Tapping Creation Stories for Healing and Energy

Excerpt from Chapter 1, Coyote Wisdom: Creation stories are ubiquitous in life. Our families tell us stories of our birth. At family gatherings and holidays across the world, families love to tell memorable, hilarious, and embarrassing stories of our childhood. At business meetings, on airplanes, and at parties, we tell stories about how we got to be where we are today. We have the short version for acquaintances, the long version for our closest friends, and the cleaned-up version for first dates and potential in-laws. Cultures also tell stories about their own creation, and people tell stories about how they got sick and how they got well. The story about how an illness arose is particularly powerful and has multiple versions. In Western society, the doctor's version is called the diagnosis, and it is a compelling story to which all members of society pay homage. People's own stories about how they got sick may or may not parallel the official medical story, and this seems like the logical place to begin a book about the healing power of stories. Thus we begin with the idea that everyone needs a creation story, just as much as cultures need stories about their origins. And all people require a story about the appearance of their illness, whether or not that story matches the medical version. The power of the creation story lies in its predictions. The medical diagnostic story predicts what treatments will work and what the results of those treatments will be. Similarly, the sick person's story about the birth of his or her illness predicts the likelihood of healing or cure and contains clues as to what treatments will work and what treatments will not work. I begin with creation stories, just as medical care begins with diagnosis. I want to draw out the person's own illness-creation story, and then, over time, as I shall show in subsequent chapters, I try to influence that story so that the chance for healing and cure increases. As many Native healers have told me, the limits to healing and curing are a great mystery, known only to the Divine; we are required to do our best to strive for wellness in every way possible, knowing that healing is always possible, but cure is up to the Divine. Creation stories are important, because the final story about how you or I got well must be compatible with the story about how we got sick, or the treatment will never work. In my studies of remarkable healings, I found that every person had a plausible story (to them) for how their illness occurred and how they got well.1 Invariably, the wellness story was logically consistent with the "how I got sick" story, even if neither story made sense in terms of my biological understanding of sickness and disease. In addition, everyone in their immediate, closest circle of family, friends, and acquaintances also believed these stories of how the person got sick and got well, buffering the person from larger groups who might challenge or question either story. Communities of believers are powerful, and are created and maintained through shared stories. Recently I met a small group of people who had experienced miracle-level healings with a particular vitamin product. Others I knew had tried the same product and had succumbed anyway to their disease. I suspected that, helpful as it was, the vitamin product was not the actual healing agent. When I looked closer, I found that the phenomenon mirrored what I had observed among people healed by Native medicine people. In both cases, the people had a plausible theory to explain their healing (the product or Spirit), they isolated themselves in a tight fellowship group (in the case of the vitamin product, a group of fellow product consumers within an enthusiastic multi-level marketing pyramid structure), and everyone around them believed with fervor in the power of the product (or Spirit) to heal them, thereby reinforcing the stories. The vitamin users who were healed loudly proclaimed testimonials about the product; they had absolute faith in it. Their involvement with marketing the product and with others who marketed the product had forced an intense, present-centered mindfulness upon them. They had no time to be bothered by the past or worry about the future--the immediate needs of marketing the product and giving testimonials about it consumed every waking moment. I had to be happy about their healing. Some people in their group had recovered from documented lupus, metastatic cancer, and other serious illnesses. Naturally, since I didn't share their absolute faith in the product, I worried about what would happen to any of them if their complete committed involvement with the product faltered, but I realized that could happen to any of us. We can all have crises of faith and lose our way. Their culture, created and maintained through shared stories about the product, had a creation story--the story about the genius who formulated the product and his trials and tribulations in getting it out to the public. The story included his persecution by the Food and Drug Administration and by medical authorities. The stories shared by this community informed its members about how to perceive themselves and their environment, including how to view people who didn't use the product and those who were outright skeptical of it. I found these followers of the vitamin product fascinating for their collective creation of a subculture through telling stories and sharing an understanding for the meaning of those stories. How did this shared culture and understanding translate into physiological healing? What are the biological principles behind this transformation of the vitamin product into an agent for healing and curing? The followers of the product would never ask these questions, of such interest to me. Such questions lie outside their worldview. They would have never imagined that their social network and the beliefs that it sustained and nurtured could have brought out the biological activity of healing, related in part to their complete and total faith in the vitamin product. Their faith in the product appeared to prevent them from creating alternate stories that would take the power of healing away from the product and give it back to the community. In my studies of extraordinary healing, I didn't encounter a single person who had healed in isolation. Perhaps such people exist, but I could never have found them if they existed in that much isolation. The philosopher Ervin Laszlo believes that communities of people are connected by fields of energy.2 He provides an explanation within the realm of contemporary physics for Jesus's statement that "I am there whenever two