, and it had to be removed. The prospect of going back on dialysis for another long and indeterminate time, with no functioning kidney, and the knowledge that his wife was living with just one kidney, was devastating. He was finally on the top of the transplant list again, and prepped.
“Give me a few more minutes,” he implored his wife. “Something will happen.”
His wife sighed. “You are so stubborn,” she said. “It’s time to go home.”
She had always been right before. The pattern of past visits was the same. Hospital personnel called late at night and asked them to come in because they might have a match. He and his wife usually got to the hospital around midnight, which gave him time to be admitted and prepared for surgery. The kidney match would be confirmed about 3 AM. It was now 7 AM—well past any realistic hope that the transplant would proceed. But he insisted on waiting longer. Trevor went back to praying. He had to believe a miracle would occur. That was all he had left.
But deep down he knew that his wife was right. His “stubborn optimism,” as she called it, had gotten him into this mess. It was also what had made him who he was—a successful lawyer and one of the most beloved public servants in his community. A community he had risen out of and returned to help. He was the lucky one, the smart one, the successful one, the one who had escaped a life of poverty and incarceration—and returned to help those who had not escaped. He was one of five children born in a small shack on a dirt road; his father picked fruit and his mother cleaned houses. Neither of his parents had been educated beyond the fifth grade. But they both worked hard and disciplined their kids to do the same. With their love and encouragement, Trevor excelled—in sports, in academics, in popularity. With good grades and an athletic body, he landed a football scholarship to an elite college. He graduated and went on to law school, taking honors and then returning to his community as a public defender—helping those he grew up with get justice and giving back to his community and church. He set up community gatherings where successful members of the community met with children to inspire and mentor them.
When he was growing up, his dad would say that Trevor was always “healthy as a horse.” Trevor believed that and never thought about his health. Except for vaccinations as a child and some periodic sports physicals, he never went to a doctor. None of his family ever did. They did not have health insurance and could not afford medical care. If he had an earache or sprained his ankle, his mom would patch it up with home remedies. He always recovered.
When he was hired as public defender, he got health insurance, so he went in for a checkup. That was five years after he left college football and regular athletics. These days, he mostly sat in an office. The doctor was alarmed. Trevor’s blood pressure was dangerously high. The doctor prescribed two different medications. “If we can’t get it down, we will need to put you in the hospital,” he said.
Trevor came back a week later, and while his blood pressure was now out of the alarming range, it was still not normal. The doctor prescribed a third medication. He returned three weeks later. His blood pressure was now under control, but he felt terrible. The medications made him tired, interfered with his sexual function, and made it hard to sleep.
“You will adjust,” said the doctor. “The most important thing is, your blood pressure is now down. It was dangerously high.” He paused, then emphasized, “You know, it is the silent killer.”
Indeed, he was right. Worldwide, untreated or undertreated high blood pressure is the most common risk factor for stroke, heart attack, kidney disease, and heart failure. In the United States, more than seventy-five million people (one in every three adults) has it. More than 30% of people with high blood pressure don’t know they have it, and only 50% have it under control. Estimates are that more than one thousand people die each day from high blood pressure. Estimated costs are $50 billion per year. The situation is worse in less economically developed countries. The WHO estimates over one billion people worldwide have high blood pressure—most of it undetected and poorly controlled. Lifestyle is a major risk factor—both for getting it and for controlling it. So is genetics. Over their lifetime, most people will require two or more drugs to control it. The doctors had Trevor on three drugs and were satisfied that it was being adequately treated. From the biological perspective, their job was done. But the job was not done. While they were treating Trevor’s disease, they had left out, as often happens in health care today, Trevor. It was this neglect of Trevor as a whole person that wou
ld eventually hurt him.
Current guidelines for treatment of high blood pressure recommend more than just drugs. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) also addresses the behavioral dimensions of healing. Lifestyle modifications are recommended no matter what level of high blood pressure a person has. This includes exercise (which Trevor had stopped doing), a low-salt diet (which Trevor had never even thought to consider), not smoking (Trevor did not smoke), or weight gain (which Trevor had experienced since stopping sports). His doctors asked about these things and suggested he start exercising again and go on a low-salt diet. They gave him a handout of foods to avoid and recommended the DASH diet (Dietary Approaches to Stop Hypertension). But, they emphasized, he would always need the medications. The Joint National Committee also recommends close attention to the social and emotional aspects of healing. The section on “Adherence to Regimens” states: “Motivation improves when patients have positive experiences with and trust in their clinicians. Empathy both builds trust and is a potent motivator. Patient attitudes are greatly influenced by cultural differences, beliefs, and previous experiences with the healthcare system. These attitudes must be understood if the clinician is to build trust and increase communication with patients and families.” The committee goes on to list other reasons for “nonadherence,” including denial of illness, perception of drugs as symbols of ill health, adverse effects of medications, cost of medications, and lack of patient involvement in the care plan.
Unfortunately, Trevor’s doctor had missed the class on empathy and trust, and Trevor had many of these reasons for nonadherence in his life—plus his stubborn optimism. He would be okay, he thought. His doctors never learned all this about Trevor. They did not know him well and did not inquire. They were not able to effectively engage him in behavioral change and found out nothing about his social and emotional background. He needed more than lifelong drugs, with their side effects, which were a key reason for nonadherence. The Joint National Committee Guidelines summary for primary care practitioners covers about twenty-five pages. There are eight pages devoted to drug management, but only one page to lifestyle and one page to nonadherence.