It is not how much you do, but how much Love you put into the doing that matters.
      - Mother Teresa

New terms
Sometimes a new word or phrase is particularly apt in describing something you might encounter but not identify until someone points it out.

Have you encountered people with "expanding hatbanditis" (Haack 2001) or "shoulder repetitive injury syndrome?" The first comes from a swollen ego, the second from patting themselves on the back too much.

Orthorexia nervosa, is the excessive attention to health food dieting. Not mentioned yet on lists of mental diagnoses, it is howeverlisted in the online Oxford English Dictionary (Bratman).

Pattern recognition is a gift that has not had much acknowledgment, although it has been touched on in studies of creativity and intuition. This is the ability to grasp relationships between a spectrum of details, finding relationships between them that can be helpful. This has been invaluable to me as a therapist, identifying meaningful patterns in what my clients present about their relationships between symptoms, old hurts, fears, wishes, dreams, and relationships. It is a great help in research as well.

9-11 is now a dictionary item. To most, this is the date of a horrendous, horrifying terrorist attack, a day of national mourning. To many, it is a provocation to revenge the thousand of deaths of innocent civilians. To many, 9-11 is a challenge that led to new relationships - within themselves and in relating to others - through reaching out to help and through realizations of the preciousness of the days and minutes given to us to spend on this planet. To some it is a challenge to look into the reasons that lie behind the attacks - not only on the terrorists' side but also to consider possible American actions and attitudes that may have contributed to the terrorists' actions.

Teacher, separating two boys who are fighting, "What's going on here?"
Johnny: "It all started when he hit me back."
       - Anonymous

Many of the terms used to describe wholistic care, spiritual awareness, and healing are new to health caregivers. These are considered below.

Aggressive language in treatment
Conventional medicine attacks, fights and wants to conquer diseases, and invests enormous resources in counteracting natural processes such as aging and death. About 30 percent of medical costs are wasted on the last month of life, to little avail other than to stimulate the medical economy and to pretend that modern medicine can deal with death.

By battling something we label as an enemy we are actually giving it lots of energy and perpetuating its negative existence. While this may work with a physical problem, it does not work with psychological, relational or spiritual problems. Fighting to make your way out of a vicious circle, you are focused constantly on the negatives in your situation. This will not make the negatives go away. In fact, battling highlights the negatives in your awareness, puts you in an aggressive, negative frame of mind that is not health-promoting, and in the end is unlikely to be effective. In fact, it is likely to perpetuate and worsen your problems.

EmotionalBodyProcess, Part II in this issue of IJHC discusses ways in which negatives can be dealt with through acceptance, love, healing and forgiveness. (See also Part I in Vol. I, no. 1)

Being angry is actually a choice. No one can make us angry if we're not in a mood or of a mind to respond with anger. However, we are conditioned to put the responsibility for our feelings on other people through the common usage of such terms as "He made me furious!" or "This makes me sick!" The opposite is equally true. We credit others with generating our positive attitudes, as in "Seeing her smile makes my day!" (This is not to say that sharing positive feelings is wrong, but that relying on others to generate them is a crutch.)

Learning to handle anger can take you out of a vicious circle and into a sweetening spiral. I work a lot with children and their families. From years of observing their behaviors (as well as observing my interactions with my own children and grandchildren), I am impressed that when parents are in a positive psychological space, children's natural misbehaviors are handled much more successfully than when parents are in a bad mood. Just last week, two year old Susie spilled a whole box of crayons on the floor in my office. Jennifer, her mother, responding from a place of anger, loudly reprimanded her: "Why do you always have to make such a mess?" Susie walked off to the play chest and refused to help her mother pick up the crayons. Jennifer continued to rant at Susie. Rather than cooperation, she elicited more rebellious and negative behaviors, stirring herself and Susie to escalating angry interactions.

