Feelings – Example

We’ve talked about how feelings, both physical and emotional, are messengers bringing you information about what’s going on inside of you. By getting the message from the feeling, we are often in a position to take meaningful, appropriate action to correct any imbalance or problem that the feeling may be “talking” to us about. That imbalance could be a lack of water, food or specific nutrient; it might be we need to get up and move around; it might be that we are harboring a host of limiting beliefs. Physical feelings do not always have physical causes. Emotional feelings do not always have emotional causes. Each feeling needs to be listened to and followed to its roots in a non-judgmental, unconditional, honest way. Any fiddling with the feeling risks blocking you from your truth.

Elizabeth (not her real name) belongs to a fairly active and close-knit group of people who collect and distribute food to house-bound elderly in their community. She is generally self-assured, confident, energetic, out-going and well aware of the messages coming to her from her body. She is very health-conscious: grows most of her own food, eats organically, her lifestyle includes plenty of exercise, she treats naturally when needed, has a spiritual practice, great relationship…stuff like that. Not too long ago, a couple of women in the group decided to take a disliking to her.

They think that she violated an agreement or something and no amount of explaining was able to change their minds. For months, these women would, seemingly out of the blue, bad-mouth her or back-stab her. Nothing she did made the situation any better. Over time, she started experiencing more anxiety and felt like she’d lost her Spiritual center. She was not sleeping as well and had become more hyper-vigilant. She also found it more difficult to listen to her body. She said she knows now how it feels to be bullied. She’s worried that the chronic, smoldering anxiety is planting the seeds of disease in her body and wants to “get back to” her sense of calm and confidence. She’s been meditating more, but it’s not working.

First, what she’s feeling is very common in people who are being attacked, whether the attack is physical, verbal or psychic. One often feels hopeless, trapped, demoralized, anxious and even depressed. She’s not used to feeling this way and now has more compassion and understanding for people who do, but she really wants to get back to how she was feeling before these two women started back-stabbing her.

This is a perfect example of what we do to ourselves with our feelings. We don’t like how we’re feeling now and we want to feel something different. So we often try to make the uncomfortable feelings go away with techniques as simple as ignoring them or as sophisticated as creating entire New Age philosophies to rationalize them. Even intelligent, psychologically adept and spiritually minded people do this. The trouble is, it doesn’t work very well.

We often try to make changes to the outer circumstances in order to change how we’re feeling. If there is anything that you can do to improve the outward situation and you feel called to do it, you definitely should give it your best effort. It was reasonable for Elizabeth to make a couple of attempts to clear up any misunderstanding that may have happened. But once that does not work, what others think, feel or believe, especially about you, is out of your jurisdiction. Unless you’re a whiz at advertising, you might not be able to effect much change in that arena.

Elizabeth was getting very clear about that. We talked about feelings and how to see them as messengers and how to stay with the feeling just as it is. We discussed the difference between thoughts and feelings. One does not need to indulge unsupportive thoughts and it’s okay to note that such thoughts are there and redirect your focus, but you want to really hear what your feelings are trying to say to you before doing anything to make them change or go away.

I spoke with her several weeks later and the anxiety was still there to some degree, but she had realized that she could not change these women so she wasn’t going to taking it so personally. She had concluded that she didn’t need to put any more effort into trying to convince these women of anything and instead was able to focus on the question, “What is the Universe trying to teach me through all this?” She realized that these women’s treatment of her bothered her so much because they were impugning her integrity. Her integrity was important to her and she didn’t like being misunderstood.

She decided that 100% integrity wasn’t enough. She resolved to keep a close eye on herself and live in “1000% integrity.” As she’s been doing this, her anxiety had been slowly abating and she’s feeling her confidence and energy return. She’s also opening back up to information from her body. Instead of seeing the anxiety and sense of disconnect as the problem that needed to be addressed directly, she was able to listen to the deeper themes underpinning the feelings and deal with them. As she did so, the feelings changed. In other words, the messengers didn’t have to keep bringing the same message once that message was dealt with in an appropriate fashion.

So often, when we go through trials in our life, if we work with them in a healthy way, we improve; if we work with them in an unhealthy way, we often get closed down. Whether you feel opened or restricted by the challenges in your life gives you a clue as to how you are working with them.

When we are able to be healthy with our feelings and keep our efforts where we have jurisdiction, we get clearer about who we are and how to make choices congruent with that, we get physical healing as our bodies start working better, we often have more energy and find it easier to “get in the flow.” These are indications that healing has happened.

Be present with your feelings. Remember, no matter how you are feeling in any given moment, you can still be kind to yourself.

Follow these steps to get the messages from your feelings and make the changes that your painful or uncomfortable feelings are asking you to make. You can do this.

Copyright 2013 Steven M. Hall, MD

Previous Posts in this Series: 1.  Healing Implies Change 2.  Emendation 3.  Faith 4.  Awareness 5.  Acceptance 6.  Compassion 7.  Feelings – Part I 8.  Feelings – Part II

Feelings – Part II

To be healthy in general, we want to be healthy with our feelings. To be able to continue to use the stuff of our everyday life to grow and reach our full potential we need to be healthy with our feelings. Managing our feelings, wanting to feel a certain way and not feel other ways, cuts us off to important information about ourselves and can keep us stuck. So far we’ve talked about how feelings are messengers, therefore they are innocent. All your feelings are valid. You never have to say, “I shouldn’t be feeling this way.” You don’t ever have to feel guilty for how you are feeling. Alcoholics Anonymous says that feelings are not facts, but the fact is, you are feeling that way. There is information in that. You want to use that information to the fullest to help yourself heal.

Some feelings you’re going to like, some you’re not. That’s just the Yin-Yang of Nature. The tide comes in, the tide goes out; the moon waxes, the moon wanes. One is not better or worse than the other. The same can be said about your feelings. Learn to treat them all equally.

Physical and emotional feelings are just two sides of the same coin. Learn to listen to yourself on both tracks simultaneously. That tension in your shoulders has emotion behind it. That frustration is causing physical changes in your body. See both, get the fullest picture of your truth in the moment that you can.

Become aware of how you are feeling. For some reason, this makes it a whole lot easier for you to work with it. Unconscious feelings have an interesting property: even though we’re oblivious to them, they’re obvious to those around us. That’s just plain not fair, (especially when you’re married) but nobody said life was fair.

Next, admit the truth of how you are feeling to yourself. No point in lying to yourself. Working with a distorted version of your truth will not free you from whatever malady you are experiencing. Denying, repressing, rationalizing, sugar-coating or putting any other kind of distorting spin on the truth of your present moment will keep you stuck in your present perspectives, beliefs and patterns. You may be able to force the content of your life to change, such as changing partners or careers, but the same feelings and patterns will keep popping up over and over, until you stop fighting and just let in your truth.

Once you fully admit how you really feel and what you really believe, see how they have been impacting you down through the years. See what experiences you went through that led to the formation of those beliefs. You might see yourself as a small baby before you have object permanence lying in a room all alone, unable to see or hear anyone else, feeling unimaginable fear and abandonment. You might see yourself as a small child being tormented by older siblings or being sexually abused by a neighbor or family member. Just trust what you see, even if it doesn’t make sense at first. Memories often start out vague and flesh themselves out over time.

