How to Practice the Ideal Medicine

How Integral Medicine is put into Practice (Please read the blog post "The Ideal Medicine" first. Thank you.)

As I said, Integral medicine is my attempt to give you this ideal medicine. Many people have similar ideas about the ideal medicine. The problem has been, “How to put these ideals into practice?” The medical community’s best attempt so far is integrative medicine.

Integral medicine is my version of integrative medicine. I needed to develop Integral medicine as a distinct practice because there are some major problems with how integrative medicine is getting practiced most of the time.

True integrative medicine is more than just sticking a few herbs on the side of conventional medicine. For example, it looks at you as a whole functioning system rather than reducing you to 12 or 13 organ systems. This results in different ideas about how your variety of problems are interrelated, and such. Conversely, integrative medicine is not just any kind of alternative medicine: it must include the best parts of conventional medicine. So most of the alternative practitioners who call themselves integrative practitioners are not, really. They can be a member of an integrative treatment team, but they are practicing their own specific alternative therapy. If they are not also trained in conventional medicine, what are they integrating?

The Integral World View

The major hurdle that has made developing a truly integrative medicine so difficult has been the fact that conventional and most forms of alternative medicine are based upon radically different world views. And those world views mix like oil and water. To create Integral medicine, I have utilized a third world view where conventional and alternative medicine can meet as equals and the best of all forms of medicine can be synthesized into one seamless, philosophically consistent system of medicine. This third world view is called the “Integral World View” and was developed by Ken Wilber.

A Scientific Model for a Whole Human Being

The next step to developing your ideal medicine, after integrating all of the valid and effective ideas and treatments about health and disease, was to figure out how to treat you as a whole human being. To do that, I needed a deeper understanding of what that is than is offered by the conventional medical model. I found what I was looking for in the concepts of a human being developed by the ancient Vedic sages thousands of years ago. This view underlies Ayurvedic medicine and yoga. They saw a human as being made up of six aspects that are arranged as sleeves within sleeves, like the Russian nesting dolls. The sixth, or inner-most aspect is pure Consciousness, not consciousness as a neuroscientist uses the word (awake, as opposed to being in a coma) but the Consciousness that underlies all of creation. They also called this aspect of you the “true self”.

A symptom is a clue that something somewhere in your system is out of balance. Understanding how these different aspects, like your body, energy, mind, and beliefs, interrelate helps me understand where the primary imbalance is to be found so that you and I can find the best treatment to get that imbalance balanced.

I like this model because it explains many things that are a mystery in medicine. It explains what your mind is, for one thing, (hint: it is not your brain) and it helps to explain the mind-body connection. It sees your energy as just as real as your body. There are many more advantages to this model of a human being that are too numerous to get into here.

How to get to the Root

The next issue to address in developing your ideal medicine, now that we can use any valid treatment and idea and treat you as a whole human being immersed in a social and environmental milieu, is to get to the real root of your problems.

When you are wanting help for your health challenges, you have two major strategies you could pursue. You could work on changing what has already been created (which is what most conventional and alternative medicines do), or you could find and change the determinants of your creativity so that you stop creating what you don’t want and start creating what you do want. You can also do both strategies at the same time, which is what I generally recommend when you are starting on your Integral treatment plan.

What has already been created is being expressed as your symptoms. So trying to change what has already been created would be to use symptom-oriented treatments. This can be helpful when the symptoms are so loud that they are disruptive to your life. It is okay to treat depression while you are rooting out its cause. It is okay to treat pain while you are rooting out its cause. It is okay to treat your high blood pressure, high blood sugar, asthma, allergies, inflammation, whatever your symptoms, while you are rooting out the cause.

The main problem with effective symptom control is it often removes your motivation to root out the cause once you feel better. But you wouldn’t do that, would you? That is so last century. Besides, if you ever want to get off of your medications, you will have to get to the roots of your problems and treat those. There are reasons you are taking those medications. If you simply stop them, you will be back to where you started. To effectively get off of your medications, you need to put some other supports in place first. If you find and treat the root causes, your problems resolve and you won’t need your medications any more. So, what are the roots?

Consciousness

According to the Vedic model we were just talking about, Consciousness is creative. Every aspect of the physical universe is an expression of some aspect of the infinite Consciousness behind it. This Consciousness is timeless, it is outside the laws of physics. It created those laws. Since every aspect of the physical world is an expression of Consciousness, that means that all of your symptoms and the imbalances behind them are also expressions of Consciousness.

As humans, we have access to this infinite Consciousness, that sixth aspect, our true self. Yet, who do you know is fully expressing infinite Consciousness? I’ve not met anyone like that. So, that implies that something limits our access to this Consciousness and determines what aspects of it get to come into material existence as the experiences and stuff of our life. Whatever that something is, that is the determinants of your creativity. The real roots of your health challenges, whatever they are, are whatever allows those particular aspects of Consciousness to be expressed in your life.

What could do that? The Vedic model gives some ideas that are worth exploring. This is what I experience when I work on someone:

·        The inner-most aspect, pure Consciousness, feels like a core of intensely bright white light that runs up and down the middle of the torso.

·        Around that core of light is the fifth aspect that is totally transparent, like the glass around the flame of a hurricane lamp. This is your inner wisdom, your inner watcher, the wise, loving observer of you living your life.

·        Around that glass sleeve is a sheet of black plastic, totally opaque to the bright white light. This is the fourth aspect in the model, your intellect.

·        There are little pin-holes in the black plastic scattered around it that let little rays of light through. These are the contents of your mind, your beliefs and conclusions.

·        Your mind, energy, and body are then three more sheaths created by the light of Consciousness that makes it through the little pin-holes.

