| Illness as a Road to Healing | ||
| Humbertho Oliveira, Mauricio Tatar, Susana Hertelendy e Vania Didier | ||
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As presented
at the Second Brazilian Conference on Psycho-Oncologyon April, 1996, at
Salvador, Bahia, Brazil 1- INTRODUCTION
2 - HEALTH CONCEPTS WITHIN AN ENERGY VISION Most people seek a health professional because they are not feeling well with recently discovered signs and/or symptoms. The states of not feeling well, of discomfort and of pain, mobilize an individual to do something in order to re-establish harmony, well-being, and a cured self. This healing is represented, both to the therapist and the client, by the achieved absence of these physical, mental or emotional signs and symptoms. This means simply going back to the state prior to the illness; going back to being asymptomatic. Generally speaking, health is understood to be a state of not-illness, of not-weakness or pain, one in which the individual is able to continue living without great discomfort or alteration of his/her lifestyle. It is much easier to take some medication, a quick fix, to relieve pain than to take the time to understand the message being given by the organism. We are too focused on immediacy, treating only the surface appearance and not looking deeper into the origin or cause of our illness. Is health static? Is it simply the absence of any symptom? If humans were machines and all the parts functioned perfectly, independent of internal or external factors, the answers to such questions would probably be yes. With that scenario, a same illness would always present the same signs and symptoms; treatment would be the same, regardless of the individual, and normal functioning would rapidly be re-established. How can we analyze the health-illness dichotomy within an energy vision? The universe, according to Chinese medicine, is in a state of dynamic balance, with all of its elements oscillating between two interdependent and complimentary opposing forces. These two opposing forces are known as yin and yang. Through this approach, the human body is a microcosm of the universe, a cell is a microcosm of the organism. The two, therefore, function according to the same principle. In the game of forces, yin only exists because of yang and vice-versa; within yin, yang is found. One can not exist without the other. In other words, nothing exists as an absolute, nothing exists without interaction and exchange. People are a good example of this: although men demonstrate yang and women yin, both present corresponding feminine and masculine aspects. The human body possesses a physiological intelligence whose basic function is to maintain the homeostasis of the organism as it faces all exterior and interior stimuli. Balance is achieved through free energy circulation, as well as through continual exchange between the organism and its surrounding environment. This continual flow of energy keeps us alive. When the flow of energy does not occur adequately, illness arises. Our body signals disequilibrium early on through small functional alterations with no physical foundation. That is, there is nothing at an organic level that justifies the signs or symptoms. As the signals are not given importance and as the same day-to-day patterns are maintained, the physio-chemical alterations become chronic and solidify until the physical segment is reached. The illness then expresses itself on some tissue, organ or viscera, accompanied by well determined mental and emotional patterns. Health and illness are aspects of the same movement. Through disharmony, we achieve new harmony, a new frequency, a new energy platform. In the transition period into this new state, illness must be experienced. Illness should not be considered something strange, but rather, a consequence of a set of factors culminating in disharmony and imbalance. It is through illness that we reach health. We frequently witness accounts by people with grave or terminal diseases who found themselves living better or in greater health after becoming conscious of their illness. In order to live in harmony, we need to have flexibility or be open to the great number of possibilities for interaction with the environment. Without flexibility, there is no harmony. Periods of precarious health are natural stages of the interaction between an individual and his/her environment. Being in a state of disharmony means passing through temporary phases of illness, in which one can learn and grow. Illness is an opportunity for introspection, so that the original problem and the chosen routes of escape can be taken to a level of consciousness where the problem can be solved. The basic function of the therapist is to mirror the truth to the patient and help him/her develop a consciousness of his/her life process and of the mechanisms (both the obstacles and the illusions) created that generate illness. Another basic function of the therapist is to empower the patient to tap into his/her own personal care resources, thus enabling the recovery of self esteem, acceptance, and forgiveness. As the song by Milton Nascimento and Fernando Brandt goes, "What matters is to listen to the voice that comes from the heart." To achieve healing is to open the channel of communication, to make oneself get in touch with one's own essence, to awaken to the ability of being, creating and "uncreating", dreaming and accomplishing. This self-discovery is the road to self-healing, which is nothing more than rescuing self love.