In anger we tend to blame others for "making us angry." Jennifer had nothing but criticisms for Susie. She could not understand what her baby sitter's secret was for dealing with Susie, who rarely had angry outbursts while she was babysitting. I suggested to Jennifer that she might explore this question with her baby sitter. Yesterday, Jennifer sheepishly acknowledged she had begun to see how her own frustrations and anger were probably stirring Susie to be an even more rebellious terrible two. With further discussions, she was able to see that her frustrations and anger (over marital and financial problems) was feeding on itself, and that she was venting her anger on Susie. She was pleased to report in a follow-up phone call that in the past two days Susie had been behaving much better, responding very quickly to her mother's more positive attitude towards her.

If you wish to experience peace, provide peace for another. If you wish to know that you are safe, cause another to know that they are safe.
      - The Dalai Lama

Words that divide and seek to control
Our Western scientific method dichotomizes. We have the world of matter and separate realms of mind and spirit.

Even our bodies are subdivided into various parcels. Health care has gerrymandered* our bodies into territories that are convenient for caregivers to treat. Focusing on a problem that is in the heart or kidneys also allows caregivers to specialize in treating these organs, honing their skills and deepening their clinical knowledge. The enormously rapid pace of development of medical research makes it impossible for any one person to master all of medical practice. So, in the name of efficiency, we have a medical system that trains doctors to care for parts of people, but often neglects the person who brings the problem for treatment.

The result is that people feel neglected - however well their various limbs and organs are being addressed. One of my favorite cartoons from the New Yorker pictures a patient at the receptionist's desk, asking "Does the doctor hug?" We warm to the observations of Naomi Remen on how therapeutic encounters can be humanized. (See book review of My Grandfather's Blessings: Stories of Strength, Refuge, and Belonging in IJHC 2002, Volume 2, No.1.)

The body is the focus of conventional medicine to such an extent that many doctors have little training in understanding or dealing with psychological problems. Western medicine has been successful in curing acute problems, particularly infections and trauma. It is less successful with chronic illnesses, where symptom management is the focus, and where psychological components are present - certainly in response to the stresses of being ill, and often in contributing to the development of the illness in the first place through poor stress management.

In the physical world of conventional medicine, we tend to view things in either/or fashion. Either the pain is caused by an infection, by trauma, or by some other cause. Wholistic medicine tends more towards both/and understandings of illnesses and approaches for dealing with problems on all levels. Yes, there is a traumatic injury, and there are also the psychological components to the injury - including the possibility of having allowed it to happen, along with subsequent responses to the injury.

What a healing we might have from the Russian word, danyet. Da means yes and nyet means no. Combine the two and you get something that is both yes and no - blending in the same word, in the same feeling; not alternating back and forth between a polar, separate yes and a distant, separate, and opposing no, but intimately intertwined and inextricably parts of each other. Colloquial German similarly uses jain for ja (yes) and nein (no) combined.

The Chinese have vastly expanded upon the appreciation of polarities in life, acknowledging that absolutely everything in the world is in a relationship with everything else. Yin is seen in open, gentle, receiving actions, while Yang is expressed in assertive, forceful, outgoing actions.

At first it seems as though yin and yang are dichotomizing, but as we delve deeper, we see that the opposite is actually the case. Yin is the shady side of a slope, representing cold, darkness, passivity, resting, inward movement, the feminine and receptive. Yang is the sunny side of a slope, warmth, light, energy, moving outward, growing, masculine, assertive. Everything has yin and yang qualities, either of which may be more apparent relative to different relationships. A given temperature can be hotter or colder; weight can be lighter or heavier; light can be brighter or dimmer, and so on. Infinite subdivisions and permutations are possible within any relationship. The back of the body is yang relative to the front, but the front at the chest is yang relative to the belly.

While yin is separate from yang, each depends upon the other to be in a relationship with itself in order to define itself. Health would not be appreciated as health were it not for illness. A terrorist could not be a terrorist or a martyr without an enemy against whom to fight. America would not be the defender of freedom without someone to defend against (Kaptchuk 1984).