Each little ray of creative Consciousness that passes through each pin-hole creates experiences in your life that are consistent with the belief that is the pin-hole. Beliefs are, quite literally, self-fulfilling prophesies. When you change your beliefs, those little pin-holes move around, allowing different Consciousness through, creating different things in your life.

Beliefs

So your beliefs are the determinants of your creativity. “Man is as he believes. As he believes, so he is.” –von Goethe. (I think the same holds true for women, as well.) “If you think you can, you can. If you think you can’t, you’re right.” –Henry Ford. Our society has understood the importance and power of beliefs for hundreds of years. And, it turns out, you get to choose what you believe, with the right practice.

Since you get to choose what you believe, you can heal. To really work on the root causes of your health issues, you would need a way to find the belief that is allowing that issue to exist in your life and change it into a belief that allows you to create more of what you want. Many therapists and health practitioners understand this, yet developing effective, reliable, teachable techniques to change beliefs has been surprisingly difficult. Some, like Byron Katie’s work, EMDR, Focusing, and Emotional Freedom Technique (EFT), are getting pretty good but there is still room for improvement.

When I looked at why finding and changing beliefs was so difficult, I saw that it had to do with two issues: how your mind works and the Laws of Consciousness. Without going into a big, long explanation, basically, you need a way to get to the hidden beliefs in the nonconscious mind and you need a way to get them aligned with higher truth that works within the laws of Consciousness. I have found a way to do both. And I can teach you.

Inner Wisdom

Actually, you already know how to heal, at least your inner wisdom knows. But since it is hiding out behind that sheet of black plastic, your conscious mind cannot readily connect with it. You first need a belief that you can hear and heed your own inner knowing and that opens up a little pin-hole that makes it possible. You can create such a belief in your mind by choosing to have faith that you can do it.

If you do whatever it takes to connect with your own inner knowing earlier rather than later on your healing path, you will save yourself a lot of work, time and money. Imagine, if the pioneers had worked on inventing the helicopter first before heading west, how much easier their travels would have been.

Your inner wisdom is very smart. Not only is it monitoring all of the physiological processes in your body and keeping them in balance as much as it can, it knows when things get out of balance and sends you a message that it needs your help. Learning how to hear and heed your own knowing is the best preventative medicine. It also knows what it needs to correct the imbalance, so it will direct you to treatments that both work and have a low risk of side-effects for you. I’ve seen people’s inner wisdom direct them to try treatments that neither their, nor my, conscious minds would have ever thought to try. And those treatments usually work miraculously.

So, by putting all of this together: an integral world view so that all of your life can be taken into account with respect to your healing, a broad science so that all valid healing concepts and modalities are available if and when you need them, an expanded model of a human being so that you can get treated as a whole person living a full life, and a connection to your own inner wisdom so that you know how to eat, exercise, play and make other important choices in your life to be in your highest interest, we have a pretty good system of medicine to help you with any issues you face. This is Integral medicine as I strive to practice it.

Now we just have to heal health insurance companies…

The Ideal Medicine

If you could design the ideal medicine to help yourself heal and stay healthy, what would it look like?

Integral medicine is my best effort to offer you the ideal medicine. I have been developing it over the last 30 or so years of my career. Since medicine is a practice (some believe that means that we never quite get it rightJ), Integral medicine is a work in progress. I am always learning new things and thinking about how to offer you better service. I would like to hear what you think would be the ideal medicine for you. Below is what I came up with.

Safety

First, you would want it to be safe. Like Hippocrates said, “First, do no harm.” It turns out that going to a conventional medical doctor for conventional medical treatments is now the third leading cause of death in the United States (http://www.bmj.com/content/353/bmj.i2139). So, conventional medicine, as it is routinely practiced, does not meet this safety criteria. I think we can do better.

Conventional medicine encompasses a wide range of ideas and treatment options, not all of them bad. In fact, some are downright powerful and very helpful. When I broke my ankle, I was thankful there was someone around who knew how to screw it back together. But I was even more thankful that there was anesthesia and sterile technique for the procedure. But, once the surgeon was done, I took over with my nutrition and herbs, affirmations, visualizations, and exercises. I healed quickly and got a very good result.

So, for the ideal medicine, we want to be able to include the tools and techniques of conventional medicine but use them with the proper consciousness and in balance with other support. With carefully considered personalized use, you can receive the benefits of conventional medicine and avoid most of the hazards. I have spent years figuring out how to use conventional medicine this way.

Find and Treat Root Causes

Second, you would want your medicine to find and treat root causes of your problems, whenever possible. Most conventional, and even most alternative approaches, just put you on treatments that suppress the symptoms but do nothing for why the symptoms are there in the first place. I think this is due to the fact that our society in general, and the medical community in particular, has a very incomplete understanding of root causes.

I have some dedicated patients who have helped me understand root causes in more detail. They have stuck with me for years as we have peeled down through the layers of their health issues. These layers have a peculiar property: each new layer, when first it was uncovered, felt like the root causes until, with further exploration, deeper layers were found. We kept searching until the level of pure consciousness was reached. So far, we have not found any deeper layers.

What we have learned is that there seems to be some property of the Universe that I will call Consciousness, with a capital “C”, which is at the root of all of physical manifestation. Some properties of you determine what aspects of this essentially infinite Consciousness manifest as your life. Unless you are working with these properties of yourself and aspects of Consciousness, you are not working with the roots.

Whenever you are working to change things that have already been created in your life, you are treating symptoms. This is necessary much of the time and we are fortunate to have a very large palate of both conventional and alternative supportive treatments from which to choose. But don’t stop there. If you don’t also change whatever is determining what you are creating as your life, you will keep creating more of what you don’t want. Integral medicine integrates this two-pronged approach to your health issues: we use the safest, most effective, most natural treatments to support you while we are searching for and changing the determinants of your creativity. You can stop creating what you don’t want and start creating what you do want. I want your treatment plan to be personalized for you, so please let me know if you want to use this two-pronged approach.