3 - BODY AND PSYCHOSOMATIC PSYCHOTHERAPY Illness is not something that happens to a person who then becomes submissive to the illness. The unwell organism is involved in the appearance, development and cure of the disease. The human being can relax into his/her illness, can gain from it, but mainly he/she can tap into deeply hidden tendencies. There exists, then, a psyche/somatic phenomenon in the process of becoming ill. The study of this phenomenon within a modern perspective - psychosomatic study - was initiated by Freud, out of his studies of hysteria conversion. In hysteria, the body relates, speaks, discharges and protests through its process of becoming ill. It is always a way for the organism to express profound conflicts. Digestive disturbances, for example, are often expressions of conflict between retention and expulsion, between desire and necessity. Thus illness is not something that comes from outside or is anticipated, but is a particular way of the person of communicating with him/herself in adverse situations. Therefore it is, in its various forms, a way to be in the world and a way to relate to others. Current knowledge of the immune system has greatly contributed to the understanding of the tenuous boundary between what is properly somatic and what is properly psychic. The immune system is seen as an intermediary system between the individual, his/her other systems, and the outside world. It is also seen as a maintainer of corporal integrity. It is therefore a self-regulating system, adaptive and intimately interacting with the nervous and endocrine systems. This places us face to face with the limitation of technical knowledge in the understanding of the mechanisms of illness formation. In the function of these principles, we reflect on the importance of shifting the therapeutic focus from the illness to the interaction with the person carrying the illness. It is from him/her that the truly healing resources may come. One of the most important formulas regarding the crossing of the psychic and the somatic is the energy formula. The concepts of Functional Unit and Basic Identity, created by Wilhelm Reich, state that the source of all human activity is bioenergy, or orgon. This means that body attitudes and mental-emotional attitudes correspond to each other, and thus are able to substitute and influence each other. (1) Each region of the body has a determined living function that can also loan itself to represent a specific conflict zone, an energetic conflict between the psychic and the somatic. These conflicts are emotional carry-overs related to vital past events, which, when badly "metabolized", are maintained and updated, creating diverse obstacles to life. When mobilized, they can liberate or distribute energy, thus facilitating consciousness of life experiences, emotional expression (previously contained), and the organization of a new psycho-corporal modus vivendi. All stress experienced during the primitive stages of somatic-emotional development generates, in each human organism, specific energy reactions. These serve as a basis for the development of future illnesses in the organism. According to Frederico Navarro, primary biopathies, which correspond to the energetic bases of grave and generally "incurable" diseases, are related to the stress experienced in the most tender periods of human life (uterine period). Secondary biopathies, which are the bases of grave and generally "curable" diseases, are also linked to the stress experienced during initial periods (uterine) and birth. Psychosomatic illnesses known as "subclinical" (i.e. gastric, non-settled ulcers, etc.) correspond to stress experienced during infancy and childhood. Somatizations linked to strong emotional occurrences (such as various hysterical paralyses) correspond to stress experienced from puberty on. (2) With the conception of mind/body/energy interaction we can create relationships between the various regions of the affected body and express subjective content. Thus we can observe that by mobilizing irregular respiratory movement, peristaltic silence, ocular contraction and diverse organism dysfunctions, we can enable an encounter with all the deepest feelings of the illness genesis. And through the re-establishment of spontaneous respiratory rhythm, rhythmic peristaltic sounds, relaxed ocular contact - in synthesis- the natural state of the organism, the individual would be mobilizing a new energetic field for his/her health. Therapeutic work based on a vision of organism integration can, then, enable deeper search for the meaning of healing. Another way of looking at the occurrence of grave illness and the possibility of death is one which intends to integrate the somatic, psychic and spiritual. With this type of outlook, as with David Boadella's, great emphasis is given to spiritual grounding and transpersonal states, recognizing that psychosomatic work opens a window to beyond the physical. Therapeutic work within perspectives that consider spirituality requires a profound reflection on the relationship between the therapist and his/her client. Resonance, empathy, and transference love are concepts used to speak of the necessary humanity in this relationship. Concepts such as inner-ground, self, superior "I" and others make reference to an essential reality which is related to what is deepest in each of us. (3) Thus there would be, within the process of being sick and/or dying, a spiritual sense of continued learning. In this way, experiencing the presence of another body/mirror/support/contact stimulating life could be of great importance to the person living the process of illness and death. As therapists we must find ways within ourselves and prepare ourselves to provide this type of assistance. According to Susan Sontag, "Illness is the dark side of life, a type of more expensive citizenship. All living people have this double citizenship, one