or more are gathered in my name." People create systems that generate an energy field, which feeds back to make the people within the system more connected to each other and more coherent in their thoughts and feelings. Ancient tradition teaches us that when two or more people gather to pray and worship, over time their prayers become more powerful. Modern research shows greater energy field strength when more people are praying together, with increased coherence among their brain wave patterns. These energy fields are generated by the relationships formed through the telling of shared stories. Powerful healing is created through the telling and retelling of shared stories that build the energy field connecting the people involved, as has happened within Native American communities throughout the ages. When the same people do ceremony together week after week for years, great healing power is created. This process can also happen outside of church or ceremony. The sociologist Erving Goffman wrote that language allows us to create any story or explanatory framework through our conversations.3 He compared this to the freedom of a playwright to first create a stage and then to people it with characters of his or her choosing. Goffman asserted that "talk" embeds, insets and intermingles." This line of thinking would imply that the talk about the product created, in a very real sense, its healing power, which increases in strength the closer one gets to the source of that dialogue--the inner sanctum around its "creator." Without the story of how the product was created, accompanied by the heart-felt testimonials about its use and effectiveness, the product would fail to have anywhere near the healing power that it demonstrated in the collection of stories told about it. In Ervin Laszlo's systems philosophy, these physical conversations affect and become embedded within a larger energy field (the quantum waveform), which, in turn, feeds back to "in-form" the people creating the conversation about a more comprehensive version that includes everyone's ideas and contributions. The field contains the entire conversation, while each individual holds only a small part of it. Rupert Sheldrake called this energy field the morphogenic field, arguing that it contains ideas that become accessible to everyone.4 What this means is that our explanatory stories, our creation stories, really do feed back to create us. They become larger than we are, even develop biological effects. Imagine that the followers of the vitamin product, through their constant living of the story about the miracle of the product and their ongoing conversations about the product, embed this information about the product into an energy field that informs their community about how to be even more effective in service to the vitamin product. Membership in the community makes one an "actor" on a stage in which the product works phenomenally well. The more central you are as an actor in that "play" about the product, the more powerful it will be for you. Peripheral characters may not get nearly the benefit that comes to true believers. This means that the power of any substance (even a conventional pharmaceutical drug) is not separable from the stories told about the substance--stories about where and how it was created, accompanied by testimonials, told perhaps in the language of science, perhaps in the language of television commercials. Biological activity is inseparable from stories about how useful something is in practice. This makes perfect sense if biology and consciousness are inseparable. The creation stories and the biological effect inform one other, building progressively greater power. Erving Goffman would further say that the followers of the product accomplished a creative act through their interaction, in which they produced a frame (like a stage) to contain and support their continued dialogue.5 Participating together within the frame makes people more attuned in purpose and understanding. In writing about creation stories, I am inviting you to imagine people coming together to create something--a community, a church, a product, a business, or health and healing. These people forge a shared story that describes how their activity began. All cultures have creation stories about how they came into being: the Book of Genesis, the Bhagavad Gita, the Native American creation stories that follow. The early Christians told the stories of the birth of Jesus, his teachings, his healings, and his Crucifixion and Ascension. Communities have founding fathers and mothers. Cities may even be named for their symbolic forbearers, as in Washington, D.C. (named for George Washington); Prince Rupert, B.C.; and San Francisco (after St. Francis), to list a few. Churches tell stories about how their faith was created. Marriott Hotels places a book inside guest rooms with the history of the Marriott brothers and their efforts to build a hotel chain. The radical departure from conventional thinking is to imagine that these creation stories are contained as information within a field of energy mutually generated by the people involved in the activity. This helps these people to be coherent with one another in their pursuit of the activity. Some of the information contained in the field is inspirational to bodily healing, as with "The Product." The more strongly we participate in the activity (church, business, school--all of which are also systems or wholes greater than the sum of their parts), the more we are influenced by this energy field that helps reorganize our thoughts to be consistent with the goals of the activity and coherent with others participating in the activity. This is what builds power. On the most mundane level, this wisdom for how to participate is contained in the stories we tell each other, notably our creation stories. I tell creation stories to inspire a person to discover the creation story for her own illness (and to eventually modify it so that getting well is not so hard to image). At minimum, I am enrolling her in a system that consists of the two of us, in which I hold an intention for her wellness and healing. The more the person interacts with me, the more she is drawn into the energy field that we are creating, one in which healing becomes more possible. The stories we share provide social structure that contains this less palpable energy field. Our relationship is the stage and we are the actors. The larger we make our community of believers (participants in the story, actors in the play), the fuller our field of energy becomes with information about healing. The sharing of the story of how healing is created builds that energy and passes it back to us.

