Building Bridges, Saving Lives

by Eve A. Wood, MD

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Last year, at the annual meeting of the American Psychiatric Association in New York City, the APA's Osker Pfister Award Lecture was entitled "Dialogue from the Rims of the Grand Canyon: On Bridging the Post-Freudian Chasm Between Religion and Psychiatry." Elizabeth S. Bowman, M.D. of Indiana University spoke about how Freud's theories on religion created a Grand Canyon of eroded trust between psychiatry and religion. "Seventy six years after The Future of an Illusion (Freud, 1927), the canyon remains largely unbridged. Religion and mental health professionals lack a comprehensive synthesis of spiritual and psychological life." This lecture, the first of its kind for the American Psychiatric Association, was a much welcomed beginning in what will be a long journey toward bridging both divided professional worlds and disparate facets of human experience. The talk spoke to the deep pain that many in the field of mental health have experienced for decades.

Freud depicted religion as inherently pathological and inconsistent with psychological maturity. Yet many of us in the field of emotional and psychological well-being have felt the opposite. We have been aided and guided in our work by spiritual concepts from both ancient and more recent traditions. We have seen the healing power of spiritual practices -- those which help us to experience the sacred, and enable us to connect with what is most central to our lives. We have seen the power of awakening, gratitude, humility and faith to promote and foster well-being.

Some of us, myself included, entered the field of medicine for religious or spiritual reasons. My Jewish background taught me, "If a person saves one life, it is as if he has saved an entire world. And if a person destroys one life, it is as if he has destroyed the entire world." (Mishnah, Sanhedrin ) This sentiment, embodying all that really matters in the universe, continues to be my touchstone. With its simple eloquence, this lesson reminds us that every life is of infinite value and deserves to be nurtured. It advises us to respect the internal world of the self, as that is where much of real consequence in this world resides. It extols the virtue of self-love and love of others. It instructs us on how to find meaning and fulfillment in life: Save yourself and save others, love yourself and love others, grow yourself and help others to do the same.

Many traditions teach that we are a creation of the sacred and that our deep inner wisdom is linked to the Divine. Examples include:

• The Kingdom of Heaven is within you. (Jesus, Christianity)
• Those who know themselves know their lord. (Mohammad, Islam)
• He is in all and all is in Him. (Judaism)
• In the depths of the soul, one sees the Divine, the One. (The Chinese Book of Changes)
• Look within, you are the Buddha. (Buddhism)

Models of healing that draw on ancient wisdom, nurture hope, encourage belief in miracles and envision the human being as much more than meets the eye, make intuitive sense to me. I have personally seen the miraculous emerge from a tiny sliver of hope, and devastation take over when all hope was snuffed out. I have seen the power of connection and love to transform lives, and the power of isolation and alienation to destroy them. I have seen children excel when told they are smart, and fail when told they are not. I have seen patients with hope survive illnesses that were thought to be fatal, and patients in despair die of curable disease. And finally, I have experienced the healing power of love, hope and acceptance in my own life. I have been lucky enough to learn how to offer these gifts to my patients. I have found that my faith in the value, purpose, and potential of each of my patients helps them to heal; and I have discovered that by teaching them to see themselves in kind, they blossom.

My patients have taught me how to bridge the medical, psychological and spiritual worlds. In entering their trauma, stories, lives and pain, I have learned to silence my cognitive mind and trust my intuition. When I see each patient as the Divine with skin on, I can help countless individuals recover and graduate from psychiatric care.

In Medicine, Mind and Meaning, I outline a step-wise approach to care that bridges the biological, psychological and spiritual realms. Drawing on many clinical tales from my practice, I demonstrate an integrative way of approaching patients that allows us to use the best of medical science to enable our patients to grow into fulfillment, joy and their unique place in the world. Diagnoses, medications, feeling states and family-of-origin issues are all crucial dimensions to address on this path to wholeness. But deep faith in the capacity to heal is the needed glue to get there. Here are some examples.

Case example #1:Gillie came to me in August of 1988 — a 42 year old widow with three young children; a troubled woman with multiple personality disorder. She was severely depressed and chronically suicidal. She had made at least ten near-fatal suicide attempts. She had not lived a single day of her life, since age five, without cutting herself or burning her forearms with a hot iron. Having been in intensive psychiatric care for many decades without much progress, she asked me to help her heal.

As a naive new psychiatrist, I took on this monumental challenge. I worried constantly about my new patient. Would she make it to the next appointment or would she take her life first? I required regular safety commitments. So when I found her unconscious outside of my office three months into our work together - she had taken an overdose - I stopped working with her. I felt we had no trust between us and no ability to partner for healing work.

A colleague became solely responsible for her care until she committed to resuming care with me without engaging in any self-destructive behavior. She understood that cutting, burning and suicide attempts would not be tolerated. I would help her in any way I could as long as she agreed to talk to me, reach out for help, establish goals for treatment and refrain from self-injury.