within the realm of health and the other within the realm of illness. Although we all prefer to only use the good passport, sooner or later each of us will be forced, at least for a short time, to identify as a citizen of the other country... In my point of view, illness is not a metaphor, and the most honest way of facing it, as well as the most healthful way of being ill, is that which is most pure of metaphorical thoughts...". (4) While working with Alice, we greatly reflected on this question. Alice had heart surgery to put in a valve. This was the consequence of a long many-yeared bout with rheumatic fever, which had been well treated. She had evidently lived a childhood limited in movement and possibilities. Any effort worsened her illness. Her stoic family taught Alice to deal naturally with her health condition but forgot to "value" the emotions experienced by a child in such a limiting situation. Also, the family probably could not value its own emotional responses as it took on the arduous task of caring, uninterruptedly, for a child with rheumatic fever. With everything so neatly contained, Alice constructed her personal experiences as natural. She felt scared as she neared the surgery, but calmed down and took good care of herself, physically. She had a good surgery, excellent recovery, and great medical and family care. And now that post-op is over and she is alone, without the nearness of her family, Alice feels hurt - in her chest. She feels depressed. She struggles against herself: "What is this? Me, feeling these uncontrollable things...?" It is necessary to "convince" her to feel emotion, to allow herself to suffer for her own pain. It's true - your illness is "natural"; it is "just an illness" that "hurts here and there..." - But cry, Alice! Your chest was opened. Feel sadness. Just be human! Alice listens. She transforms...now in tears and stoicism. Bravo, Alice! Bravo! Would there be a way to apply this non-biased view of the naturality of illness to the conceptions surrounding death?
4 - ILLNESS AS MEANING (MANIFEST OR HIDDEN) The contingencies of language in the beginning of the third millenium "...
it’s not possible to wait for the world Paulo Freire
One of our proposals, as a group, is to uncover layers of meaning in words and explore forgotten concepts, so that we can make effective contact both with the underlying theoretical contents and the concrete purpose and direction of our work. In many instances, meanings have become obsolete and inappropriate. Paradigm shifts taking place at any specific period in time are profoundly reflected in language. And language, of course, expresses these shifts as they occur in meaning. Based on that, it is possible to go one step further into areas of human experience, and note that old behaviors and attitudes can only be substituted for new ones if concepts associated with them are clearly expressed in language. But in times of profound change clarity is not an item readily available. Observation will show that new words are appearing continuously to designate notions related to contemporary matters, inventions and relations, while many older words and expressions, currently still in use, are ambiguous, carry manifold meanings and are often misleading.
Take illness, for example. In tune with western medicine, it is acceptable to believe that what could also be referred to as a state of imbalance results from external interferences--a virus, bacteria, poor nutrition, and so on. In other words, dis-ease for traditional medicine is something that strikes us from the outside and, therefore, should be eradicated by means of external – from the outside into the system – resources. This can, in effect, be considered one side of the issue. Yet, if we are organisms with dimensions beyond the physical and physiological, existing within a wider context and depending on our surroudings, then we can be responsible for what befalls us. On the other hand, we might also, as a choice, practice being humble. In other words, actual relief is possible when we give up control and realize that there is only so much that can be known and done. As to what goes on beyond that, there are other kinds of world views and manners of experiencing reality. Thus, it is worth meditating on the fact that the world we live in is so vast and interactions and influences of varying sources so unpredictable and, quite often, so incomprehensible, that perhaps at this stage of humanity we should approach illness, and also health or cure, as states about which we are learning but which essentially constitute what we could refer to as mystery. And, for that matter, the same applies to life and death.
Illness and emotional difficulty – they often go hand-in-hand – could be viewed as pathways to other dimensions of being possibly neglected. But connection with these dimensions may lead to a confrontation with what, in Junguian terms, is referred to as shadow. Experiencing this archetype may result in a softening of boundaries between known and unknown aspects of ourselves and thus it may bring us to a closer contact with our very essence.
We could argue that illness is a "strategy" resorted to by another aspect of ourselves in its effort to open pathways to more nourishing ways of relating to ourselves, to nature, to animate and inanimate beings, to life, and essentially to the divine.
The first reaction to illness is often rebellion against these new circumstances. That is often followed by other attitudes or states such as accomodation and submissiveness to treatments or to imposed directions, depression and abandonment in relation to assertive behaviors such as seeking new information and resources to understand and bring about new and positive ways to deal with what is happening to us. There is a passive acceptance of whatever is being transmitted to us through medical, therapeutic, religious and spiritual, family and other circles.