Treat You as a Whole Human Being

Third, try to come up with some aspect of your life that has absolutely no impact or influence upon your health. Most people can’t. So, the ideal medicine would be able to take every aspect of your life into account when looking for causes and treatments. How you eat and exercise impacts your health. How you sleep, how you stress out, your relationships, your work, your play, what you think and believe, the environment around you…the list goes on…they all play a role in your health, and imbalances can occur any place in your system and fields, not just in your body. The ideal medicine would be able to treat you as a whole human being (not just a skin-bag of biochemicals) involved in society and immersed in your environment.

Utilize Every Valid Concept of Health and Healing

Fourth, people all over the world have been thinking about health and disease for centuries and some of them have come up with some pretty good ideas. The ideal medicine would have a place in it for every valid concept and every effective treatment that we, as a species, have so far devised. But, to put this noble goal into practice, two major challenges need to be met. First, we need to figure out how to determine whether or not a particular idea or treatment is valid, and then we need to figure out how to fit all of the valid approaches together into one seamless, internally consistent framework.  

Conventional medicine as solved these problems by being exclusive: it defined what it does as valid and excludes everything else. This strategy essentially ignores the challenges and leads to the exclusion of some very safe, effective, and affordable approaches that we would like to be able to utilize. Integral medicine rises to and solves these two challenges.

Integral medicine is inclusive but, obviously, not every idea can be included: there needs to be some validity to it. One of my students summed it up nicely, “I want to be open-minded, but not so open that my brain plops out onto the floor.”

Validity

So, how do we determine whether or not a medical idea or treatment is valid and effective? The materialist science upon which conventional medicine is based has its ideas about what is valid and what is bogus and it steadfastly refuses to accept the validity of any kind of knowing other than the third-person, objective knowing.

That is a problem because, if you want your medicine to be able to take into account all of human experience, humans can know things three different ways, not just one:

1.      You can know something objectively, by looking at it, examining it, and measuring its physical properties.

2.      You can also know something subjectively, your own impression or personal experience of something.

3.      And, it turns out, you can know something transcendently. You can just sit and think about something and a level of understanding of that thing will come to you. Have you ever practiced that? It is called “contemplation” and is a valued method of teaching in many parts of the world.

The scientific process of inquiry can be applied to each of the three ways of knowing, it doesn’t have to be limited to just the objective; and each way of knowing has its own way of sorting the valid from the bogus. So, your ideal medicine would, ideally, be based upon a broad science of all three ways of knowing, rather than the narrow science of only objective knowing. That would make it more able to take all aspects of your life and experiences into account. Integral medicine is based upon such a broad science.

Integrate all Ideas

So, we’ve solved the first challenge: how to determine the validity of all the world’s ideas about health, disease, and healing. The second challenge arises because these ideas and treatments are so varied, how do we get them to fit and work together? Some of them, Chinese medicine and conventional medicine, for example, come from such different world views that, unless both practitioners know each other’s systems, they can’t even talk to each other about a patient.

But every system of healing so far examined can be placed into one of the four quadrants of Ken Wilber’s integral world view. This integral world view provides the framework that can hold all the different healing traditions. If patients and practitioners are willing to adopt this integral world view and learn a bit about other healing traditions, everyone can get along and work toward the benefit of the patient.

I believe that the Integral medicine that I practice solves these two challenges so that we can bring to bear the best the world has to offer for you to use on your healing path.

Preventative

Fifth, you’ve probably heard the saying, “A stitch in time saves nine.” I don’t know if this has been scientifically proven: in my experience, sometimes it saves a lot more than nine. The point is that prevention is often a better strategy than needing to dig yourself out of the pit once you’ve fallen into it. So, again, you would like your ideal medicine to be focused on prevention at least as much as it does on treatment. “Prevention” to the conventional physician usually means “immunizations”. But there is so much more to real preventative medicine. Learning how to listen to the messages coming to you from your life and taking actions when the warnings are little whispers generally prevents the need for a 2x4 upside the head. You don’t want your life coming after you with a 2x4, believe me.

Participatory

Sixth, if you’re like me, I bet you don’t like being told what to do. I bet you like understanding the reasons you ought to do something and would like a say in the decision-making process. Your ideal medicine would be fully explained to you and encourage you to participate in the decisions and treatments, as much as possible.

Personalized

Also, no one size fits all, so your ideal medicine would be personalized for you, for your unique genetic makeup, your personality, your life. You would be in the driver’s seat. Your practitioners are your advisors, not your dictators.  

A Healthy Delivery System for a Healthy Medicine

Medicine is also dependent upon the social systems used to dispense it. I bet you would also like your ideal medicine to be accessible and affordable. Unfortunately, but not surprisingly, the healthcare delivery system in the US is as sick as is conventional medicine. I have tried many different practice formats over the course of my career, looking for the best way to dispense Integral medicine. In order to get insurance coverage for you to see me, I have had to make certain compromises to stay within the requirements put forth my your insurance companies. But I keep searching and, for now, the compromises are working fairly well.

Summary

So, let’s summarize. You would like your ideal medicine to be:

·        Safe

·        Effective

·        Comprehensive

·        Preventative

·        Participatory

·        Personalized

·        Available

·        Affordable

Did I leave anything out? Please let me know if you would like to add anything to this list.