Medical Writing: The Healing Power of Narrative

Today begins my 2012 journey to Australia for Culture Camp with the Gippsland and East Gippsland Aboriginal Cooperative. We continue our mission to assist them to incorporate more of their culture and heritage into their health care. Particularly, we hope to midwife a process of their discovering their own ways instead of just grafting onto their world the practices of the people from the Northern Territories who never lost their ceremonies and their language. However, Gippsland and East Gippsland are very different from the North. They are the farthest Southeast tip of Australia. Only the island of Tasmania lies any further East. They are a lake, ocean, and woodland people from a temperate climate where snow occurs in the winter in the high mountains. They are not people of the tropics. Their culture and language (Gunnai/Kernai) is different from those of the Northern Territories. Through a convergence of our delegation of Native Americans and of those from the Northern Territories and of those from Gippsland and East Gippsland, perhaps something magical will occur. Changes have occurred in our party. My colleague, Rocky Crocker, is still coming. He is a family physician who teaches in the Center for Integrative Medicine at the University of Arizona -- Andy Weil's program. He is also the President of our Board for the Coyote Institute for Studies of Change and Transformation, based in Brattleboro, Vermont. Rocky is Choctaw from Mississippi and talks like a real Southern gentleman. We were also going to bring two Lakota colleagues from South Dakota, but the woman had to have surgery and also couldn't come. Barbara Mainguy, however, could not come. She has come each year for the past three years. We are high over the Western New Mexico desert in a United Airlines flight from Albuquerque to Los Angeles. So Rocky and I will carry on for everyone. Beneath us are clouds and desert. No snow. The land is arid and dry -- so opposite of our home in Vermont. Melbourne will be in the height of summer, like the latter half of July in the United States. I've never been there in summer but I'm told that temperatures can top 40 degrees, though still not as hot as Tucson. My hottest day ever was +53 degrees one summer in Phoenix where we fried eggs on the car hood just because we could and mercifully spent most of the day in the swimming pool. I can't even remember why I was there anymore, but I was. We are coming from the Creativity and Madness Conference in Santa Fe, New Mexico. My talk was physician writers: the healing power of Narrative. Besides a marvelous Saturday night dinner, we spent most of our time preparing this talk. Our only other activities consisted of lunch with our friend Marga and her daughter. Marga is an amazing fitness expert and filmmaker who is currently unemployed thanks to the vicissitudes and foibles of St. Vincent Hospital in Santa Fe. She had been working there as a patient's complaints manager, but most of her department was "retired". I wondered with her who the hospital would get to talk the angry patients out of suing, since that had been her primary task. We wondered if the malpractice insurance premiums were perhaps less expensive than the salaries of people to prevent malpractice actions. We didn't know. We saw our friend, Amy Stein, who does a marvelous workshop for physicians and other health practitioners on how to draw a self-portrait. Amy has published a paper on her work in the Permanente Journal, a medical publication. It can be accessed at no charge by typing into google's search engine, "Amy Stein Permanente Journal self-portrait". In a beautiful place like Santa Fe, it's important to remind them that other places have beauty, also. We began with a quote from the physician, Anton Chekov, who said, "'Medicine is my lawful wife; literature is my mistress.'' I quipped to the audience, by the time we're done, "I hope you'll agree that Chekov should have said, as Dr. Tom Janisse (Editor of The Permanente Journal) said, "Medicine is storytelling; storytelling is medicine." Writing about our patients brings out the huge amount that is left unsaid in the encounter between physician and patient and physician and world. Writing allows us to be more than a clinical voice. It not only humanizes the patient, but also the physician. Current availability of media and access to ways of creating text is a revolution in medicine, allowing us now to write our clinical histories (stories) with our patients and allowing patients to edit and re-write those stories so that a rich, life-capturing document can emerge from the clinical encounter. Writing also allows us to manage the difficulties of medical practice. Writing the case story gives us more perspectives and awareness than we had before. Helping the patient to write his/her story reveals details and clarity never present before. It is also therapeutic (aka healing) for the person telling the story. I mentioned a 1999 study in the Journal of the American Medical Association in which writing about traumatic experiences helped people to make additional improvement over optimal medical management for both asthma and rheumatoid arthritis. For these people, storytelling is medicine. Engaging in this storying process also facilitates a more ethical and socially just relationship with patients because of the equalization of power that it entails and the respect the hearing people's stories creates. Then I made a humorous "black box warning" like the FDA does for drugs. James Gates Percival, an early 19th-century physician poet from Connecticut wrote: "If pleasure meet my ever-weeping eye, I see a demon lurking 'neath its flow'rs; The smile of joy but wakes the heavy sigh, And seems as sad as when the tempest low'rs" Diane Cox of the New York Times wrote that "Dr. Percival spent most of his life rejecting medicine for writing, then rejecting writing for medicine, all interspersed with nervous breakdowns and suicide attempts." So apparently writing doesn't work for everyone, though we could make the counter-argument that perhaps Dr. Percival would have succeeded at suicide had he not had poetry as an outlet. It's all in how you see the road: as leading to the bleak, horrors of winter, or toward the joys of another season's passage. Writing helps us get clear on that. Then I offered a poem by Mary Dowd, MD, from The Permanente Journal, Fall 2008. 