But while we react in ways that, consciously, we take as expressing our weaknesses, at less conscious levels we are, in fact, actively attempting to elaborate and come to terms with our life circumstances. It is a relief, in this sense, to realize that for most of us presently there are many resources available which could make such journeys easier. We can thus note that our current planetary transition has allowed the return of pathways previously in the dark or restricted to esoteric groups and, therefore, not accessible by the ordinary person.
Today, accessing different dimensions or aspects of ourselves or joining different religious, spiritual or support groups in the society in which we live, is becoming easier. Debates and public events, such as this particular one, can be used as examples of opportunities for exchanging ideas and sharing aspirations, as well as for confirming the appropriateness of chosen paths. Such openness and the exercise of reflection with regards to our belief systems and the self-management of our health issues – or, at least, the possibility of participation in the understanding and treating of our illnesses -- increase our sense of self-assurance and add to our self-esteem.
Such opportunities are part of the effort of construction for a "middle ground" of cooperation between medical and pscyhotherapeutic pathways of treatment, and hopefully lead to states of more balance and harmony.
Thus, in a life transition we can search for a balanced perspective, i.e., one that blends traditional and alternative treatments. We can try to visualize a medical approach which includes the therapeutic and spiritual dimensions. This will provide more space and comfort for our individual process while, at the same time, allowing us to be a part of the "management" of the circumstances affecting our life and well being. It leads to conscious growth as it teaches the practice of serenity both to make the decisions that concern us and to accept the inevitable consequences of choice.
Such an integrated approach to dis-ease on the part of health professionals implies that, while we are treated through traditional medicine, we know that we can also soften our attitude towards illness, allowing its message to come forth and clearly express previously unspoken (or unheard) needs of our system. It also implies that we are capable of expressing our intention with reference to the medication we take and the treatments we are submitted to. These attittudes, when allowed and encouraged by the health professional, show a positive approach in a particular treatment. This may be thought of as a rare and daring proposal in our western context, but it should be stressed that such a style of viewing health and healing is an integrated part of medical practices commonly used within certain spiritual traditions or cultures.
Furthermore, meditation and prayer are practices which can help in this process; and so can massage therapy, energy work, visualization and relaxation. These practices and techniques lead to a different approach to illness, where we neither succumb to it, nor reject it, but instead allow for its presence, while listening to what it has to say.
This line of thought is part of the work of renewing meaning. To meditate on the true meanings contained in what we speak, to search for coherence between words standing for thought and intention, and attitudes, values and behaviors which express such consistency while also reflecting a cultural moment, is to decide for a conscious and responsible stance in life, as well as to choose wholeness in the way we are present in the world.
The paradigm shift occurring in the linguistic sphere will go on for a long time, both through the profound transformation in existing languages, which is accompanied by the appearance of new words and expressions, and through the maintenance of old words with renewed meanings and new energetic charge.
To conclude, we will not always be able to understand and/or explain what happens to us. There are many mysterious facts in life and decyphering them will remain beyond our reach despite insistent efforts. Yet, if we learn to be humble and hopeful, our essence may reward us by showing what is possible and, in terms of what lies beyond that, it will offer guidance and help towards acceptance, so we may find one more way to pay homage to the divine will.
5 - IMPERMANENCE AND CONSCIOUSNESS "Death
in the First Person" I'm a nursing student. I am dying. I write to
you, who are or will become nurses, in the hope that through sharing my
feelings you will someday be more capable of helping others who share
my experience. At the moment I am not hospitalized. I'm out for maybe
a month, six months, maybe a year. But nobody likes to talk about these
things. Actually, nobody likes to talk much about anything. Nursing must
be evolving, but I'd like it to hurry up. They currently teach us to not
exaggerate happiness, to omit the routine of "everything is ok",
and we do our duty well. But we've ended up in a silent and lonely emptiness.
Once the "everything is ok" routine is removed, the team is
left only its own vulnerability and fear. The patient who is dying is
still not seen as a person and is therefore not communicated with as such.
He/she is the symbol of what every human being fears and what every one
of us knows, at least academically, will have to be faced one day. What
did they say in psychiatric nursing about the confrontation of pathology
with pathology in detriment, both the patient's as well as the nurse's?
They also talked a lot about the fact that before helping anyone with
their feelings it is necessary to know our own. How true that is. But
in my case, the fear is today and death is now. You run in and out of
my room, give me medication and take my blood pressure. Is it because
I myself am a nursing student or simply because I am a human being who
senses your fear? But your fears increase mine. Why are you afraid? It's
me who is dying! I know you feel insecure, you don't know what to say,
what to do. But please believe me, if you care, there's no possible mistake.