If you are doing this exploration yourself, hold yourself to a very high standard of integrity. Avoid making assumptions or jumping to conclusions. Stay with the observing and asking questions and you will avoid most of the detours and dead-ends on your path. During this process, if you are working with a therapist, it is very important that your therapist also not make assumptions or jump to conclusions. They need to stay with non-judgmental, un-loaded, open-ended questions and let you draw your own conclusions.  Studies have shown that false memories can be implanted in susceptible people, especially during highly emotionally charged moments. People also have the tendency to embellish and amplify memories as well. Both of these distort and block the truth, interfering with your healing. Whether or not your memory is literally true or more symbolic is very important if you want to engage the legal system and prosecute a perpetrator. But if your major goal is to release yourself from a limiting belief, the distinction is less important. Whether or not something you remember actually happened is immaterial as long as you work honestly with the feelings that you are having.

For example, I’ve had patients who were convinced that they had been sexually abused as children. They exhibited all the symptoms of PTSD around intimacy and so forth. But upon deeper exploration they saw that they had picked up on the abuse some of their classmates were going through and internalized that. If you put thirty children in a classroom, statistically, several of them will have been or are currently being sexually abused. A sensitive child can pick up on that and possibly own it as their own, like they do with so many other energies in their environment. But whether or not that child was actually abused is immaterial. They feel abused and that abuse still needs to be healed in them. We are all interconnected and interdependent. If you hurt yourself or another, you are hurting the entire system. Conversely, if you love yourself or another, you are loving the entire system. Therefore, finding and living from your source of deep inner love is something real and definite that you as an individual can do to make this world a better place for everyone, whether or not you ever sign another on-line petition. But I digress.

So once you are in touch with the experience that led to the formation of the belief, imagine bringing your present day adult self back in time to be with your younger self as you are going through those experiences. Ask your younger self how it wants you to be with it right then. I’d be willing to bet that it won’t ask to be attacked or annihilated; it won’t ask to be judged or criticized. Most likely, it will just ask you to be with it, to be supportive and understanding, to be kind to it. This is the compassion piece. If you can, give yourself what you are asking.

Usually, this is all it takes to get the limiting belief to change, to draw different conclusions from that original experience, to get the belief to align itself with higher Spiritual truths. Once the belief changes, then the feelings that are being generated by that belief change and that is often how you know that the change has happened. Any given experience has multiple possible interpretations. As you inventory the seminal experiences of your life, ask yourself, “How does God (or Spirit) view this? How does this look through Spirit eyes?” Trust what you know.

If you want to see an excellent, graphic representation of this kind of therapy, watch the Walt Disney movie “The Kid” starring Bruce Willis.

Copyright 2013 Steven M. Hall, MD

Previous Posts in this Series: 1.  Healing Implies Change 2.  Emendation 3.  Faith 4.  Awareness 5.  Acceptance 6.  Compassion 7.  Feelings – Part I

Feelings – Part I

So now we have a work-horse to help us make whatever changes we need to in order to heal. The healing we’re talking about is deeper than lifestyle changes. You can know how you are supposed to eat and exercise and participate in family and community and not stress out, but often getting yourself to actually live that way is problematic. Things just seem to get in the way. Ideally, the “doing” in your life springs directly from your “being,” from who you really are. Who you really are is a Divine Being, whole and healthy. Finding out who you really are, underneath all the wounding, conditioning and domestication is what we’re about here. On a foundation of faith in whatever helps us the most, we practice compassionate accepting awareness of what is. This brings us face-to-face with our truth and we can see how our own personal truth aligns with a higher Spiritual truth.

The practice of awareness, acceptance and compassion also form the foundation for a healthy relationship with your feelings. Why is that so important? Because being messed up with your feelings causes you a lot of grief, which is a metaphorical way of saying that it is not an optimal condition. Just think of the amount of human suffering that can be linked to misunderstanding our feelings. Over 20% of Americans are now on an antidepressant. Emotional eating accounts for a lot of obesity and type II diabetes. Addictions complicate millions of people’s lives and break up families. Domestic abuse, child abuse, employee abuse…the list goes on and on. All of these conditions and more can be helped by being healthy with your feelings.

Sometimes, like a panic attack, feelings are so powerful that they pull you completely off your center; you may even spend time in the Emergency Room thinking you’re having a heart attack. Other times, like depression, they are so insidious and grinding that you can start to believe that the only relief is in death. Sometimes your feelings drive your behaviors and you might do things that you later regret. Managing your feelings, especially trying to make them be a certain way, is my definition of addiction.

All of these problems with feelings can be prevented by knowing what feelings are, by knowing how they work inside of you and by understanding how to work effectively with them. That is what I mean when I say “have a healthy relationship with your feelings.”

So, what are feelings from the Integral Medicine perspective? First, let me emphatically state what they are not: feelings are not the problem. No matter how you are feeling, feeling that way is not the problem. So you don’t really need to do anything about the feeling per se. The feeling is caused by something; the feeling is a result of something. The feeling can be thought of as a symptom: a clue to what is really going on. You want to be able to follow the clues back to the real treasure.

A feeling is just a messenger bringing you information, it is not the message.

The message is buried in the feeling and your job is to figure out how to get the feeling to deliver its message so it can go on its merry way. A healthy relationship with feelings does that. Thinking that the feeling is the problem and/or the message is a big confusion for many people, including mental health professionals, in our society. This confusion leads to unhealthy relationships with feelings and ineffective counseling.

Your awareness of who you are, your conscious sense of self, is housed in your conscious mind. The conscious mind processes information by thinking. You become consciously aware of how you are feeling by thinking about the feeling. This is why it is sometimes difficult to distinguish a thought from a feeling.

I see feelings as messengers coming to the conscious mind from the non-conscious mind and from the physical body. Physical and emotional feelings follow the same rules and the same tools can be used to be healthy with them. (Recent research shows that physical and emotional feelings even use some of the same neural circuitry in your brain: http://www.psychologytoday.com/blog/tech-support/201308/the-science-heartache-6-things-you-need-know.) Your headache is just as much a messenger as is your angst. Both can be listened to; both can help you deepen your understanding of yourself, including what actions to take that are in harmony with who you are and what you need right then.

Some feelings are just reporting the status quo like, “Oh, ya, my foot is touching the floor.” Some are letting you know that an action needs to be taken like, “Oh, ya, my bladder is full, I better get up from this computer soon.” (That is a random example I just made up, this article is not to be construed as autobiographical.) And some feelings are trying to call your attention to aspects of your world view that need examination and perhaps updating like, “Oh, ya, I’m a big imposition on everybody around me.” (Oops, that part is autobiographical.)

Because feelings are just messengers and it is generally considered bad form to chop the head off the messenger just because you don’t like the message that they’re bringing, you can conclude that all feelings are valid. This means that you never have to say to yourself, “I shouldn’t be feeling this way.” The fact is, you are feeling that way. What’s behind it? Where did that feeling come from? What generated it? Those are better questions.

Some feelings you are going to just naturally like, some you will just naturally not like. Learn to treat them all equally. Equanimity toward your feelings is a very helpful skill if you want to be healthy with them.

Physical feelings and emotional feelings are correlates of each other. In other words, every physical feeling has an emotional feeling associated with it and vice versa. Another helpful skill to develop is the ability to listen to both tracks, the physical and emotional, at the same time. Sometimes it’s easy, like when you hit your head on the corner of the cupboard door. Other times take practice.