12 (4): The door clangs shut. All eyes turn toward the diversion. The nurse and I walk in, two little female sticks, bobbing in a sea of men. Refresh Tag(s): Aboriginal; Culture; Healing; Language; Medicine; Poetry; Story; StoryTelling; StoryTelling; Suffering; (more...) Add to My Group(s) February 23, 2012 at 12:35:46 View Ratings | Rate It Promoted to Headline (H3) on 2/23/12: Permalink Medical Writing: the Healing Power of Narrative Add this Page to Facebook! Submit to Twitter Submit to Reddit Submit to Stumble Upon Tell A Friend Become a Fan SAVE AS FAVORITE VIEW FAVORITES Get Embed HTML Code By Lewis Mehl-Madrona (about the author) Become a Fan Become a Fan (22 fans) -- Page 2 of 5 page(s) futurehealth.org The room is large, but small, dimly lit, swarming with elbows, feet, faces dozens of men in orange scrubs talking, joking shoving, pushing pacing, roaming. The ceiling is high, but low, from two tiers up it presses down on me, filled with a gray-brown cloud, invisible, of something nameless, edgy, hostile and immeasurably sad. I feel the stares of men looking, and not looking at me wanting contact, conversation, attention, sympathy, distraction, anything, anything at all Wanting, so much wanting I feel it pressing in squeezing me bruising me like thumbprints, collapsing me. I shut down all my doors and windows and focus on a spot across the room Refresh Tag(s): Aboriginal; Culture; Healing; Language; Medicine; Poetry; Story; StoryTelling; StoryTelling; Suffering; (more...) Add to My Group(s) February 23, 2012 at 12:35:46 View Ratings | Rate It Promoted to Headline (H3) on 2/23/12: Permalink Medical Writing: the Healing Power of Narrative Add this Page to Facebook! Submit to Twitter Submit to Reddit Submit to Stumble Upon Tell A Friend Become a Fan SAVE AS FAVORITE VIEW FAVORITES Get Embed HTML Code By Lewis Mehl-Madrona (about the author) Become a Fan Become a Fan (22 fans) -- Page 4 of 5 page(s) futurehealth.org where a thin bar of sunlight filters through barbed wire to light a concrete court. I met Mary at a narrative medicine day for a literary arts conference at Goddard College. She works as a physician for the Department of Corrections in Maine. Her beautiful poem represents how physicians use poetry to make sense and meaning of difficult experiences. Then we looked at Kimberly Myers and Michael J. Green's paper from the Annals of Internal Medicine. January 18, 2011 (vol. 154 no. 2 129-130). They wrote how telling (and listening to) stories has long been held to have a positive effect on health. Narrative medicine studies suggest that telling others about one's illness can help ease suffering, by imposing a narrative order on frightening events. This was by way of introducing a paper by Thomas Houston and colleagues from the University of Massachusetts Medical School which was entitled "Culturally Appropriate Storytelling to Improve Blood Pressure: A Randomized Trial (same journal, pp. 77-84). They studied 230 African Americans with hypertension in an inner-city safety-net clinic in the southern United States. They provided people with 3 DVDs that contained patient stories about how people got their blood pressure under control, told by people who were very much like the patients who were watching the DVD's. The outcomes were changes in blood pressure for patients in the intervention versus the comparison group at baseline, 3 months, and 6 to 9 months. Most patients (71.4%) were women, and the mean age was 53.7 years. Among patients with baseline uncontrolled hypertension, watching stories statistically significantly reduced blood pressures. Patients with already controlled hypertension at baseline did not change over time between study groups. So writing and storytelling matters! Then I used the example of Oliver Sachs, best-selling author, physician, and professor of neurology and psychiatry at the Columbia University Medical Center. In 2007, he was named the first Columbia University Artist, in recognition of his contributions to the arts. He is best known for his collections of neurological case histories, including The Man who Mistook his Wife for a Hat (1985), Musicophilia: Tales of Music and the Brain (2007) and The Mind's Eye (2010). Awakenings (1973), his book about a group of patients who had survived the great encephalitis lethargica epidemic of the early twentieth century, inspired the 1990 Academy Award-nominated feature film starring Robert De Niro and Robin Williams. The New York Times has referred to him as "the poet laureate of medicine." Sachs is an example of turning case histories into literature and reveals much about how writing and literature can help us understand human suffering. Here's a short quote from The Man who Mistook his Wife for a Hat, which is an example of cortical blindness, in which a man "sees" without actually knowing that he sees. His optical system works and his brain works with it, but he has lost awareness of it because of a stroke. "And yet there was something a bit odd. He faced me as he spoke, was oriented