All of this may seem rather esoteric, so let me bring it back to a focus of the IJHC, healing research. The commonly held view is that research proves whether a therapy is effective or not. Actually, research generates data as observations which are quantified as numbes. The observer - be it the original experimenter, the editor of a journal, or a reader of the published report - must interpret the observations and data. This is how believers and skeptics come to argue so vehemently over whether healing is real or not. Believers look for reasons to confirm their beliefs, people with neutral opinions may be swayed one way or another, and skeptics look for every possible way to discount a study. In Healing Research, Volume I, professional edition (Benor 2001a), I acknowledge that there is often no clear truth demonstrated in a study. I present discussions of the data from the points of view of both believer and skeptic - leaving readrs reader to decide which appeals to them.

Labeling terms

Give it a name and you feel you know what you're talking about.
       - D.B.

Words play important roles in the realms of healing. Words are analogs for perceptions and actions that allow us to communicate with each other about our personal experiences, feelings, desires, and thoughts.

While words can facilitate learning, they may also retard or even obstruct learning. The commonly accepted use of a label may impede changes in perceptions about that subject, and may make it difficult to change our ways of relating to the concepts conveyed by the label. This is a serious problem in health care.

The words we use to define our relationships between caregivers and careseekers shape the course of treatment. A major focus of the IJHC is on wholistic spiritual healing. Each of these terms deserves scrutiny.

Conventional medicine focuses on physical problems. It offers medicines and other physical manipulations (hormones, surgery, and genetic manipulations) as ways of dealing with problems. We are conditioned through the use of the term, medicine, to view these physical approaches as therapies of choice. This focus tends to divert awareness from other ways of understanding and dealing with disease and dis-ease, such as bioenergy therapies and spiritual healing.

Wholistic medicine focuses on body, emotions, mind, relationships and spirit. This extends the range of conceptualization of the causes of illnesses and of potential ways for dealing with them. More on this below.

Healing
Healing comes from Germanic and Old English roots that mean to make whole. Within Western medicine, healing has been narrowed in common parlance to mean restoration of the body or psyche to its pre-traumatized condition.

Among practitioners of Therapeutic Touch (TT), Healing Touch (HT), Qigong, Reiki, and numerous other such traditions, healing refers to the laying-on of hands and/or to healing by mental intent, meditation, and/or prayer. Within the community of healers, there are widely varying opinions about the best name for this therapeutic modality.

The laying-on of hands has been used for many centuries - offered within religious contexts and by monarchs of Europe (Benor 2001a; Pavek 1987; Rose 1971). This has colored an otherwise simple, descriptive term with religious overtones that many find uncomfortable.

Spiritual healing alludes to the spiritual awarenesses and awakenings that occur in healers and healees during and as a result of healing. Within this understanding of healing, the process is one of growth towards a deeper understanding of our connection with something vaster than ourselves. For some, the vastness is rooted in the natural, physical and energetic universe (McFadden 1991; Medicine Eagle 1989); for others it is primarily an omniscient, omnipotent Deity (MacNutt 1974; Sanford 1949). Spiritual healing is used generically in the UK to designate the entire spectrum of healing by the laying-on of hands and by prayer/meditation/intent. Spiritual healing is the term that I, the editor of the IJHC, prefer and the one I will use to designate this form of treatment (Benor 1996; Benor and Benor 1993). Where it is clear that this is the subject for discussion (i.e. not to be confused with healing of the physical body), the term healing alone will be used.

Faith healing is a term used by several groups.

Members of some religious communities believe that faith in their teachings about religion is required in order for healing to occur, that illness is manifested when members of the flock lack or lose faith; and that health will be restored when faith is restored. Members of these communities - who hold to these beliefs - may indeed be able to influence their states of health through shifts in beliefs and acts of faith (Eddy 1934). There are sects who go to the extrremes of handling hot coals and poisonous snakes, as well as ingesting cyanide to prove their faith (Schwarz 1967).

Members of the scientific community have used this term out of a belief that healing is no more than the product of suggestion - a placebo effect - that is potent only to the extent that healees believe it might work.

Many journalists use this term, under the influence of either of these communities.