Who was I to demand the impossible? And what made me think it would work? I really saw no choice. Were I to be able to help Gillie, she needed to choose to partner with me. She needed to choose life over death. I needed to support her through the ongoing hopelessness and despair.

Today, Gillie no longer suffers from multiple personality disorder. She is no longer clinically depressed. She has not cut herself, burned herself or made a suicide attempt for 13 years. Although she didn't believe she could stop these behaviors, she agreed to my terms! What a decision! Although her healing journey has been long, challenging and often overwhelming, Gillie now says: "I used to have mental illness!" She is now healed.

Case example #2: Chris came to me in his early 50's. He, like Gillie, had been in psychiatric treatment since childhood. His referring psychiatrist had given up on him. She actually told me: "Chris has been with me for years. He is poly-addicted, has an acerbic personality, a history of no intimate relationships and no current friends. I have hit a wall with him. I hope you can help. I see no endpoint to his therapeutic need!"

I thought I would find Chris to be a recalcitrant and uncooperative fellow. I was truly surprised by what I found. He was open to change and willing to work very hard. Our journey together was fraught with challenge. We needed to tackle addictions, family-of-origin issues, spiritual bankruptcy and much more. But, over the course of ten years, Chris was able to transform his life. He ultimately graduated from my care a married man with children! He no longer needs psychiatric treatment.

Both Chris and Gillie participated in a step-wise journey to healing. Their paths involved identifying and working creatively on biological, psychological and spiritual issues. Both experienced fits and starts, ups and downs, and moments of hopelessness. Yet each was able to triumph and graduate from psychiatric care.

Case example #3: I met Mindy at a book talk I gave some months ago. She wandered in part-way through the talk. She had never been to that bookstore before and had not planned to come. Something drew her in and she sat rapt through the remainder of my talk. During the book signing that followed, she tearfully told me that she had given up on her capacity to be happy some years ago. Until hearing me talk about the power of the possible, she saw no hope for herself. Now she wondered if I would be willing to help her get better.

I have met with Mindy a total of eight times. Addressing self-esteem, family-of-origin and addictive issues, she is now in a hopeful, positive and peaceful place. During her most recent visit, tears came to her eyes as she said: "I can't begin to tell you how much you have helped me. Your belief in my healing potential is transforming my life."

I believe in every individual's capacity to heal. I believe each of us can take charge of our emotional life. Every psychiatric diagnosis is made on the basis of the individual's story. There are no diagnostic tests in psychiatry! We have only screening tools. Therefore, if we know enough about the symptoms of common disorders, we can determine whether or not we might have a particular problem like depression or anxiety disorder. We can become the best stewards of our own healing journeys. We can begin to find right-enough-fit providers to help ourselves heal. We can take on our family of origin and spiritual dimension issues in a similar way. We need to educate ourselves and trust our gut. We have amazing potential! Like Gillie, Chris and Mindy, we can transform our lives.

What ingredient is most crucial to our healing? Our belief in the power of the possible. We need to keep searching for those providers, partners, mentors and guides who nurture us. We must use what makes sense as long as it makes sense to us, continue to ask for help and never allow ourselves to give up. Where there's a will to transform a life, there's a way to do it. Nurturing spirit, in this sense, saves lives. By working together to build bridges between disciplines rather than canyons; we can better save the world, one life at a time.

Mishnah, Sanhedrin. Jewish commentary on the Old Testament.

Eve A. Wood, MD is Clinical Associate Professor of Medicine at the University of Arizona Program in Integrative Medicine. A practicing psychiatrist, author, speaker and consultant, Dr. Wood is a pioneer in the field of integrative psychiatry. Having spent nearly two decades and over 28,000 hours in the care of troubled individuals from all walks of life, Dr. Wood has developed a treatment approach that involves traditional psychiatric medicine, psychology and universal spiritual principles. Her method has attracted attention and acclaim from the nation's leading authorities in the fields of medicine, health and spiritual well-being.

Dr. Wood has served on the faculty of the University of Pennsylvania School of Medicine, the Executive Committee of the Institute of Pennsylvania Hospital, written articles for medical and professional publications, lectured widely to professional and lay audiences, appeared on over 65 radio programs and been the guest on many television programs in major cities. In her book, Medicine, Mind and Meaning: A psychiatrist's guide to treating the body, mind and spirit, she shares her patients' captivating clinical tales to demystify the therapeutic process and illustrate her treatment approach. Dr. Wood is committed to building bridges between the disciplines, empowering colleagues and helping as many people as possible to heal.

Dr. Wood lives in Tucson with her physician husband and four children, ages 7 to 17. She maintains a small clinical and consulting practice and teaches at the University of Arizona Medical School.

Contact:
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http://www.drevewood.com/.

This book is a candidate for many awards (reviewed in this issue of IJHC).

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