towards me, and yet there was something the matter -- it was difficult to formulate. He faced me with his ears, I came to think, but not with his eyes. These, instead of looking, gazing, at me, "taking me in', in the normal way, made sudden strange fixations -- on my nose, on my right ear, down to my chin, up to my right eye -- as if noting (even studying) these individual features, but not seeing my whole face, its changing expressions, "me', as a whole. -- p. 9 ""Can I help?' I asked. "Help what? Help whom?' "Help you put on your shoe.' "Ach,' he said, "I had forgotten the shoe,' adding, sotto voce, "The shoe? The shoe?' He seemed baffled. "Your shoe,' I repeated. "Perhaps you'd put it on.' He continued to look downwards, thought not at the shoe, with an intense but misplaced concentration. Finally his gaze settled on his foot: "That is my shoe, yes?' "Did I mishear? Did he mis-see? "My eyes,' he explained, and put a hand to his foot. "This is my shoe, no?' "No, it is not. That is your foot. There is your shoe.' "Ah! I thought that was my foot.' Was he joking? Was he mad? Was he blind?" This passage gives us such a wonderful sense of what it's like to sit with someone who looks like they can see but can't actually see. The man eventually puts his hand on his wife's hair thinking it's his hat and tries to lift up her hair to put it on his head, which is how the story gets its name. On March 10th and 11th, I'll be in the Woodstock, NY area for a two day weekend workshop on narrative approaches to creating community through ceremony. On April 29th, I do a one week event at Kripalu Center for Health and Healing which involves Cherokee bodywork and ceremony and ritual. The details are on their website at www.kripalu.org.

On the Nature of Afflictions

"The affliction is the doorway; it is not the thing itself. The afflicted one is being asked to make an offering for the community." Thus, began Deena Metzger this past Saturday in a workshop which I co-facilitated with her in Topanga Canyon, California. Deena is a writer, a novelist and essayist, perhaps best known for her personal and inspirational writing about her own breast cancer experience. We sat together with a room full of people on top of a mountain next to the largest "inside city limits" park in the world, the Topanga Canyon Preserve which lies entirely within the city of Los Angeles. Coyotes intermittently howled their agreements and disagreements with our discourse from close quarters inside the canyon. Large ground squirrels (as large as our Vermont woodchucks) scampered from boulder to boulder outside the window. The vast expanse of Los Angeles lay nearby but out of sight from this panoramic vista. Within contemporary medicine and psychology, we have invented "things" to have. We have bipolar. We have attention deficit. We have PTSD. People want to know what they have. Rarely do the come to the consultation room acknowledging that they have been invited to enter a doorway to explore the nature of the universe. Yesterday I sat in my office with a woman who "had" leukemia. She had come to the understanding that she had never permitted herself the indulgence of exploring her own life until she was diagnosed with leukemia. Then she had something sufficiently serious as to justify her adventures into inner space. As her leukemia improved (co-incident with her inner journey), she wondered if she would reach a time when the severity of her condition no longer justified the indulgence of exploring the world of her mind and relationships to others. "So," I said, "in order for us to continue our work, will your leukemia have to relapse?" That comment shocked an awareness in her that she could continue for the sheer joy of exploring without the excuse of having a potentially life-threatening illness. Leukemia had invited her to open a door, but she could remain in the dimensions of the mind long after the invitation had expired. In 1976, Deena wrote that "cancer is silence". She was describing women who went "crazy", had nervous breakdowns, got heavily drugged, and then got cancer. She was determined to speak whatever had been silenced in her. Of course, I don't think cancer is always silence, but I do think cancer, as well as other illnesses, emerge interactively as meaning-making opportunities for those who have them. The meaning of the illness can sometimes be transformed into the meaning of the healing. Deena was describing an experiential phenomenon of her time -- the silencing of wild and crazy women through drugs and the emergence of that energy in other ways. She reminded me of the insanity of the changes in our small brook that happened during Hurricane Irene. So much water fell from the sky that nothing could contain it. Dams burst. The rise in water level was measured in meters. We can appreciate that still when we see refrigerators wrapped around the top of trees or car hoods nestled in branches far too high to reach. Deena believed that telling her story would be healing. For her, and for a generation of women, it was. The radical departure of this brand of narrative medicine from the biomedical model lies in the awareness of the embeddedness of illness in the entire context of a life story, even if the affliction is a mysterious visitor, even if it remains silent and cannot be made to speak. However shrouded in mystery it remains, it is a being with ontological validity. Within the medical model, illness is isolated, fragmented, and silenced. Its existence is denied. Its presence as a being is avoided. I believe illness has a story to tell. Visitor, friend, enemy, obstacle, antagonist, helper, or villain -- whatever it may be (and it can be all simultaneously), our affliction stands before us