A Brief Introduction to Integral Medicine: Part Three

Last week I began to explain the five aspects of the philosophical underpinnings of Integral Medicine:

1. The Integral Worldview
2. Broad science
3. An expanded model of a human being
4. A definition of health
5. The education metaphor

We got through the first three aspects in Integral Medicine: Part Two. Today I’ll discuss the fourth and fifth aspects.

A Definition of Health

In science, we usually define our terms. Science needs a precise language with which scientists can communicate with each other and the public. If healthcare were to be truly scientific, we’d need a definition of health and the healing process.

In fact, searching for just such a definition has defined the direction of my professional life.

Ever since the sixth grade, when I started wanting to be doctor, I’ve carried this image in my mind that doctors help improve people’s lives. When I was a resident and seeing my own patients in clinic, I was already bumping into the limitations of applying what I’d been taught to help my patients. I didn’t even know at the time what I was expecting to see in my patients’ lives, I just knew I wasn’t seeing it. I was asking myself why it is that people even go to the doctor. There are lots of reasons, but ultimately, I thought they were coming in to heal their lives.

“Heal their lives.” What did that mean? It was then that I was struck with a lightning bolt. There I was, in my seventh year of training in a discipline that prided itself on being scientific, yet no one to that point had defined healing or health. We all just talked like we knew what it was. But upon closer observation, doctors usually only use the word “healing” with respect to fractures or incisions. Not to people’s lives. They might cure an illness or treat a condition, but that’s about as far as it goes.

Why is that? Does it reveal an unspoken belief that healing can’t happen? That healing is too complicated, too capricious, too mysterious? Has the medical profession resigned itself to treating symptoms, thinking that root causes are somehow unfathomable or unreachable? I can’t speak for others, but I do have a difficult time understanding how a physician can really listen carefully to their patients, strive to truly help them and remain conventional at the same time, unless you see yourself as a technician, like a surgeon. (Although I’ve met some surgeons who are surprisingly good at working with their patients on very deep levels.)

Anyway, I thought the whole situation ludicrous, so I started on a search for the definition of healing. Seven years later I started to appreciate why the medical profession had left that question alone.

I started my search with Webster’s, whose definition is actually fairly good, the World Health Organization, the AMA, the American Holistic Medical Association (AHMA) and such. Each had attempted to define healing but relied on words such as “balance” and “harmony”: words which themselves needed defining. I needed a practical, boots-on-the-ground definition I could take into an exam room and actually do with a patient. The AHMA, for example, defined health as a state of balance and harmony with the Cosmos. Now go do that with a patient.

I thought perhaps other systems of healing might have some better answers. I looked into nutrition, herbs, Homeopathy, lay midwifery, Naturopathy, Chinese medicine, Ayurvedic medicine, Native American Shamanism, Buddhism, Chiropractic and some other forms of bodywork. I found they all have pieces to the puzzle that can be brought to the Integral Worldview, but none had what I was looking for.

About this time, I’d integrated much of what I had learned into my Family Practice, in what today would be called an Integrative practice, and I noticed that sometimes one of my patients would heal a bit. Even though I didn’t have a rigorous definition of it, curiously, we can recognize it when we see it. Perhaps that is why we can get by to some degree without defining. I reasoned thusly: “If a symptom is a clue that healing needs to happen, then the resolution of the symptom is a clue the healing has happened (assuming one has not just used a suppressive therapy), it is not the healing itself.”

So I started looking at my patients who healed to see what else, besides the resolution of their condition, had changed in them. What I saw was that they had learned something. And that something usually related to the understanding they had of themselves.

I wondered if that learning was the healing.

So I asked, “What if I define the process of healing as the process of us finding out who we really are and then acting in ways that are consistent with that?”

So far, that definition has been holding up pretty well. Ultimately, healing is mysterious and we cannot hope to control all aspects of it. But I think we doctors, as a profession, could do a much better job helping you use your health experiences to deepen your understanding of yourself.

For example, if you look again at Figure 5 below from Part Two, beliefs have creative influence over the body, mind, energy, how we behave in society and in how society and the environment influence us. Therefore, symptoms or imbalances in any of those horizontal aspects are clues to the underlying beliefs. Once limiting beliefs change, an entirely different experience in the body, mind, energy, etc. can be created.

IM_Figure 5_500

Each illness you experience has consciousness behind it. You can work with the physical, mental, emotional, social and such aspects of the illness and make some impact. But you can also work with the consciousness of it and make deep and lasting change in the illness.

These approaches are not mutually exclusive. But working with the horizontal aspects of the illness is generally supportive while working with the consciousness behind the illness is curative. Using Integral Medicine, we can work effectively with all aspects of you depicted in Figure 5 above.

Over many years of searching, I’ve developed good, practical ways to work with people on all of these levels at once. And I can teach other practitioners how to do that.

The Education Metaphor

You can generally tell a lot about the underlying assumptions and world view of a discipline by the metaphors it employs.

Conventional medicine uses two dominant metaphors: the war metaphor and the machine metaphor. In the war metaphor, the illness is the enemy to be fought and either vanquished or you become a victim of it. We develop new drugs in our armamentarium against cancer, for example. Your body is the battle ground, often trampled and scarred and even destroyed during the battle. The doctors delusionally think they are the Generals in the battle, but actually they are just the foot soldiers. The CEO’s of the large medical corporations such as the drug and insurance companies are the real Generals. The soldiers just do as they are told or they are dishonorably discharged.

Very early in my search for a definition of healing I observed that healing is not about war. No one actually wins a war. There are always casualties on both sides. One cannot heal if they are at war with themselves and one has a very difficult time (not impossible) healing if they are at war with others or the environment.

One of my first jobs when a new patient starts seeing me is helping them stop the war that they are having with themselves.