Just admit you care. That's what we're looking for. Maybe we'll ask you
why or when, but we really don't expect answers. Don't run away - wait
- I just want to know if there will be somebody to hold my hand when I
need it. I'm scared. Maybe death becomes routine to you, but it is new
to me. Maybe to you I'm not special, but I've never died before. To me,
once is very special! You whisper about my youth, but when someone is
dying is he/she still young? There's a lot I'd like to talk about. And
that wouldn't take much of your time because, after all, you already spend
a lot of time here. If we could at least be honest and both admit our
fears, touch each other. If you really care, would it be unprofessional
if you cried with me? Person to person? If it were like that, it wouldn't
be so bad to die at a hospital, surrounded by friends. (anonymous letter
dated Feb. 1970, from Elizabeth Kubler-Ross 'Death: The Final Stage of
Growth'.) The young nurse's letter is a touching testimony of someone
who is about to die and who, when facing this crucial experience, raises
questions as important as they are disquieting. Questions which directly
touch on how professionals who are in direct contact with the processes
of illness and death are unprepared to deal with feelings and emotions
evoked, not only of the individuals living through this experience, but
of their own. We can ask ourselves whether the routine she refers to,
the infantilizing of the patient which denies him/her the signs and symbols
of an autonomous adult condition - are these not for the convenience and
moral comfort of the team, keeping it safe from despair, panic, revolt
and pain? In addition, we have an inheritance from the Cartesian tradition
- a bio-medical model which operates out of a basic belief that people
who are ill are broken machines. In case of malfunctioning of constituent
parts, they should be fixed - by a mechanic, of course! It is naturally
expected of the machines to remain completely passive while the mechanic
does the job and to not present undesirable reactions. We might obviously
be over-simplifying the issue, or even doing an injustice to the health
care professional, but we very frequently find professionals who seem
perfectly apt to treat illnesses, though not with unique individuals.
These individuals can be reduced to categories and clinical profiles.
We have information of procedures from other cultures, different from
our models of therapeutic aid, in which shamans, healers and doctors take
under consideration the socio-spiritual environment of the person who
is ill as well as his/her emotional needs. Where body and soul are not
disassociated and where ways of giving support, comfort and intervention
are not reduced to surgical/chemical/physiological interventions. In addition
to the philosophical Cartesian assumptions which guide our understanding
of the human being, we also have, as part of the package, a narcissistic
orientation demanding that we be continually focused on the creation of
a self-image. A self-image in which economic status, a socially successful
profile, beauty and the attempt to extend youth indefinitely are considered
principal. In attempting to evade nature, we are doomed to failure. We
grow old. We die. It is through our narcissism that we attempt to control
death and aging, to impose on nature our aspirations of power and immortality.
The laws which govern our reality are unyielding. All of the elements
which on one day come together to create a whole, on another day, we never
know when, disintegrate. Our basic insecurity makes us both avoid and
negate the finite aspect of our existence. In this way, we cheat ourselves
of preparing emotionally and spiritually for the most certain of all uncertainties
that fills and forms our existence. The illusion of an isolated "I"
within the boundaries of physical experience, confined in time and space,
does not allow us to see that our consciousness does not have the same
limitations. Deepak Chopra, when sharing his experience of realizing his
non-physical potentiality, gives us a testimony which may help us re-understand
our perception of ourselves. "My spirit experiences the material
world through perception lenses, but even without seeing and hearing,
I am still me, an eternal presence of consciousness. In practical terms,
this realization becomes genuine when no external event can shake the
sense of self. A person who knows him/herself as spirit never loses the
vision of experimenter in the midst of experience. His/her inner truth
affirms that I carry with me the consciousness of immortality in the midst
of mortality." When the paradigm shift, this renewal of meaning of
being, permeates our scientific/philosophical/social vision of the individual
(shift which is already taking place), then we will certainly create more
compassionate and comforting practices of assisting, accompanying, and
caring for all of us who are living our rites of passage, our transit
in the life/death continuum. Let's not forget the young nurse's words:
before helping anyone with their feelings, it is necessary to know our
own.
Bibliography 1 - REICH,
W. - "A função do Orgasmo" - Editora Brasiliense,
11a edição, São Paulo, 1985. About the Authors: Humbertho
Oliveira, Psychosomatic Doctor, Psychotherapist Susana Hertelendy,
Somatic Psychotherapist |
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