ready for discourse, no longer silent. The transition from positivist to narrative medicine gives illness back its voice and is fundamentally reanimating to the world. In medieval times, illness spoke. Ingmar Bergman's famous movie, The Seventh Seal, reveals the voice of the Black Plague in the being of Death itself who plays chess with the knight, returning from the crusades, expecting to lose, but with the intent of saving the lives of others with whom he is traveling. However, assuming that illness necessarily has a message is also positivist. The message may be the one that interactively arises through the dialogue with affliction. We co-create the message with the illness. What emerges may not have been present at the moment of affliction. A member of the workshop speaks up about using narrative methods with women who have received violence from a romantic partner. She now approaches them with genuine curiosity, with what Harlene Anderson and Harry Goolishian of the Houston-Galveston Family Center called a "not knowing" stance. She learned she could ask legitimately about the ways in which the women recipients of violence still loved their partners. In her old model, victims were not allowed to love perpetrators. Through narrative means, she could embrace the rich complexity of relationship in which love and violence can co-exist She shared how this awareness removed her from the frustration of being a social worker who was angry at women who returned to men who beat them. She could be less judgmental. She could be curious about how they would do this and the value of love over battery. She came to understand violence as a visitor into a situational relationship which deserved query. A part of us hates the violence. A part of us is angry at the person who is violent. A part of us still loves this person. How can these parts, these characters negotiate? How can you, the person who receives the violence, balance your anger, your love, and your desire to avoid being hit? How can we negotiate this? She told us how this approach was so much more effective than her previous black and white stance. When she allowed her clients to acknowledge the love, they could actually more successfully problem solve about how to avoid the violence. Narrative paradigms do not oppose biomedical therapies, only the blind reliance upon them. We realize that more levels can be considered beyond the merely biochemical. "What about athlete's foot?" one participant asked. "That can be quickly treated with an anti-fungal medication." "But there is a story there," I countered. "I have had this problem and it came from a story in which I was too busy to dry between my toes after showering at the gym. Going a little slower and doing self-care became an important theme that had manifestations in other areas of my life. I could take a narrative approach to athlete's foot by wondering about all the other areas in which bit of self-care could prevent a more serious problem from developing." Here I was proposing that everything that happens to and inside of our bodies involves story. Because our bodies are our lives, whatever happens to and in them has ongoing meaning and purpose, even if it didn't when it occurred. Illness takes place within a field that remains to be discovered and explored as potentially part of the healing process. This is also the message of Brian Broom, a professor of rheumatology at the University of Auckland Medical School in New Zealand, in his book, Meaning-full Illness. He writes how exploring the field of relationships, locales, and situations surrounding the illness can allow its meaning to appear and lead to its healing. Again, for him, illness serves as an invitation to enter into a dialogue. Even when illness appears to have no intrinsic meaning, we can seize the opportunity to construct meaning , to re-vision ourselves, to re-construct our lives. Brushes with mortality have that life-changing effect. Professor Hardy in the UK studies spiritual transformations and found a common antecedent to be near-death experiences. We humans have the unique capacity, as existentialists like Victor Frankl have written, to create meaning where none was before. This arises from our inherent, intrinsic capacity for storying, for applying our biologically primed narrative capacity to the physical world in which we are embedded. I'm happy to live in a storied world of magic and purpose more than a material world of randomness and meaninglessness. I'm happy to believe that my efforts at elucidating the field around an illness and identifying the characters who move in that field, matters. The rules of evidence also differ for me. I'm not as interested in mass produced, randomized, controlled trials, as I am in whether or not the people I see grow and change in meaningful and important ways which others can recognize. I use outcome measuring instruments like the MYMOP (My Medical Outcome Profile), Duncan and Miller's Outcome Rating Scale, and more. I do care if I'm effective or not. But I also listen to the stories I'm hearing and ask whether or not they're changing. The affliction, the label placed upon the suffering, gives us an excuse to sit and talk, to start a conversation in which change and transformation could occur. If it's early, for instance, in the course of metabolic syndrome, we could transform our lifestyle and loose the illness. If it's late, perhaps our goal is comfort and meaning, especially after the renal failure and blindness have occurred. In my experience, asthma also always responds to dialogue; less so, COPD. Cancer is its own unique set of complications. We can also develop strategies for interfacing with the remainder of the medical system. Recently a