While faith may facilitate healing in the faithful of a given religion, it is not a general requirement for spiritual healing. This is witnessed by numerous experiments in which animals, plants, bacteria, yeasts, cells in laboratory culture, enzymes, and DNA responded to Spiritual healing.

Mental healing is the term under which studies of spiritual healing have been listed for many years in the Index Medicus, the physician's annual compendium of published research in journals selected by the editors of this hefty tome. Many of the parapsychology journals (which are peer-reviewed and which hold to standards for research that exceed those of many medical journals) in which healing studies are published are excluded from the Index Medicus. This term draws on the one hand from a belief that healing cannot be more than a placebo, and on the other hand from the traditions of Christian Science and related approaches that teach ways of thinking as methods of healing. Many of the parapsychology journals in which spiritual healing studies are published - which are peer-reviewed and which hold to standards for research that exceed those of many medical journals - are excluded from the Index Medicus. Such publication biases maintain conventional medicine's limited awareness of spiritual healing as a potent intervention.

Psychic healing, or psi healing (taken from that Greek letter psi) is a common term of parapsychologists, who for decades were the main group of scientists publishing studies of spiritual healing. Healing overlaps with psychic abilities that have been extensively researched by parapsychologists, including telepathy, clairsentience, pre- and retro-cognition, and psychokinesis (PK; "mind over matter"). Healers often have intuitive/psychic impressions that guide them in assessing and treating the problems of healees. These may include insights into past physical and emotional traumas, as well as current stressors that have contributed to current problems.

Quantum healing is a term popularized by Deepak Chopra, referring to explanations from quantum physics that suggest explanations for healing.

Shamanic healing refers to healing in traditional societies in which the shaman is a priest, healer, counselor, mediator in conflicts, and mediator between worlds of spirits and the physical world.

Bioenergetic healing, vibrational healing and subtle energy healing refer to perceptions common to healers and healees during laying-on of hands treatments, including sensations of heat, tingling, vibration, and cold. These create the distinct impression that an exchange of some sort of energy is occurring between healer and healee (Benor 2001a). Thus far, there have not been conventional energies identified consistently that account for the effects of spiritual healing.

Divine healing alludes to the ultimate source attributed by some to all change and healing.

Unconventional healing and paranormal healing are terms used by scientists who view spiritual healing as something that is outside of the ordinary ambit of conventional science.

Distant mental influence on living systems (DMILS) is a term coined by William Braud (1990), in studies of intent, projected from a distance, to influence the electrodermal response of subjects in a laboratory.

Therapeutic Touch, Healing Touch, Qigong, Reiki and numerous other healing modalities are specific approaches taught by various schools and healing traditions. TT and HT are names well-chosen - to give modern labels to the laying-on of hands in terms that are not value-laden. TT has found its way into medical settings around the world, particularly among nurses. Its name has facilitated its acceptance - as well as its promotion of more research than any other healing modality. HT, a recent offshoot of TT, is making similar progress. Qigong and Reiki derive from Eastern awarenesses of bioenergies that are called qi (pronounced chee) in China and ki in Japan.

No one term encompasses all of the processes and manifestations of healing. My own preference is to add wholistic to spiritual healing to indicate that healing can come through body, emotions, mind, relationships, and spirit.

Unacknowledged spiritual healing
Many healings occur through compassionate caring, without any fuss or bother or labeling of the interactions as healing. A mother kissing away a child's hurt is healing. Putting your arm around someone's shoulders, or reaching out with soothing words can be a healing to a person who is hurting - physically or emotionally.

Many caregivers have a healing presence, commonly acknowledged as good bedside manner, a soothing voice, a gentle touch. People who are sensitive to bioenergy healing have told me of doctors, nurses, massage therapists, chiropractors, and other caregivers who have "hot hands" when they are ministering to people's ills. Heat is a common sensation perceived by healers and healees during laying-on of hands treatments. Many caregivers probably have considerable natural healing gifts without ever being consciously aware of this (Benor 1995).

There are specific therapeutic modalities that involve spiritual healing, where this is often not identified per se as an aspect of the therapy..