Try this exercise. Take a moment, settle yourself and your awareness into yourself. Put your awareness into your left hand. Just make a mental note of whatever sensory information you are getting from your left hand: the position of your fingers, the air temperature, any pain or tension, etc. Now become aware of the emotional tone of your left hand. What emotional feeling comes up as you put your awareness into your left hand. Now, pause for a moment, center yourself and then put your awareness into your right hand. Again, make a mental note of any sensory information you are receiving from your right hand. Then note the emotional feelings that come up as you put your awareness into your right hand. Are they different from those from the left?

When many people start this exercise, they cannot identify the emotional tone in their hands. Keep trying. Your perceptions sharpen with practice. Those who are able to sense the emotional tone in their hands generally see that they are different from each other. And well they should be. Your left hand has had a left-handed experience of your life and your right hand a right-handed experience. Generally one hand is preferred for certain tasks over the other and so forth. Some people are aware enough that they can easily move their awareness from hand to hand and identify the different physical and emotional feelings. Practice listening to yourself until you are in this group. This exercise can be repeated using your knees, feet, ear lobes or whatever.

So far we’ve gone over three perspectives and/or skills that will help you work with your feelings in a healthy way:

• All feelings are valid
• Develop equanimity toward all your feelings (hint: practice awareness, acceptance and compassion for how you are currently feeling about your feelings.)
• Learn to listen simultaneously to both the physical and emotional aspects of your feelings.

Next we’ll go over ways to get to the message that the feeling is carrying and then what to do with the message once you get it.

Copyright 2013 Steven M. Hall, MD

Previous Posts in this Series: 1.  Healing Implies Change 2.  Emendation 3.  Faith 4.  Awareness 5.  Acceptance 6.  Compassion

Compassion

You want to heal. In order to heal, something inside, outside or about you must change…because to continue doing what you’ve been doing and expect to get anything different than what you’ve been getting is just plain crazy. And you’re not crazy…at least not in that way.

So we’re reviewing the steps that I’ve observed in my practice and in my own life that help to bring on healing change. If you’re just joining the conversation, this is the sixth post on the topic, so you may want to go to the archives and start from the beginning (Healing Implies Change).

On a foundation of faith that there are higher, self-evident truths, that the truest frequency in the Universe is love and that you are a part of the Universe and, therefore a part of that love, that you can find your way to a happy, meaningful, satisfying life, you pay attention to your life in order to seek the truth of your illusions. You then surrender the fight, stop deluding yourself, open and fully admit the truth of your life to yourself.

Change can happen at any point along these steps. Sometimes we have to go to the final step to get the shift to happen. So what is the next step? How does your inner loving, intelligent guide recommend you be or relate to whatever belief, memory or circumstance in your life that you just became aware of and accepted?

Over and over again, when one of my patients gets to this point in their session, their guidance says things like, “Just get off your back about that.” Or, “Just be kind to yourself about that.” Or, “See the pain that person is in, just open your heart to them.” Advice like that. I call this step compassion.

No matter what you are experiencing, no matter how much pain you are in, how fatigued you are, how addicted, how abused by others, how abusive you are to others, no matter what, you can be kind to yourself about it. Kindness cures.

In fact, in my thirty-some-odd years of practice, I would have to say that compassion is the only thing I’ve ever seen actually heal somebody.

How could that be? Compassion is the only thing that heals? That’s a pretty bodacious statement. What about all the treatments encompassed by conventional and alternative medicines? Surgeons are fond of the saying, “To cut is to cure.” What about cutting? Doesn’t cutting cure? Bummer, I like to cut. Drugs and supplements do some pretty amazing things. Doesn’t taking drugs and supplements heal you? Some pundits are claiming that lifestyle is the root of all your health problems. What about changing your diet and exercise? What about acupuncture and energy medicine and body work? Lots of people have had amazing healings from all of these things.

All of these things have their place, many might be just what the doctor ordered (literally), but if you looked at all of the possible therapies out there, all the possible supplements to take, all the kinds of energy medicine to try, all the different diets and theories about exercise, which are right for you? Does any practitioner know you well enough to make the best recommendation? Is any practitioner knowledgeable enough about all the options to fully inform you of your choices? Is there enough time in an office visit to even go over them?

You often need to seek your inner guidance to know what outer treatments are right for you. That connection with your deeper guidance often comes when you are in an aware, open-hearted state of consciousness.

What is the difference between supporting your body/mind/energy complex and healing? When it comes to picking a treatment, what is suppressive, what is supportive and what is curative?

Many people I’ve talked to have never explored these questions.

Much of what we do in conventional medicine is suppressive. Take blood pressure, for example. From the machine metaphor, your heart is a pump, your arteries and veins are pipes and the blood is the volume of fluid. If you want to decrease the pressure in the system, you could slow the pump down, make it not pump as hard, drain some fluid out of the system or make the pipes bigger. We have blood pressure medicines for each of these approaches. But your high blood pressure is not the cause of your high blood pressure. Forcing your blood pressure down may help prevent the damage that high blood pressure causes, but does nothing for why your blood pressure is high in the first place. Conventional medicine uses the same approach for high blood sugar and high cholesterol, for too much inflammation, for tumors, for allergies…the list goes on. These treatments are helpful and important and have their right time, place and person. But the mistake conventional medicine makes is stopping there and not digging to the roots.

Some things we do in conventional medicine are also aimed at detecting problems early (Pap smears and mammograms) or preventing future problems (vaccines) but I’m having a hard time right now trying to think of a good example of a conventional medical treatment that is supportive or curative. Perhaps psychoanalysis, but most doctors think of such treatments as supported by soft science at best.

Much, but perhaps not as much, of what we do in alternative medicine is also suppressive; we just use herbs or supplements to do the suppressing. But more treatment approaches are supportive, such as good diets, nutraceuticals, exercise, body work, energy work and such. Many doctors would now consider lifestyle changes as part of conventional medicine, but that is a welcome transition that is still happening and not yet universally adopted, in my observation.

Practitioners generally know their little slice of the therapeutic pie and just hope that the people who choose to see them happen to need what they have to offer. Patients know this and often visit several to dozens of practitioners before they find the one who can help them. Maybe this is the best healthcare delivery system we can devise, but I can’t help wondering if there isn’t a better way for people to get the help they need.

Perhaps it is serendipity, perhaps people are listening to their intuition more than they know, but if people look hard enough, they generally find the supplements, treatments and people who can help them. I believe that “Seek and ye shall find” is one of those universal truths. This searching and all that you learn along the way is part of the emendation that I spoke of earlier.

But I’ve noticed an interesting pattern: people generally find the therapy that works for them at about the same time that they are willing to embrace and respond to whatever symbolic or meaning work their health issues represent for them.

(The danger here is that people often give the credit to the treatment, not to them doing their emotional/symbolic work. If you have had a serious health issue and underwent a treatment that completely resolved it for you, look carefully at your experience and see if you didn’t also learn something important about yourself, free yourself from a limiting belief or find the inner strength to take the reins of your life into your own hands in some way. I bet you’ll see something of the sort also happened inside while the treatment was doing its thing.)

To shift the limiting beliefs, to free yourself from the weight of your own criticism, to value yourself enough to step up and claim your power…in other words, to really become your true authentic self in your life…all of these curative changes often require the application of compassion to pull them off. That is why I say that compassion is the only thing I’ve ever seen actually heal anyone. You can take supplements and exercise until the cows come home (Are these agrarian metaphors even comprehensible these days?) and you won’t heal until you love yourself.