patient of mine had her second bypass surgery in 11 years. I knew it was coming because I could not get at the stories that kept her from controlling her blood glucose adequately. After it happened, however, the young specialists had a bevy of protocols on which to place her. If she took all their recommended medications, she would have been taking 12 different drugs each day, many of which interacted and all of which had side effects. We generated a plan of demanding end points from the specialists. What was the goal? Rather than take everything, she wanted to take only those medications which would clearly advance her capacity to walk extended distances and up and down stairs without shortness of breath. She proposed to the specialists to assess each drug individually for its contribution (or lack thereof) to her walking and climbing capacity. If it didn't make a difference, probably it was unnecessary, even though recommended by protocol. This was a new story for the specialists (but a common one to geriatricians who often joke about killing the patient to cure the illness). I was able to help this patient to negotiate with her specialists in a way in which she got what she wanted and they learned to respect her. We are still working to find meaning in the heart disease through co-authoring a story called "adventures of the heart". It is a work in progress but one that has already comforted her despite her limitations. Thus, illness or other afflictions present opportunities for meaning-making, through dialogue with the illness, through allowing it to speak and be heard, through querying it, through negotiating with it, through transcending it, through the myriad of relational opportunities available. Sometimes this allows the illness to calm itself, to depart, and sometimes it doesn't. Always the opportunity exists, however, to make more meaning than existed previously. This is the invitation that every affliction makes -- to co-create meaning and value.

Reflections after a Hypnosis Workshop

I spent this weekend in Wakefield, Rhode Island, co-teaching a workshop with my friend Peter Blum, a hypnotherapist from Woodstock, NY. Peter and I have co-taught previously in Woodstock, and once in Malibu, California, and even once at the annual meeting of the National Guild of Hypnotists in Massachusetts. We were at the largest non-residential yoga center in the Northeast, All That Matters. We had the pleasure of staying with Joan and David Dwyer (who started All That Matters) in their lovely three story house, nestled deeply in the Rhode Island woods. They have five children, one of whom we met, Greg, who was home for the weekend. Peter and I combine his Ericksonian approach with my narrative foundation to produce a hypnosis of changing stories to change lives. I had the opportunity to demonstrate a narrative interview with a man who didn't believe in stories, only in the truth. My challenge was to show him (and the participants in the workshop) how a narrative approach could be relevant even to him. Our new friend whom we'll call Mark, had a large story of people who did him wrong, from doctors who failed to diagnose his rheumatoid arthritis to investigators who failed to investigate his wife's murder which had happened twelve years earlier. Mark was a challenge because he wanted to tell all the details of the conspiracy that led to his wife's murder and the cover up of that murder. "Let's get "just the facts'," I said to Mark. I decided to focus on his son with whom he was currently estranged. "Let's focus on what your son would see as the facts." Mark agreed with that. Through great effort at stopping Mark every time he wandered into his conspiracy story, I was finally able to arrive at his view of his son's view of the facts. Mark agreed that his son would have said that he was born in Rhode Island, an only child. His father had been ill and unable to work for as long as he could remember. His father suffered from a mystery illness which no doctor had diagnosed that included migratory joint pain. Tests had been run and never showed anything. His mother supported the family, working as an investigator for the Rhode Island State Police. Finally when Mark's son left for college, a rheumatoid arthritis titer was positive and a rheumatologist finally diagnosed his father with that condition, started him on the appropriate medication, and his father improved dramatically. Things were looking up until his mother died in a car accident on an isolated highway at 4 in the morning near the time of his graduation from college. For the first year, he did his best to comfort his father who was distraught, but he tired of his father's unfolding conspiracy theories about how the accident being a murder covered up by politicians. Mark's son proceeded to find a good job, get engaged, get married, have a child, get divorced when his wife found someone else, find a new relationship, get remarried, and have two more children. His youngest was 3 months old at the time of my interview of Mark. That had kept him busy and removed from his father's struggles to expose government corruption. Now I was ready for Mark's story, which involved incompetent doctors who failed to diagnose his obvious problem for over twenty years followed by corrupt lawyers, police, and politicians who covered up his wife's death because she was investigating them. Mark had spent the past twelve years trying to find someone to declare his wife's death a murder and to expose the government corruption she had been investigating. The story was convoluted and difficult to understand, and in so many ways, never-ending. Mark was angry with his son for not believing the conspiracies (the truth, as he said) and for