In craniosacral therapy, derived from osteopathy, therapists hold their hands either lightly touching or near the head, sacrum, and sometimes other parts of the body of the healee. Various natural pulsations in the bioenergies of the healee are monitored and treatments are given through the hands, guided by sensations in the hands and by intuitive awarenesses (Sills 2001). This is nearly identical with spiritual healing treatments by the many other names considered above. Oddly, most craniosacral therapists are focused on the body they are treating far more than on the bioenergies they are sensing and manipulating. A converse oddity is that I know of few spiritual healers who identify the pulsations of bioenergy which are the focus of much of craniosacral therapy.

Acupuncture has classically used needles to stimulate particular points on the body that lie along bioenergy lines which run throughout the body, from toes to head.and fingers. Acupressure uses the tip of a small wooden stick or the practitioner's finger pressure to stimulate the acupuncture points. Again, there is little general awareness among acupuncturists that the practitioner may be an important part of the treament.

My personal impression is that many therapists do not want to be labeled as healers. They are concerned that this label could discredit them - despite the fact that there is more research to confirm that healing is a potent intervention than there is for many of the other CAM modalities.

Caregivers and careseekers
We have many terms for those who offer treatments and those who seek them. Each has its own tradition and shapes the relationships of the caregivers and careseekers in subtle but pervasive ways.

The first term I suggest for consideration is respant, asking you to consider all the other terms in relation to this one.

Respants
Bernie Siegel (1986), a remarkable surgeon, developed support groups for people he was treating who had cancer. He says that the most important thing he learned was to be quiet and listen, letting the group members sort out their problems within the group sharing process. He finds that people have a deep wisdom within themselves that understands their problems and knows ways to deal with them. The doctor's job is not to prescribe the solution, but rather to ask questions that will challenge people to discover their own solutions to their problems.

Siegel coined the term, "respant" - standing for responsible participant - to replace the term, patient. Respants are encouraged to ask their doctors lots of questions, so that they themselves can make informed decisions about dealing with their problems. Respants look for ways that they can improve their own conditions, including:

* Lifestyle changes - exercise, healthy foods in reasonable quantities, avoiding toxic substances
* Healthy diets - balanced for nutrition, varied for essential elements, free of toxins
* Supplements - vitamins, minerals, herbs
* Self-healing techniques - relaxation, meditation, imagery, prayer, communing with nature
* Seeking out caregivers who respect the rights of respants to decide for themselves, after appropriate consultations
* Seeking treatments that are consonant with their beliefs and wishes
* Refusing recommendations that are not clear or acceptable

In IJHC, 2002, Volume 2, No. 1,  Siegel expands on his concept of the respant.

Not every patient is ready to be a respant. Some prefer to accept the educated advice of an expert. This is fine, as there are plenty of experts who are happier with patients who accept their advice without question.

Doctor
Doctors are perceived to have the knowledge and expertise to diagnose and treat problems. This places most of the responsibility for dealing with problems on the physician. The doctor questions the patient, seeking symptom patterns and supporting diagnostic factors in physical examination and laboratory data that fit recognized disease patterns, for which the doctor supplies a diagnostic name. Treatments are administered directly (as in surgery or physiotherapy) or prescribed (as in diets or medication). The advantage to this system is that within the conventional medical model that views most medical problems as dysfunctions of the physical body, this works reasonably well. Modern medicine is excellent in diagnosing and treating infections, physical trauma, structural abnormalities, and hormonal imbalances that fit well within this model.

The disadvantage is that the prescriptive model is often less successful with chronic problems. For instance, arthritis, chronic pains, neurological disorders, chronic fatigue syndrome and other chronic disorders often do not respond to medical treatments. Doctors continue to prescribe one medicine after another, hoping to find one that will provide symptomatic relief. Patients may have adverse reactions to the medications, for which they are given further medications. They often become weary or despairing with the lack of progress.