What if there were something you could do to get ready to do your deep inner work sooner rather than later in your search? If you apply these steps to your situation, if you embrace these ideas in your life, I believe that you will get to your answers sooner.

If you think about faith as the foundation, then awareness, acceptance and compassion are the workhorses for change built upon that foundation. Awareness, acceptance and compassion work together as a seamless unit.

I have an affirmation that helps me put this all together:                     I practice compassionate, accepting, awareness of what is.

“What is” is the here and now, the present. This affirmation helps me stay in the present moment with open eyes and an open heart. This has been a very difficult skill for me to learn, especially when I’m at home. I have compassion for anyone who takes on this challenge. But the practice is worth the effort. Like any skill, the more you practice it the better you get at it.

As your compassion grows, you are able to see yourself and others in a new light. You are able to see things you didn’t see before. You are able to make different choices that you didn’t know were open to you before.

This is how your life changes. An important result of healing is that you become more of your true authentic self. I believe we are ultimately divine beings of incredible wisdom and open hearts. If this is true, then the practice of compassion allows you to be more of who you really are. That is another reason why kindness cures.

Faith, awareness, acceptance and compassion are also the components of a healthy relationship with your feelings.

Every aspect of your life is packed with clues that can lead you to your truth, but your feelings, both physical and emotional, arguably offer you some of your best clues. Learning how to follow them to their roots has helped more of my patients than any pill I could prescribe. Next we’ll discuss how to be healthy with your feelings and how to use them to speed your healing.

Copyright 2013 Steven M. Hall, MD

Previous Posts in this Series: 1.  Healing Implies Change 2.  Emendation 3.  Faith 4.  Awareness 5.  Acceptance

Acceptance

We’re talking about a way of working with the mystery of healing that has helped thousands of my patients. Start with a foundation of faith. Practice strengthening your faith until it reaches certainty. Have faith that you can heal, that you can be happy, that you can be successful, that you can live a life that is pleasing to your soul. Your life is full of clues about what is really going on inside of yourself, what you truly believe. How do your beliefs and conclusions compare with higher truths? Pay attention to your life so that you can pick out the clues and follow them back to your own personal truth. Forget for the moment whether or not your personal truth is really true from a higher perspective. The important point to note for yourself is what you actually believe for yourself, your own personal truth.

After faith and awareness, the next step is to open to and fully accept your personal truth. So often when we see some aspect of ourselves that we don’t like or that we know immediately to be untrue, we do something to alter it. We deny it, repress it, rationalize it, intellectualize it, sugar coat it or a whole host of other Freudian things. But how well have those things been working for you? People pay me a lot for my advice, but I’ll give it to you here for free: stop doing those things! Just admit the raw, naked, unadulterated truth of that aspect to yourself.

Years ago, when I was still a Resident in Saginaw, Michigan, my wife and I would go to Quaker meetings on Sunday mornings. These meetings were mostly silent opportunities for inner reflection. I remember one morning I was thinking about what it meant to be a doctor and how to be a good one. I knew I needed to be able to meet any patient right exactly where they are in their process and accept them just as they are and then gently lead them at their own pace to resolutions to their problems. Therefore, a doctor should not be judgmental, I concluded. I told myself that I wasn’t going to be judgmental. Unbeknownst to me, in that moment, I started an inner struggle that would take me years to realize and resolve.

When I finished my residency, I went to be the only doctor in a small town in Maine. I did obstetrics as part of my family practice. One of my patients had a long and difficult labor. I stayed with her at the hospital the entire time. I had done all of her prenatal care and knew her fairly well. She wanted to be as natural as possible during her labor. Over the course of the day, the OB nurse on duty thought that I should be much more interventional with her labor management. I disagreed. I monitored my patient very carefully and kept in good communication with her and her husband. I didn’t know him as well as he had not come to any of her prenatal visits. He was a young man who worked as a logger and had a reputation as somewhat of a hell-raiser around town. I ate lunch with him in the hospital cafeteria and explained what was happening with his wife’s labor and why the nurse wanted what she wanted and compared that to what his wife wanted. I felt like he was pretty on board with how everything was going.

Weeks later, my family and I were eating dinner at the local greasy spoon in Strong when he came in drunk and started yelling in my face about being so judgmental. I had no clue what I’d done to set him off. I was completely stumped. Several months later, some other patient stormed into my office and also yelled in my face about being so judgmental. Again, I had no clue what he was referring to. But to have two people do that within a matter of months was a wake-up call and I started to wonder what was going on. I didn’t know much about these steps back then, but I did start searching for answers. In that moment, though, I just redoubled my resolve to be open and accepting of everyone. (Little did I know that I had just redoubled my efforts to repress any judgmental qualities.)

Shortly after that, my family and I moved to Seattle where I got a job working for a hospital-owned clinic in downtown. I rode the bus to work which gave me built-in time in my day to read. I read all of Stephen Levine’s books and his ideas really changed the way that I thought about medicine. One day on the way home, the bus was going up University Ave near the University of Washington. University Ave is a microcosm of all of the diversity in town. There are people sporting every fashion of dress and every color of hair, sometimes all on the same head. I was reading a magazine and every time the bus stopped and people got on, I would look up from my magazine and this little voice in my head would snobbily say, “Look at that person’s clothes. Look at that person’s hair.” And I would say to myself, “Stop it! Stop it!” and go back to my magazine. Next bus stop, same thing. This went on nearly all the way up the Ave until it was driving me crazy. Somewhere near the top of the Ave I finally saw what I was doing to myself: I was judging myself for being judgmental.

In that moment of realization I said to myself, “I wonder if I can just accept the fact that I’m a judgmental SOB?” As soon as I said it, I felt a big knot of 2 inch thick rope untie in my solar plexus. That was in the late 80’s. I still may be one judgmental SOB—who knows?—but at least since that day, it has not been an issue in my life and, knock on wood, no one has come into my office and yelled in my face about it.

Accept the truth of what is really going on inside of yourself. Denying it and fighting it will not change it, it will probably hide it from you but not from everyone around you. I fought with my tendency to be judgmental every which way I knew how and in over five years, that fighting had not changed it one little iota, it was still an issue that I had to face. But one moment of acceptance and…poof!...as far as I can tell, it is gone. I am still discerning and I still have opinions but being judgmental does not seem to be an emotional button or problem-causing issue in my life.

So the steps to encouraging healthy change that we’ve covered so far are:

1. Have faith that healing is possible, that you can know your truth, that you can find good solutions to your problems, that there is a good resolution to your suffering. You can do this.
2. Pay attention to the truth of your life and to yourself living your life. Trust what you know. Get in touch with your wise, loving inner guidance. It will help you know how to have a healthy relationship with yourself and others. It will help you know what supplements, treatments and such are best you. It knows what you ought to eat, how much and when. It knows how much and what kind of exercise to do. It knows what career is right for you. Listen and trust.
3. Accept the truth of what you see when you use your awareness. Your intentions may be pure (like me wanting to be a good doctor for my patients), and how we repress and deny may be very subtle, but pay attention to your life and the truth will out. Accept it when you see it. Quite often, that is all that is needed to get major perceptions or foundational beliefs to shift and change.