The machine metaphor likens your body to a machine. Your heart is a pump, your brain a computer, your joints are hinges, your lungs bellows and so forth. But, as the Vedic model points out, we are more than machines. Our bodies have consciousness, intelligence, wisdom and loving compassion. We do not just have to order our bodies around. We can develop a more collegial relationship with it: listening, dialoguing, working things out.

Natural medicines of several types often use a garden metaphor for health and the body. You prepare the soil, plant seeds, pull the weeds, avoid toxins, nurture and support and Nature does the rest. This metaphor is much gentler than the war metaphor but a garden is still a controlled, human-ego created environment. It does not have the same Spirit and sustainability as does deep wilderness. Many of the greatest teachers in human history gained their critical insights while in wilderness. Is that just a coincidence? If you listen to the stories of people who have experienced spontaneous remissions from cancer or HIV, for example, many of their critical insights happened when they were with Nature. What is that about?

Integral Medicine uses what I call “The Education Metaphor.” If healing is the process of us finding out who we truly are and then living in a way that is congruent with who we are, that is a learning process. Seeing all of life as a chance to learn helps that process.

In the Education Metaphor, the “student” is you…your conscious sense of who you are. By definition in psychology, this is your ego: whatever comes to mind when you say the word “I” to yourself. The teacher, then, is pure consciousness, your Atman, God, your Higher Self, whatever concept of your deeper wisdom that works for you. The classroom is all of creation, the curriculum is all of your experiences, both conscious and non-conscious, and the learning objective is answering the question: “Who am I?”

This is and has been the perennial question in mythology, literature and the arts.

In ancient Greece, the famous seer the Oracle of Delphi used to hang out in the temple of Apollo. On a column leading to the door of the temple there was a plaque with an inscription on it that explained everything you needed to know in order to accurately interpret what the Oracle told you. It said, “Know Thyself.” Some of the best Greek tragedies that survive today are about what happened to people who mis-interpreted what the Oracle told them because they did not know themselves well enough.

As your education proceeds, who you think you are (your ego) gradually starts to look more and more like who you really are (your deep wisdom) until they become indistinguishable. Spiritual traditions have a name for this: enlightenment.

So you don’t want to kill your ego (as some misdirected people talk about), that’s pretty stupid and uncompassionate. Good teachers don’t generally kill their students during their education. But if the student learns well, they can grow up to be teachers in their own right.

From this perspective, your health challenges can be viewed as stepping stones on your path to deeper understanding of yourself, on your path to enlightenment. Suppressive therapies and other therapies that just treat symptoms – that just shut the body up-bind and gag the teacher and throw her in the closet. This generally impedes the progress of the class. Most of what conventional and alternative medicines do today actually slows down your learning, in reality prolonging your suffering.

How do you think your inner teacher feels about you? Is s/he going to give up on you if you don’t learn the lesson the first time? That’s not been my observation. Lessons not learned in one relationship show up in the next. Lessons not learned in one health crisis show up in the next, usually with louder volume.

The converse is also often true: once you learn a lesson, the teacher doesn’t have to keep presenting it to you over and over, you can move on to the next lesson. (The lessons seem to keep coming as long as we’re breathing.)

No matter what is happening to us, potentially we can learn from it. Therefore, I believe healing is always possible.

We want our bodies to work well, our minds to be sharp, our energy to be abundant, our relationships to be loving and supportive and our environment to be non-toxic, but we are bound by the laws of physics in this: I’ve not yet witnessed someone grow back an amputated leg, for example. But healing in a higher sense is always possible. I like to always leave the door open for miracles, but it may be true that while there is always a possible relief to suffering, there may not always be relief of pain. But I don’t know this for a fact yet.

Keep Searching

Remember, healing has very little if anything to do with the functioning of your body, the workings of your mind, the robustness of your energy and such. But before you start thinking that I’m a therapeutic nihilist, remember that we barely have an inkling of who we really are and how powerful we are as divine beings. The creativity that we have potential access to is limitless. In fact, it is only limited by our own imagination, and much more is possible along the lines of physical, mental and energetic balancing than we yet understand.

For these reasons, never give up.

Keep searching for answers to your questions, to solutions to your health problems. Search outside yourself in the world around you for therapies, treatments, supplements and such that are helpful.

But also search inside yourself for the opinion of your own wisdom. How does it want you to be with yourself, with your problems and challenges? What is the consciousness creating your illness and is that the only consciousness you have access to? What are the beliefs that are allowing that illness-consciousness to flow into your life and are they really true? If need be, find a practitioner, friend or some other person who can help you explore questions like these.

Copyright 2012 Steven M. Hall, MD

A Brief Introduction to Integral Medicine: Part Two

In this post, I’ll start to explain the five aspects of the philosophical underpinnings of Integral Medicine:

1. The Integral Worldview
2. Broad science
3. An expanded model of a human being
4. A definition of health
5. The education metaphor

The Integral World View

The Integral Worldview is based upon Ken Wilber’s work. He observed that our era is the first in Human history where we can have access to all the different world traditions at the same time. Not just all the branches of science and psychology but also religions, languages, music, art and literature. Each world tradition has its own view of the Truth. He asked, “What if we took literally everything that all the various cultures have to tell us about human potential – about spiritual growth, psychological growth, social growth – and put it all on the table? What if we attempted to find the critically essential keys to human growth, based on the sum total of human knowledge now open to us? What if we attempted, based upon extensive cross-cultural study, to use all of the world’s great traditions to create a composite map, a comprehensive map, an all-inclusive or integral map that included the best elements from all of them?” (The Integral Vision, page 16). Mr. Wilbur is also founder of the Integral Institute.

Without going into too much detail, he found that one could construct such a map with just five (relatively) simple elements: quadrants, lines, levels, states and types. Figure 1 shows some details of the four quadrants.