The label, doctor, conveys a mantle of priestliness to those who have earned this title. It carries an aura of knowledge, wisdom, and power to heal. On the positive side, this mantle of authority vastly enhances the placebo, or self-healing potential in all medical interventions. Patients come with the expectation that they will be given a cure, and this produces self-healing that will respond in about a third of cases to any treatment whatsoever.

The doctor's arrival is the first part of the cure.
       - Anonymous

Sadly, on the negative side, power corrupts. There are many within the medical profession who have assumed that their methods of healing are the only true methods, all others being the work of infidels. This attitude, along with medical economics and politics, have led doctors to lobby successfully over the past century for exclusive legislative license to declare who should treat and how treatments should be given.

Many members of the public, not fooled by this arrogance, have voted with their feet and health care dollars in a big way for therapies that have been outside the knowledge and competence of the medical profession. Awareness of the billions of dollars spent out of pocket for complementary/ alternative medicine (CAM) has encouraged medicine to begin to integrate these approaches into medical care, and is encouraging legislation that allows the public freer access to these treatments. For instance, in Minnesota, a law was passed recently that grants freedom of practice to many CAM therapies.

Wholistic doctors are learning to integrate CAM approaches in their practices. More on this below.

Therapist
Therapists traditionally provide treatments much as doctors do. They are the experts, dispensing advice, psychotherapy, herbs, homeopathic remedies, flower essences, providing acupuncture, craniosacral therapy, massage, or other interventions.

As with doctors, many therapists today are joining in wholistic care.

Coach
Coaching is instruction for business people, especially executives, in human relations, to develop smoother team efforts in the workplace. This term has facilitated the acceptance of what is essentially counseling, which is not well accepted because it carries the implication that the executive needs treatment. By using coaching, there is no implied criticism or suggestion that there may be something wrong with the executive (Berman Fortgang 2000; Flaherty 1998; Richardson 1988).

Teacher
In many of the CAM modalities that promote self-healing, the caregiver is more a teacher than a therapist. Respants are instructed in lifestyle changes, meditations, relaxations, imagery exercises, and other self-healing approaches that they practice on their own.

I have come to perceive myself primarily as a teacher or guide in most of my interactions with my psychiatric psychotherapy clients. In addition to instructing them in their options with various medications, I often introduce self-healing approaches - particularly acupressure techniques that are rapidly and potently effective in dealing with stress reactions, pains, and allergies.

Healer and Healee
There are people we call healers who have gifts of intuitive awareness and abilities to facilitate wholistic changes in body, emotions, mind, relationships and spirit. In Western society, many healers and their patients have modeled aspects of their interactions on the conventional medical system. Healers are perceived as intervening to identify problems and provide the necessary treatments. This mode of interpreting healing is reinforced by the media, who like to headline unusual cures that occasionally result from healings. Some healers promote this perception of healing, thriving on a sense of power, providing their healing as a medical doctor would perform surgery, with every bit as much ego inflation.

Recipients of healing are often called healees. In following the medical model, healees are often passive, expecting healers to provide whatever is necessary for dealing with their problems.

There is a trend among progressive healers toward encouraging healees to take more responsibility for their own care, empowering people to activate their self-healing abilities, encouraging them to be respants. Within this definition of healing, treatment is viewed by many as a boost to healee energies rather than as a cure provided by the healer for their problems. Others view this respantifying process as helping people to connect with their innate healing wisdom, with their higher selves, with spiritual guidance, or directly with the Infinite Source.

While this is a growing trend, the term healer carries entrenched nuances of passivity that can hinder the shift towards healees taking charge of their lives and dealing with their problems themselves. Healers have not found an alternative to this word that feels comfortable. Consider the following alternatives on the other side of the healing interaction..

Patient
Patients expect doctors to diagnose their problems and prescribe treatments to fix them. The very term, patient, suggests someone who patiently waits for someone else to intervene on his or her behalf.

Doctor: "What's your problem?"
Patient: "You're the doctor. You should tell me what's wrong!"
      - Anonymous

Client
Many CAM practitioners refer to the people they treat as clients. This shapes the conceptualization of their relationship, acknowledging that people have choices in selecting therapists and that therapists are in advisory and teaching roles.