Build a foundation of faith that you can do this, your inner love and intelligence can guide you to live a life that is true to who you really are. A strong faith tempered by reason is a critical resource for your healing journey. And if you’re going on a journey, you pretty much have to start out from where you are. Find out where you are right now by paying attention to your life, both inner and outer. Admit the truth to yourself.

Living in illusion will not bring you lasting happiness, fulfillment and meaning. And your body or life circumstances will have to keep trying to shock you out of your illusion. That can be pretty painful. (Hey, I’ve lived everything I’m talking to you about, as well as seen it over and over in my patient’s lives.)

I call the next step in the process of healing change “the Alchemist” because it is what actually works the change. It can take an experience or aspect of yourself that is functioning like a lump of lead in your life and turn it into a lump of gold.

Copyright 2013 Steven M. Hall, MD

Awareness

So we’re talking about how to change, especially how to heal. Healing is more than just getting symptoms to go away. Symptom resolution is an important consequence of healing, and certainly something that we want to accomplish for ourselves, but is not the whole picture. And, surprisingly, there are many stories of people who experienced amazing healing when getting symptoms to go away wasn’t even their focus. (http://ahha.org/articles.asp?Id=55). I highly recommend you read Evy’s story, she’s a nurse-turned-minister who healed herself from a here-to-fore 100% fatal illness and has deep insights into her process.) I’ve been thinking about these concepts for decades and helping people with their healing has been my life’s work. As much as I’d like to have all of the answers, I must admit at this point that I believe that, ultimately, healing is a mystery. I can talk about how a person changes during the healing process or what a person is like after healing has happened, but how that process actually happens and how to get it to happen to you when you want it to…that part seems to be the mystery.

There are things we can do to set the stage or bait the trap, so to speak, but whether or not healing steps onto the stage or into the trap does not seem to be up to us. At the same time, I also believe that healing is always possible…for anyone…at any moment. And you can heal your whole life and still die. Dying is not an “F” on your Spiritual report card. After all, how many of us are getting out of here alive?

More importantly, what did your soul come here to experience? How can you live from your soul’s guidance? What is stopping you? Does your soul make mistakes?

Most of us seem to have a smoke screen, house of mirrors, game of hide-and-seek or some other perception blocking or altering process going on between our conscious knowing and our souls’ knowing. The process of healing seems to clear that path. The process of healing seems to open a line of communication between a person’s conscious mind and their deep inner source of love and knowing. They then have that loving and knowing to inform their thoughts, words and choices.

Imagine having that resource to help you live your life. You do, it is inside of you already. It does not have to be created: it just has to be contacted. Which is not as hard as you think: whether you know it or not, it is already talking to you all day (and night) long. To strengthen your connection to your soul, all you have to do is pay attention to your life.

You do that through awareness. After Faith, Awareness is the second step in bringing on changes that heal. For some reason, it is easier for us to work on an issue if we know it is there. And then if we ever want to be free of a particular malady, block or problem, we must work with the truth of it. Remember, the adage is not “you shall know your fantasy and your fantasy shall set you free”. Which is too bad: fantasies are so much easier. If you want to heal, use your power of awareness to become aware of your own truth, your own raw, naked, unadulterated truth. How are you feeling? What are you thinking? What do you believe? What is underneath the patterns in your life? What motivates your behavior? Have you made some assumptions you’re not aware of? What do you have control over in your life? Keep peeling back the layers to get to the root of your truth. Once you get there, how does your truth look to you from your soul’s perspective?

Awareness gets better with practice. Become aware of your surroundings and the people in your life but just as importantly, become aware of your inner workings, of your world view. How does your current world view compare to higher Spiritual truths? We all have our own rack of lenses in our psyche through which we are peering out at the world. These lenses determine how our life looks to us, how we experience what happens to us. In psychology, we refer to these lenses as your “structure of interpretation”. We each have our own unique structure of interpretation made up of many things such as all of the conclusions we’ve ever drawn from our past experiences, cultural influences, family patterns, genetics and such.

At the same time, there is a higher truth. Wherever your own structure of interpretation does not line up or resonate with the higher truth, symptoms will develop. The purpose of the symptom is to get you to explore your structure of interpretation and get it aligned with higher truth. I see this in my patients as they heal. The more a person’s own structure of interpretation resembles higher truth, the healthier they get.

Pay attention to your symptoms. Doggedly follow them back to their roots and open to the truth that is to be found there. View your present personal truth through Spirit eyes. Often, that is all that is required to get your old limiting beliefs to shift into alignment with higher truths. Be kind to yourself in the process, you deserve that.

Recently I’ve been working with a young woman whose primary problem is a tight knot in her left trapezius (upper shoulder and neck area). It keeps pulling her neck and ribs out and her left shoulder up and feels like a continuous Charlie-horse in her neck. She’s seen chiropractors and physiatrists who can get the knot to go away temporarily but it keeps coming back if she does anything at all physical. She had a very difficult childhood and has survived by using her prodigious left-brain intellect. The first few cranial sessions we did, whenever I asked her to listen to her body, she could feel the physical pain, spasm and twisting but when I asked her what emotions were associated with the pain, she drew a blank. All the while I was getting the sense from her body that she was just about ready to explode in frustration.

Physical feelings and emotional feelings are just correlates of each other. Every physical feeling has an associated emotion and every emotion has a physical representation in your body. If you cannot get information on both the physical and emotional tract, something in you is blocked. Use your awareness to find the block. (We’ll go over what to do about the block once you find it in later posts.) During her third or fourth treatment (I like to give people a chance to make their own discoveries before I get more directive and interventional) we discussed the possibility of a block and she was able to admit her frustration.

Then she was silent for a moment and said “My outlook on life has gotten really negative over the past five years.” She could see that chronic job stress and how she’d been treated by her team had caused the change. She was able to see how the negative attitude was affecting her. She had been aiming that negativity at herself as well. With more careful listening, she heard that the knot wanted her to start treating herself with honor and respect. This is one of those higher Spiritual truths: no matter how anyone else treats you, whether your parents, friends or co-workers, you are always worthy of honor and respect. No one else on the planet gets to define your self-worth. That’s between you and your Soul.

As so often happens in people’s lives, several issues are coming to a head for her at once. She’s working on a career change, moving and selling her condo, dealing with a lemon car to name a few. She is going to use this intense time in her life to re-awaken her positive attitude and practice honoring and respecting herself and letting that spread out like ripples through her life. She is making gains in her awareness. She’s learning to listen to her body not just on the physical level but also on the emotional and meaning levels as well. Instead of just being in pain, she’s getting meaningful information that she is using to improve her health as well as her work and personal life. At the end of that session, her neck and shoulder were completely relaxed and she knows that if the spasm returns, she can listen to it again.

So the steps we’ve covered so far to invite healing change into your life are:

1. Have faith that healing is possible, that you can find good solutions to your problems, that there is a good resolution to your suffering. You can do this.
2. Pay attention to your life and to yourself living your life. Trust what you see. Trust what you know. Get in touch with your wise, loving inner guidance. It will help you know how to have a healthy relationship with yourself and others. It will help you know what supplements, treatments and such are best for you. It knows what you ought to eat, how much and when. It knows how much and what kind of exercise to do. It knows what career is right for you. Listen and trust. Use your intelligence to figure out how to be happy.