IM_Figure 1_500

The right upper quadrant is the objective aspects of the singular or individual. The left upper quadrant is the subjective or inner experience of the singular or individual. The right lower quadrant is the objective or exterior of the collective and the left lower quadrant houses the inner or subjective aspects of the collective.

For example, if you wanted to know the chemical composition of wheat, that would be in the right upper quadrant (RUQ). If you wanted to know how much wheat Canada produced in a year, that would be in the right lower quadrant (RLQ). If you wanted to know what it felt like to be a Canadian, that would be in the left lower quadrant (LLQ) and if you wanted to know the beliefs, aspirations, personal and spiritual growth any particular Canadian, that would be left upper quadrant (LUQ).

Pick any experience you have and look at it closely. You’ll see that influences from all four quadrants are active in it all the time. This reminder is one strength of the Integral World View. It is very easy for us to hone in on the influences of one particular quadrant in any given experience and ignore the others.

Figure 2 shows that though most philosophers don’t ignore the other quadrants, they tend to emphasize one enough to be associated with it.

IM_Figure 2_450

Real deep healing requires us to take all influences into account. How your insurance company treats you (RLQ) throughout the course of your illness and recovery has an impact on your health, just as surely as does the medicine or surgery (RUQ) you experience. Your inner strength and fortitude (LUQ) along with your social support systems (LLQ) play enormous roles in the path your healing takes.

Broad Science

The Integral World view leads directly to the development of a broad science. Most of what we think of as science in our culture confines itself to the RUQ.  The science upon which Conventional Medicine is based is primarily RUQ. But science is taking place in the other quadrants as well. Sociology, archeology, geography, systems theory, psychological studies on individuals and groups, the list goes on. Science is the best methodology we have so far for knowing things. There is no logical reason that the scientific method could not be applied to the knowing in each quadrant.

But there is another concept that needs to be taken into account. Not only can we study Nature from the perspectives of all four quadrants, there are also three ways, for lack of a better descriptor, that Humans can know something.

We can know things objectively. I can measure your blood chemistries, your EEG, your EKG, I can CT your entire body. I can collect all kinds of objective information about you. (You ought to see the kind of information Target collects on you when you shop there…information they use to refine their marketing efforts toward you. (That is why they call their store “Target”: because you have one on your back as soon as you walk in the door.)) But all this kind of information only gives me one side of who you are. To learn all this about you, I don’t even have to talk to you. This is a monological way of knowing things. I can study the right two quadrants with monological science.

We can also know things subjectively. I can ask you questions and find out what you believe, what inspires you, what’s holding you back, etc. To learn this side of you, I have to have a conversation with you, a dialog. This is a dialogical way of knowing things. I can study the left two quadrants this way.

Then it turns out that if we just stew about something, if we pick something and contemplate it deeply, we can know things about it – often deep or fundamental things, like true natures and stuff like that. This is a very common way of knowing, taught in many Spiritual traditions around the world. This kind of knowing is transcendental, it transcends the other two, so is often called translogical. I can use transcendental knowing to learn about all four quadrants and the consciousness underlying them.

Broad science is based upon the idea that one can use the scientific method to find the valid ideas and concepts revealed by all three ways of knowing, not just the monological. Many monological RUQ scientists have difficulty accepting the validity claims of the other three quadrants (Figure 3).

IM_Figure 3_450

The broad science of Integral Medicine accepts these validity claims, when they are adequately met.

A Proposed Model of a Human Being

As was already mentioned in Part One, Science needs to work with models of Nature, since Nature itself is currently too complex to study all at once. Since you are the “system of study” for the science underpinning medicine, we need a good model of you with which to work. The conventional medical model says that you are a skin-bag of biochemical reactions. For example, serious research is currently going on trying to figure out how the chemistry of your brain generates consciousness. I have not found this model robust enough to be of much help when working with real people having real problems in real life. Of all the models of a human being I’ve looked at over the years, I’ve found the Vedic model to be the most helpful, so far. (Figure 4.)

IM_Figure 4_450

The Vedic model says that a human is composed of six aspects, six irreducible perspectives, so to speak, that the ancient sages saw as arranged like sheaths over sheaths, like the Russian nesting dolls. The outer most aspect is the physical body, with all of its biochemistry. Under this is energy they called Prana. It is the energy that allows the true self to be animated in the physical world. The next layer is the mind. (Note that in this model the brain would be part of the body, while the mind is its own separate and distinct perspective.) The mind processes the information from the physical senses and makes conscious sense out of it. It also is able to control the energy and the body. The next sheath is wisdom or intellect. I see it functioning in people as the collections of beliefs they’ve drawn during their lifetime that functions as their world view.

These outer four sheaths make sense to us in the West because if we were to make a robot, it would have these four aspects: it would have a body, a battery pack or power source of some kind, it would have a computer to process the information the robot detected and tell it what to do, and it would have software programmed into the computer. But, and this may come as a surprise to some followers of Conventional medicine, as humans we are more than robots. We have two more deeper aspects.

The fifth aspect is called “bliss.” This is not just feeling good, but is pure being, the inner peace that is not disturbed by any shenanigans in the body, mind, energy or beliefs. I see this aspect functioning in people as their inner observer. But it is not just any old cold scientific observer. It is wise, kind, understanding and deeply loving. The closest I’ve seen the West come to the concept of this is the Transcendentalists of the mid and late 19th century: Emerson, Thoreau and those guys. But I’ve found that learning how to touch into and communicate with this aspect of themselves is vital for my patients’ healing.

The deepest and sixth aspect of us is pure undifferentiated consciousness. This is that part of us that is outside the laws of physics. It was never born and will never die. People touch into this in Samadhi during deep meditation.