not picking up the torch to expose corruption. I had found a potential place for intervention. "Do you see how there could be two stories here, both of which use the same facts?" I asked. "The facts are that you were sick for a long time, finally someone made a diagnosis and treated you in a way that helped you, and then your wife tragically died. In your story, a conspiracy murdered her. Your son, on the other hand, accepts the official story, that she died in a car accident. Of course, Mark quickly interjected, "The truth was that she was murdered." "Of course," I answered, "but that story doesn't work for your son who's at a different stage of life than you and is preoccupied with relationships and having children and getting divorced and finding new love and getting remarried and having more children. His concerns are more immediate and different from yours," "He just doesn't want to see the truth," Mark said. "That may be," I asked, "but are you interested in being close to your son?" "Yes," he said, but not if I can't speak my mind. That reminded me of a movie which I described to Mark. In this movie, which several people in the workshop had seen, a man invents the variable speed windshield wiper and takes it to a big car manufacturer who steals his idea and pays him nothing. He spends the next 15 or more years of his life fighting for justice, even learning how to function as his own attorney, when he runs out of funds to pay legal fees. Eventually he wins his lawsuit but at the cost of his marriage and his relationships with his children and all of his money. Mark became really animated at hearing about this man. "That's great," he said. "He finally found justice." "But at what cost?" I countered. "The cost doesn't matter," Mark said. "Justice is worth it." "That's where you and your son disagree," I said. "The two of you have different stories about what justice is worth." Mark then argued that his story was the correct one. "If you want a better relationship with your son," I said, "you might have to respect his story as valid for him even though you wouldn't choose it. My reaction to that movie was the same as your son's might have been. Justice wasn't worth the price the man paid," "That's just wrong," Mark said. "We all have to fight for justice." "And that's where we disagree," I said. "So, if I was going to work with you, I probably couldn't help you find justice, because that's not my specialty. I know lots of situations in which injustices occur. I'm aware that governments are often corrupt and that bad things happen to good people. Just yesterday I saw a documentary about three men convicted of a murder in 1993 on flimsy circumstantial evidence who were finally exonerated with DNA. For every case that ends well, there are probably five that don't. I could help you find a way to respect your son's story and act around him in such a way that you get to see your grandchildren more often." Mark's other complaint was that people didn't want to be around him. They got tired of hearing his story and avoided him. So I added, "I could also help you learn better storytelling skills so you know when to tell the really short version of your story, like, I was sick for a long time and then my wife, and to hold the long version for those less common situations when your with people who actually want to hear about conspiracies and corruptions." That approach didn't really appeal to him either, but the demonstration was concluded. The moral of the story is that we can't help everyone, and we can be clear about what we can do and what we can't do. I asked Mark to agree not to talk about conspiracies or corruption for the rest of the day and then talked about my approach to people who have too big a story, which is to encourage them to write their book as therapeutic activity. I have two clients who are doing that to good results. Another client got amazing benefit out of writing a "zine" about her life. (Zines are short novellas written almost like comic books.) We can also sometimes enter into the story and work from within the story. I told a story about a young woman whom Barbara, my co-therapist, see. This young woman believes that aliens are broadcasting thoughts into her mind and trying to control it. Many had tried to dissuade her from that conviction to no avail. We enthusiastically entered into the story to help her to find ways to protect herself from the aliens. This approach is working because we are strengthening characters within her mind that can protect her from the aliens. We suggested that dogs are impervious to alien invasion because they lack a pre-frontal cortex. Therefore, the aliens can't control them and she could draw strength and comfort from her dog, which she is doing. We began studying movies with her, like Invasion of the Body Snatchers, and collected strategies that have been used in the past to protect minds from alien takeover. In the midst of this, our client has started exercising, eats better, has made new friends, and is doing things to get healthier. We were able to form a coalition with her. The key was her willingness to work with us. Following my interaction with Mark, Peter demonstrated hypnosis with someone with a physical affliction. A participant volunteered who had a dislocated toe. That was a greaexample, because some people said, "how can a dislocated toe have a story?" However, the toe wasn't healing as fast as expected. A story did emerge about the toe being at the end of the gall bladder meridian and the injury relating to moving too fast without taking proper self-care. So, even toes have stories that could be told. Every aspect of our lives is multiply determined with potential explanations on many levels.