There are more steps to the process that we’ll cover in the next couple of posts. Practice, practice, practice.

Copyright 2013 Steven M. Hall, MD

Faith

You can heal. No question. You can always improve your circumstances. And when you can’t, you can decrease how much you are suffering because of your circumstances. And you can always learn more about who you are and how best to live true to yourself. Each and every moment of your life offers you that opportunity. If you have no proof in your life of the truth of what I’m saying, have faith. Faith is the first step in any process of change. You must at least have faith that change is possible. “If you think you can, you can. If you think you can’t, you’re right.” Henry Ford said that and he was arguably pretty good at manifesting his vision. One (of the many) quirky aspect(s) of faith is that faith requires no empirical data to support it. This means that you are free to have faith in whatever. What could you have faith in that would help you with healing whatever you are facing in your life? Take a moment and write down 4-5 suggestions for yourself. The stronger your faith, the better it works. Faith at the level of certainty is nearly unstoppable.

Faith gets stronger with practice. You practice strengthening your faith by focusing on whatever you are having faith in and imagining it filling your whole body with strength and certainty. Feel the strength in your body. If whatever you are having faith in is also in alignment with higher truth, all the better. What are some higher truths you can align yourself with to help with your healing?

• You deserve to be here in this life, drawing breath, taking up space
• You are lovable
• You are forgivable
• You are worthy of happiness
• You have something valuable to contribute to those around you, perhaps to the whole world
• You can find and be your true authentic self
• You have a loving heart
• You are smart in your own way
• Write down a few more that feel true and germane for you

Higher truths are the kind of truths that can be held to be self-evident. Pick a few and practice strengthening your faith in them, just for the heck of it. See how it feels. Let me know what you like to have faith in that works for you.

Learning what to have faith in and then strengthening your faith is an important part of learning how to heal. You can do this. I have faith in you.

Copyright 2013 Steven M. Hall, MD

Emendation

“To enjoy good health, to bring true happiness to one's family, to bring peace to all, one must first discipline and control one's own mind. If a man can control his mind he can find the way to Enlightenment, and all wisdom and virtue will naturally come to him.” –Buddha As a young man, Spinoza asked himself: “how does one prepare the mind to receive Spirit?” He wrote a paper called “The Emendation of the Mind” to explore that question. He worked on that paper most of his life and rumor has it he never completed it to his satisfaction. I think he got stuck on the question: “how do we know that what we know is the truth?” That’s a tough question and philosophers of science still cannot satisfactorily answer it. But that’s not what I want to talk about this blog.

If one asks the question: “how does one prepare one’s self to receive healing?” a similar emendation process is often required. “Emendation” means to correct, often by editing. I’ve noticed in my patients that they often go through a process of getting their own deeply held beliefs aligned with higher truths as they heal. This is kind of a circular process. As their beliefs move closer and closer to higher truths, they suffer less and their bodies heal more and as they heal more they are more able to get their beliefs aligned with higher truths. You can do this, too.

Certain knowledge, skills and ways of looking at the world can really help you open to receive the healing that you’re looking for, the healing that your experiences hold for you.

AN is now in her late forties. I started seeing her about ten years ago because she wanted to try to clear her Hepatitis C by natural means. She had just had a liver biopsy that showed stage 4 (very advanced) cirrhosis or scarring of the liver, a known complication of prolonged hepatitis C infection. She didn’t feel comfortable with Interferon after all she’d read about it, especially since the strain of virus that she had, combined with her advanced stage of cirrhosis, gave her only a 25% chance of clearing the virus. During our initial visit, I was a bit surprised to find that she worked as a mail carrier for the Post Office. As she had a certain specific sense about her, I was sure she worked in the Healing professions in some way. But she didn’t. She did practice Yoga and meditation and had made major changes in her lifestyle already. She ate organically and very few processed foods. She exercised regularly and was fairly happy and at peace in her life. She had an optimistic view of life and felt sure that she could heal from her Hep C.

We did all the usual Functional Medicine things of removing any allergens, making sure her hormones were balanced and that her digestive system was working well. We discussed ways of boosting her immune function with supplements and herbs and we started a series of CranioSacral Therapy (CST) sessions with the intention of exploring what the experience of having Hep C meant in the bigger picture of her life. During her treatment, she was able to get to a place of genuine forgiveness in her life. But even with that, nothing we did made any difference to her viral load, the number of virus particles in her blood. She saw other practitioners who also tried what they had to offer, again with no improvement. Within a few years she started to show signs of worsening cirrhosis.

But over those years, she had learned a great deal about how to take really good care of herself, both physically and emotionally. She had also come to peace with the idea of trying Interferon, and the treatment regimen had evolved to also include Ribavirin, an anti-viral medicine that improved the success rate. So she told herself that she was willing to give the Interferon + Ribavirin a try under one condition: she was determined to take such good care of herself that she would be able to tolerate the entire treatment regimen and not have to stop it for side-effects or take sick time off of work. She got very clear about her goals, about getting healthy, about healing the cirrhosis, about clearing the virus, about tolerating the medications and helping them do their job. She stayed very focused. Not only did she clear the virus over the next year, she didn’t get sick from the treatment and her last liver biopsy showed no sign of cirrhosis.

She still works as a mail carrier but has also learned Accutonics, where she treats people by stimulating acupuncture points with tuning forks of specific frequency, and she’s studied Craniosacral Therapy and Gin Shin Jyutsu. The years of work she did leading up to the Interferon treatment was clearly her own emendation process. She started out wanting treatments to clear the virus and ended up learning how to get very clear and focused and take exquisitely good care of herself on multiple levels simultaneously. She also found a way to feed and express that “healer” side of herself that I sensed on our first visit. So often, when a person heals themselves from a chronic illness, their life afterward is very different from their life when they got sick. I see this pattern over and over.

She knows the Interferon + Ribavirin helped her body clear the virus, but it didn’t help her heal her cirrhosis. She credits being very clear in her goals and staying focused on them with the bulk of her success. By listening to and trusting her own deep knowing, she was able to put together a treatment regimen that worked for her.

There are thousands of similar stories. The self-help literature is full of advice on how to set goals, focus, visualize, say affirmations, think positively and similar tactics. How do these practices translate into changes in your body or changes in your life? How do thoughts become things? And what is getting in the way when these tactics don’t seem to be working?

I’ve searched high and low for the answers to these questions. I’ve listened to some of the best teachers of our day, I’ve looked at most of the major world traditions and I’ve watched my patients carefully as they’ve travelled their respective healing paths…and I’ve looked inside myself.

I believe that the personal process of seeking and finding your own answers to these questions is more important for your healing than copying something someone else found that worked for them. No doubt in your search you’re going to hear lots of other people’s healing stories. What worked for them is helpful information to take into consideration, but which approaches you use for yourself should be selected by your deep conviction, your deep inner guidance, your gut sense of knowing what is right for you rather than by what anyone else says.

When it comes to healing yourself, your journey is just as important as your destination. How best, then, to walk your healing journey? I suggest you practice the Seven Tools of Healing.

I will put up a blog post for each of the Seven Tools. There is also a brief summary of them on my website: www.stevenmhallmd.com.