Just like all four quadrants are influencing every moment at all times, all six aspects of you are operating at the same time. Pragmatically, I see most of them operating like different arms of a mobile or, in more technical terms, correlates of each other. If you walk up to a mobile and bump one part of it, the whole mobile moves. Thus, if I add chemicals to your body and change the physical, that change will have analogous changes in your energy and in your mind. If I stick you appropriately with acupuncture needles and change your energy, that will initiate changes in your body and mind. If we do some cognitive behavioral therapy and change your mind, that will trigger changes in your biochemistry and energy. This explains the mind-body connection, which is a misnomer, actually. To be connected they must first be separated. They are not separated, they are really just different sides of the same coin, different ways to observe who we really are, which, as Spinoza describes it, is a divine mystery.

We are obviously also influenced by society and the environment. So the model of a human being that helps me deal with all four quadrants and the complexity of cause and effect with respect to disease looks like Figure 5.

IM_Figure 5_500

Pure Consciousness: There is only one. It is outside the laws of physics and has causative influence on the physical. In the Vedic cosmology, this is called Brahman or Purusha. Our deepest inner core of it is often referred to as Atman. I think of it as pure potential. In quantum mechanics, infinity keeps popping up in the math of it and is always needing to be adjusted out so the equations make physical sense. Pure consciousness is the infinite. I think of pure consciousness as the “nothingness” (more rightly thought of as the “everythingness”) out of which the strings appear and into which they disappear in String Theory. In the Judeo-Christian cosmology, pure consciousness could be thought of as God transcendent.

The Inner Observer functions like pure consciousness’ right-hand man within the laws of physics. It has many of the same qualities Spirit has: wise, kind, loving, compassionate, understanding, forgiving. Imagine if we could continuously view ourselves and feel towards ourselves in these ways as we go through our lives.

Beliefs are next in line and not on the horizontal line because they are so fundamental to what we are able to create and how we experience the aspects of us that are on the horizontal line. It’s as if pure consciousness, also pure creativity, since consciousness creates the material, is like a pure white light shining in our cores. The inner observer surrounds that white light and fully transmits it, like clear glass. The next layer, our beliefs, functions like a layer of black plastic, opaque to the flow of creativity. Our beliefs are like pin-holes in the plastic, only letting through that light that is consistent with it. Like Henry Ford said, if we believe we can, we can, if we believe we can’t we’re right. Perhaps you’ve also heard the saying, “If you want to know what a person believes, just look at their life.” Changing your beliefs can totally change your biochemistry, your energy, what you think about, how people treat you and the choices you make in your life.

The items along the horizontal line are self-explanatory and function like the arms of the mobile.

I like this model because it explains so many observations. It says that conscious is primary. This is why we can have intuition, spontaneous creativity and volition. It explains why we can go inside and find wisdom. We can, but we don’t need to learn about wisdom by reading about it. It explains why we can know something intellectually yet it doesn’t change our biochemistry. We need to know it on a deeper level, the level of changing non-consciously held beliefs, to effect a physical change. It explains why basic human nature, underneath the wounding and confusion of life, is loving and kind. It explains a lot of other things as well, like Spiritual healing and the physical effects of meditation, too many things to go into here.

Broad science can then be used to flesh out the details of how these components interact and influence each other. This would give us a much deeper understanding of healing and how to responsibly use other modalities than just drugs and surgery. We would deepen our understanding and appropriate use of group therapy, community, meditation, exercise, body work, energy work, prayer and such.

If Medicine adopted a model such as this and used broad science to deepen our understanding of all of its facets, we would have a medicine that could make good use of all the data of human experience. It would be able to see you and treat you as a Whole Human Being. It would be Integral Medicine.

I’ll discuss a definition of health in Part Three.

Copyright 2012 Steven M. Hall, MD

A Brief Introduction to Integral Medicine: Part One

I met a woman recently who had been insured by Anthem for twelve years. Within three weeks of her diagnosis of a brain tumor, Anthem notified her that they would no longer cover her. Can you imagine having to deal with the news that you have a brain tumor then have your health insurance yanked out from under your feet? This happened to her in 2010. Luckily, she’s survived her brain tumor and now Obamacare has made such reprehensible behavior by health insurance corporations illegal. Obamacare patches up a few things but Conventional medicine still has a terminal illness. If not for the dedication and humanity of most of the people working within that sick system, it would have collapsed long ago. Doctors, nurses, pharmacists and the like are carrying the burden of the healthcare system on their backs, but they are burning out at an ever increasing rate. We can’t keep propping up Medicine while medical corporations continue to run amok.

I don’t need to elaborate the symptoms of Medicine’s illness, we know them all too well: the run-away costs that are breaking the financial back of the industrialized world; going to your conventional doctor for treatment is now the third leading cause of death in the US; we spend the most per capita on our healthcare yet we rank around 40^th on most measures of health, such as infant mortality and such; millions of people are uninsured…the list goes on.

We all know the symptoms of the disease. People are proposing solutions that attempt to treat the symptoms. No one is talking about the cause. Changing the way we pay for healthcare will not cure the system: that just treats some of the symptoms. When I look at the healthcare crisis, I see two causes: 1) the corporatization of healthcare and 2) the science upon which medicine is based. In this blog, I want to address the latter and come back to the former.

Clinical Medicine is not a science. It is a discipline based upon a science. Doctors are fond of saying that the practice of Medicine is both an art and a science. They are flattering themselves: the clinical practice of Medicine is engineering. The practice of medicine is not science. When that anesthesiologist is putting you to sleep, you hope the science has been done and that he’s not experimenting on you. And art is…well, how do you define art? Engineering can be defined as the artful application of scientific principles toward the solution of problems. And that is definitely what most doctors want to do with their patients if the System would just let them (see previous blog posts).