Copyright 2013 Steven M. Hall, MD

Healing Implies Change

Healing implies change. If you are at a place in your life where you are suffering for whatever reason and you grow to a place in your life where that suffering has been alleviated, something has changed. That something might be how you eat, maybe you identified and eliminated a reactive food; that something might be the way you act, maybe you started a good exercise or yoga routine; that something might be better boundaries or finding just the right career or releasing yourself from limiting beliefs that formed when you were younger. When you look at people who have healed something in their life, generally something has changed. So if you want to get better at healing, ask yourself, “How do I change?” This is not a trivial question. Most of the ways that we as a society have developed to help ourselves change only work for a small percentage of people. The five year success rate for diets, any diet, runs around five percent. Before AA, the sobriety success rate for alcohol recovery programs was also around five percent. AA tripled that to a whopping 15%. That means that even AA doesn’t work for 85% of people who try it. The process of change is so unpredictable that many experts have concluded that it just doesn’t happen: people don’t change. Pedophiles, sex offenders, rage-a-holics, drug addicts, narcissists, and people with borderline personality disorder are among the people experts have given up on.

Yet look at how much effort we all put into trying to change: the education system, diets, gyms, the whole self-help industry, medicine, psychology, most religions. Most of us have aspects of ourselves that we want desperately to change and we buy into the lottery mentality when proponents of any particular approach hold up someone in their five percent as a stellar example of what their technique can do for you.

One might do a little math and figure that we only need 20 different diets or 20 different kinds of psychotherapy and everyone could be served. But it doesn’t work that way. Whether or not you change has much more to do with you than with whatever technique you use. Gendlin¹ showed that back in the ‘70s.  So it turns out that about five percent of the population is good at changing and the rest aren’t. Yet we continue to develop newer and fancier techniques and the 95% continue to flock to them with renewed hope and open wallets each time. What do the good changers know that the rest don’t? How can you insure that you’re one of the five percent?

I’ve focused my career on these questions and I have some answers that I think will help you in your quest to change and heal. In this blog, we’ll explore these and similar questions and their answers.

1. Focusing Eugene T. Gendlin, PhD, Bantam New Age Books, NY, NY. 1978.

Copyright 2013 Steven M. Hall, MD

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 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

Children and Consciousness

I’d like to get back for a moment to the topic of the very first blog post: how do we raise our consciousness? The best advice I’ve seen was up on the wall behind the counter of the pro shop of a small community golf course in northern Idaho. It said, “Want to improve your game? Then go back and start playing when you were much younger.” This might not give us much hope for ourselves, but it hints at what we ought to offer our children. But before we get into this much more, we need to figure out what we’re even talking about when we say “consciousness”.

Neuroscience, which doggedly holds onto the belief that the brain is primary and that activity in the brain determines everything else, including generating consciousness, has a difficult time defining it. One prominent scientist says that consciousness is what goes away when you are asleep and comes back when you wake up. This, obviously, is a very shallow, most superficial view of consciousness. It is consciousness with a small c, the distinction between being awake or being asleep. As if you don’t have any experiences when you are asleep.

Another Way to Think of Consciousness

The consciousness I’m referring to could be thought of as a property of the Universe, just as matter, or more properly, mass and energy are properties of the Universe. Mass and energy are just two sides of the same coin, interchangeable through the famous equation E=mc² where m is the mass and c is the speed of light. Consciousness could be thought of as information, a third property of the Universe. There is no simple equation relating information to mass and energy that I know of, but physicists have recently started with a few basic tenets of information theory and from there, derived the mathematics of quantum mechanics (http://arxiv.org/abs/1011.6451v3). I think this feat hints at the primacy of consciousness over matter/energy.

More properly, more than information, consciousness, as I conceive of it, is the source of matter, energy and information. Pure consciousness is the infinite potential out of which come the little strings of String Theory. Information tells the subatomic particles how to structure themselves into matter/energy (our word even says it: in formation) then the structure of the matter/energy stores that information. The Universe is conscious, otherwise consciousness wouldn’t exist. The Universe is intelligent, otherwise intelligence wouldn’t exist. The Universe stores information holographically, otherwise holograms wouldn’t exist.

So the consciousness is there for us to tap into. We are each experiencing and expressing, through how we think and live our lives, a unique combination of properties of the one and indivisible consciousness. We could just as easily be experiencing and expressing other properties of consciousness. Anything any one of us has ever thought or experienced is potential for all of us.

What determines which aspects of consciousness we express? Is it genetic? Is it cultural? Is it how we are parented? How we are educated? The language we speak? Is it karma, destiny or “past lives”? The answer is “yes”.

Consciousness and Beliefs

All of our experiences, awake and asleep, conscious and unconscious, literal and symbolic, lead to the formation of beliefs. What we believe determines which aspects of greater consciousness we can access and express. When children are raised to believe that they can do whatever they put their mind to, they often can. When children are raised to feel stupid and worthless, they often find huge roadblocks in their way no matter which way they turn.

Henry Ford said, “If you think you can, you can. If you think you can’t, you’re right.” “I’ll believe it when I see it” is not really how people function. “I’ll see it when I believe it” is much more accurate. People have known this sort of thing for ages, yet deciding what beliefs to instill in our children, and how best to do that, has been problematic. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790748/pdf/hde0052-0211.pdf)

Teaching our Children

Many different theories about parenting and education exist. The old adage “when there are lots of ways to get the same job done, that generally means none of them works very well” definitely applies to parenting and education. The problem lies in the fact that when you say something to another person, you never really know what they hear, how they take it and what conclusion they draw from it.

“If you give a man a fish, you feed him for an afternoon. If you teach a man to fish, you feed him for a lifetime.” If you give a child a belief, they may be stuck with it for the rest of their life, locking them into a set way of seeing and being.

If you teach a child how to know themselves, how to see for themselves what they believe, and teach them the tools to be able to change their own beliefs, you make them adaptable for the rest of their lives.

So, instead of trying to instill a certain set of beliefs in our children, which smacks of brain-washing, no matter the end intended, why not teach our children how to find out what they believe, check their beliefs with the higher truth and correct or align their beliefs with higher truth? Imagine, if we all had that skill, we would be very adept at learning the real and deeper lessons ensconced in our life experiences. Then our life experiences will just naturally take us down the path to self-knowing…which is also healing…which is also enlightenment.

P.S. You don’t have to go back to childhood to learn how to change your beliefs for yourself. It’s never too late.

Copyright 2012 Steven M. Hall, MD

Health, Freedom, Fear and Haves vs. Have Nots

Things get really heated in an election year. But so much time, energy and resources get misdirected. Most of us just want to be free. And we look to the political system to help us with that. But if we really want to be free, we need to know who is threatening our freedom, how they are doing it and how best to counter-act the threat. Politics is really not about Republicans vs. Democrats or Liberals vs. Conservatives. Politics is and always has been about the Haves vs. the Haves Not. If you look back over the last six thousand years or so of civilization, you can explain most of history by how two basic principles are playing out. The first is the Haves have to remain the Haves and the second is the Haves have to be protected from the rabble (the rest of us).

The Haves have used different strategies down through the years to maintain their needed sense of balance. For a long time, there was Royalty. There was also Religion. And there has always been the Military. Today there is Banking.

Not very much of the population can be the Haves at any one time, so you can imagine how threatening the concept of democracy must be to them. But they noticed that the idea of democracy is popular among the masses and uprisings are inconvenient. So, to keep their incredible share of power and resources while maintaining the façade of democracy, more intricate tactics had to be devised.