The problems that Medicine is trying to solve are those of human disease and suffering and the creation and maintenance of health. Medicine needs to be based upon a science that is appropriate to the task. The science upon which Conventional medicine is based is too limited to encompass all of human experience. Yet we have good data to support the idea that all of human experience impacts health. We need a medicine that is based upon a broader science, one that can explore all of human experience, not just the physical, biochemical level or our experience.

Integral Medicine is based upon such a science.

The purpose of science is to understand Nature (so that we can ultimately bend her to our will.) Over time, the discipline of science has developed a strategy, called the Scientific Method, which is arguably the best method we have for sifting out the truth from a lot of different possibilities. The Scientific Method is not perfect, for it is performed by human beings. But, when followed properly, it is self-correcting. Interestingly, a method of inquiry akin to the Scientific Method is one of the seven classical pathways to enlightenment.

The Scientific Method has several defined steps that we are all supposed to learn in High School science classes. The first step is to pick some part of Nature you want to study, for example, an ant hill. The next step is not mentioned much but is more or less assumed: look through the published literature and see what others have already learned about ant hills. The next step is to observe an ant hill and collect some raw data. Then you look at the data and try to make some sense out of it. You propose a theory that tries to explain as much of the data as possible. Here is where it gets interesting.

Since we don’t know Nature, we need to propose a model of Nature, or at least of that aspect of Nature that we’re studying (scientists are still working on a Unified Theory of everything). The model, by definition, needs to be a simplification of Nature. In order to make that simplification, we must make some assumptions, usually called “simplifying assumptions”, about our system of study. Every scientific discipline has its model. Conventional Medicine, for example, has its medical model.

Ideally, your theory fits within the current prevailing model for that scientific discipline. On rare occasions down through history, Science has had to make major modifications to foundational assumptions underlying the predominant model and a Scientific Revolution ensues. (http://www.amazon.com/Structure-Scientific-Revolutions-Thomas-Kuhn/dp/0226458083) But this is rare. The bulk of scientific work entails discovering new and useful details that help to “flesh out” the prevailing model.

So let’s assume that your theory about your ant hill fits within the prevailing model of life currently held by most biologists. The next step, then, would be to pose a question and make a prediction: “If I dropped some bread crumbs here, this is what I expect the ants to do.” This is called developing an hypothesis. (If this is triggering PTSD from your high school science class, I apologize. I’m laying a foundation to get to my point.) Once you construct your hypothesis, you design an experiment to test your hypothesis. In your experiment, you have to try to anticipate and adequately control possible confounding variables, that is, other things that might happen that would make interpreting your results more difficult or less reliable. For example, every time you dropped bread crumbs, you want them to be the same kind of bread crumbs.

Then you actually perform your experiment, collect the observations and see how they compare with what you predicted. You also compare your results with others who have performed the same or similar experiments to see how your results stack up to theirs. The more experiments you do that match the prediction you made based upon your theory, the more you start to have confidence that your theory actually captures and represents some important or vital aspect of Nature.

In medicine, the aspect of Nature that we’re exploring is you. Some people would use scientific information about you to bend you to their will (http://www.huffingtonpost.com/warren-adler/keeping-the-sheep-dogs-at_b_950151.html) but in Medicine we like to think that we’re high-minded enough to use science not to bend you to our will but to help you improve your health, which, hopefully, is bending yourself to your own will. In Medicine, the data that we need our model to explain is all of human experience. How is that so? Well, try to think of one experience you’ve had that has absolutely no impact whatsoever on your health. Pretty hard to do, I expect. Everything in your life influences your health. Everything in your life is fair game when it comes to looking for the root causes of your health problems. We need a medical science and a medical model that can take all this kind of information into account.

In The Structure of Scientific Revolution, Kuhn elaborates on several symptoms a particular branch of science will exhibit when the pressure for a scientific revolution is building. Conventional medicine exhibits all of them. There is a great body of human experience that lies outside, that is, cannot be adequately explained by conventional medicine. A large number of alternative models of healing and health are being put forward. More and more practitioners are becoming aware of the limitations of conventional medicine (lagging somewhat behind the awareness of the general population.) The predominant underlying assumption upon which the conventional medical model is based says that you are but a skin-bag of biochemical reactions and all diseases are an imbalance of those chemical reactions, injuries or natural aging. If we but knew what those reactions were, we could pour in other chemicals and you could then be the person you want to be or we could sew you back up, wire you together or replace worn-out parts.

More than Biochemistry

You are indeed a skin-bag of biochemistry. But is that all you are? Are you a victim of your genes and environment, merely reacting to and from them all the time, or do you have consciousness, identity, creativity, volition, free will? Do you have meaning in your life? Do you see meaning in some of the events around you? How can there ever be spontaneous creativity if we’re all locked into a physical deterministic chain of cause and effect? I think it is high time we make a new medical model.

Kuhn also elaborated some of the characteristics that the new paradigm replacing the old ought to have. It needs to first adequately explain all the data and observations covered by the old model and it ought to also be able to explain and incorporate most of the observations that were out-lying to the old model. It also ought to be amenable to the process of science fleshing it out. Integral Medicine is based upon such a science. It is able to take into account and make sense out of most human experiences that lie outside of the current medical model, such as mind-body connections, placebo effect, spontaneous healing, shamanism and such.

The framework of Integral Medicine has five parts:

1. The Integral Worldview
2. Broad science
3. An expanded model of a human being
4. A definition of health
5. The education metaphor

Let’s explore this framework in Part 2.

Copyright 2012 Steven M. Hall, MD