Since the Industrial Revolution there has been Banking and Corporate ownership. But also nearly every other major social institution – from the media to public education to home ownership to the judicial system to the two-party political system – is designed to keep the masses in their place. And we obediently stay there. And national politics in the US is tightly choreographed. What are the chances that a nation as large and diverse as the US would have only two political parties and they’d always run neck-and-neck?

A major personality trait of the Haves is that they are insatiable. The concept of “enough” is a weakness to them. The world is now so owned that if one Have wants more, they pretty much have to take it from another Have. An African proverb states that “When the elephants fight, it is the grass that suffers.” The twentieth century was the bloodiest century in human history. Millions and millions of blades of grass got trampled. And even though the Haves profited incredibly from all the wars, they noticed that wars were getting less popular among the masses and besides, with the advent of the atom bomb, they might not be able to keep themselves as safe from each other anymore.

So no more big wars. Little skirmishes here and there can still be incredibly profitable, but no more “world wars”.

Perhaps as a concession for the incredible destructiveness of WWII, the Haves allowed the development of a middle class. I don’t know if you’ve noticed, but historically and economically, a middle class is an anomaly. Without some kind of meddling and intervention, such as Unions and government regulations, a free market should never develop a middle class. (Who ends up in the Middle Class when you play Monopoly?)

So the Haves are in a pickle. They are driven from the inside to continue increasing their holdings, yet they are reticent to start big wars to do it. So they are recanting their generosity and moving to do away with the Middle Class.

The result? Over the last twenty years, corporate profits have skyrocketed while the average American’s disposable income has decreased. While the wealth of the wealthiest has greatly increased, the number of Americans living in poverty has increased by the millions. This trend has been going on long before the crash of 2008, that just accelerated it.

And, over the last couple of decades, the Haves have grown much more emboldened. They used to try to work behind the scenes, in secrecy, making us the “mushroom people” (you know, kept in the dark and fed a bunch of manure). But now they are blatant. Wall Street bail-outs, Citizens United, the Patriot Act, Internet censorship, Media consolidation, indefinite detention…the list goes on.

You might be wondering why I am talking about this stuff when my primary concern is health.

For several reasons. First, the medical literature is very clear that when people become impoverished, their health declines. There is a strong direct correlation between a person’s income and their health, up to a point. Most people are not insatiable. Most would be happy with meaningful work, a good roof over their head, adequate clothing, the ability to buy and eat good food, enough money to take a vacation once in a while and to retire. Much above this level, increased wealth does not lead to increased health. Most people don’t need to own seven houses and forty cars and 5000 pairs of shoes to be healthy. So, as a healthcare professional, I’m concerned about the social and economic forces that move more people into poverty.

Second, your personal health is not independent of the community in which you live. You cannot personally be healthy and live in a sick community at the same time. I think we forget this in our society. We’re exercising, eating as best we can, taking supplements, going to yoga, getting counseling and meditating, all the while living in a society that is intrinsically unhealthy. Trying to be healthy in our culture is like walking upstream through a rapid.

Most people are kind, caring and loving most of the time. Most people see the wisdom behind the rule of law, the benefits of education, the need to help each other out. That’s why our systems work as well as they do. That is why our society works as well as it does. Believe me, I know things could be worse. But I also believe they can be better.

So what makes our society unhealthy? What is John Bradshaw seeing when he says that 99.5% of families in the US are dysfunctional? How can we make healthier communities?

The answer, as I see it, is surprisingly simple: make the main focus of our society be to raise children to be humane and strong; support families and develop social systems to do that.

Imagine a society where the vast majority of people were humane and strong. By humane, I mean kind and caring – not just for those they love, but for themselves and all of the planet – a wise citizen of the world. By strong, I mean someone who believes in themselves, has strength of their convictions, is self-transcendent, self-actualized, a master of their fears.

Can you see how such a society would be totally counter to the desires of the Haves? Humane and strong people could not be manipulated or controlled by advertising. As the Haves see it, the masses must be controlled and kept powerless. Fearful people give their power away. The main focus of our society now is to raise our children to be fearful. We’re afraid to let them play outside. We’re afraid to let them walk to school. We’re afraid of germs. We’re afraid of Terrorists.

Fearful people believe what they are told, they react more from emotion than reason. They have their minds made up and are incapable of considering new data that contradicts what they already believe. Fearful people give their power away and the Haves sit at the top of the heap and rake all that power up for themselves.

There are only two motivations in life: Love and Fear.

How are your motivations divided between the two?

How much are you motivated by Fear vs. motivated by Love?

The level to which our society is fear-based is the level to which it is unhealthy.

To raise healthy children, to create healthy societies, we need to question the very foundation upon which Civilization has been built. Rather than letting the Haves grab all the power and run the world, perhaps we ought to treat people with insatiable material appetites for mental illness. They’ve obviously got some messed-up belief systems inside.

Businesses would do better if people everywhere did better. How much are those global corporations making off the billions of people on the planet who live on less than ten dollars a day? They ought to be trying to grow the middle class, not destroy it. Sure, they can make tremendous profits by raping and running, by pillaging and burning, but that’s not sustainable, that’s not in the higher good of all, that’s insane by any reasonable definition. When the middle class is gone, then they’ll have to go back to fighting amongst themselves to increase their holdings and we’ll go right back to world wars, with devastating consequences.

The point I’m trying to make is that freedom is our birthright. Free is who we are as divine beings.

Freedom is important to our health. No one gives us our freedom but the Haves love to take it away. To stay free, we need to figure out how to be healthy with our fears. We need to be mindful of how, when and to whom we give our power away… and make good choices from a Spiritual perspective.

We all have very similar needs and wants. We want to make life choices for ourselves, we want to take good care of our families, we want our children to be happy and we want to be happy. These are universal and reasonable wants held by most who are mentally stable. Why would someone else not want you to have your life this way? When most people in a community have similar needs, then community-based solutions make the most sense.

(When what you want becomes more important in your mind than how you treat others and yourself, you are set up to abuse others and yourself. To most corporations, the need for profit is more important than how they treat people or the planet. That’s how we got here.)

We can run our schools so that the needs of the students are more important than the needs of the school system. We can have healthcare where the needs of the patient are more important than the needs of the healthcare system and so forth.

The best way we can take our power back from the large multi-national corporations is through non-violent non-participation.  Just don’t buy their stuff.

But most importantly, don’t stop caring.

Hold onto that aspect of yourself, it is a very important part of who you are. When we stop caring, they’ve got our power. Hold onto your personal power even when you are in situations over which you have no control. Whether you hold onto your power or give it up is just a personal choice you make moment by moment.

Be aware, watch yourself, be sure of your convictions, your choices, your words, your actions. Such awareness is a practice and it gets better and easier the more we practice it.

We are only victims when we are over-powered. But you are more powerful than you realize and victimization will happen less and less the more you move into your power…and the more we work together to create a world that supports us being healthy and happy. When you do get overpowered, you can re-group, take stock, learn, and come back stronger and smarter.

The road to making this world a better place starts at your own front door. By virtue of their actions, the insatiable Haves have shown themselves to be insane. Don’t let crazy people run your life.

Care and be aware.

Practice non-violent nonparticipation with the corporations you don’t agree with.

And work to make a society that raises our children to be humane and strong.

Steven M. Hall, MD

Copyright 2012 Steven M. Hall, MD