Complementary vs. Alternative vs. Integrative
Alternative therapy is the term most commonly used for therapies that have been outside the spectrum of conventional medical care. These include therapist-administered treatments such as acupuncture and massage, as well as the self-healing techniques of relaxation, meditation and imagery (the latter three have been combined as psychoneuroimmunology). When expertise is required in learning the methods or in choosing remedies, as in aromatherapy, flower essences and homeopathy, the approaches and therapist/ respant relationship can be fairly similar to those found in conventional care. The self-healing approaches are also often practiced under the guidance of trained practitioners.

Complementary therapy suggests that CAM practitioners can work harmoniously with conventional therapists. However, some in the CAM field object to this, feeling that they should not be labeled as "add-on" modalities.

Integrative care is the latest variation on this theme, suggesting that all therapies should be practiced harmoniously. Indeed, there are now hundreds of doctors in the American Holistic Medical.Association, and thousands of nurses in the American Holisitc Nurses Association who practice integrative care. Board examinations in Holistic Medicine have been initiated for doctors

Holistic vs. Wholistic
Holistic has been in use for several decades, generally indicating a focus in treatment that extends beyond physical problems as addressed by conventional medicine. In some instances holistic includes what I term wholistic, but in most instances it refers to the addition of some aspects of CAM therapies to medical care. Often this sort of holism includes bits and pieces of therapies, such as needling particular acupuncture points for pain relief, or providing massage for relaxation and post-injury rehabilitation.

Holistic may overlap with psychosomatic, addressing psychological aspects of illness, as reflected in emotional responses to the physical problems, in mental aberrations that occur as the result of disorders of the body (e.g. psychosis that may result for hormonal abnormalities), and psychological influences on the body. All too often, minimal consideration is given in most medical schools to the psychological concomitants to disease, and psychosomatic medicine has been grossly neglected in medical training.

Wholistic refers to whole person care, including body, emotions, mind, relationships and spirit. Where CAM therapies are modalities for wholistic care, therapists acknowledge the broader philosophies of these approaches and incorporate them in their treatments . For instance, acupuncture includes a complete system of biological energy diagnosis and treatment. This is fundamentally different from Western medicine, addressing the biological energies of the body as avenues for assessment and intervention. Western medicine tends to discount and discredit acupuncture (and the theoretical and philosophical cosmologies of other CAM modalities), ignoring the fact that many of these have served the larger portion of our world's populace over several centuries, and continue to do so. Growing bodies of research confirm that these modalities are helpful in treating many problems.

Many varieties of bioenergy therapies are available within the wholistic healing spectrum.

Integrative care
Integrative care - in its highest form - seeks to blend the best of conventional and CAM modalities, respecting the approaches of each modality. However, this term, too, may be used to cover token selected CAM interventions that are lifted out of their original contexts into Western settings.

Congruence of caregivers with their teachings
Within all of the above variations on the theme of caregiver, we often tend to focus on the content of their ministrations. The family doctor prescribes medicines, the surgeon cuts and sews, the herbalist prescribes plants, the massage therapist kneads your flesh, and so on. We should not overlook the importance of caregivers as healing agents, in and of themselves. Within wholistic frameworks, caregivers are an essential part of the healing.

Caregivers are far more effective when they model what they are teaching than when they are simply purveyors of information or providers of interventions. A quiet voice, a heart connection, and suggestions based on personal experience enhance the impact of any therapeutic intervention.

Biofeedback is an excellent example of the importance of therapist congruence with the therapy. Biofeedback introduces instruments or other methods for becoming aware of bodily processes that are usually outside of conscious awareness. For instance, a very sensitive thermometer or electrodes that measure electrical skin resistance may be taped to your hand. Your challenge is to discover ways to raise the temperature of your hand or to alter the electrical resistance of your skin, using the feedback provided by that thermometer or resistance meter. There are no precise instructions that can be given in how to do this. Each person must explore what works best for her. Biofeedback therapists who have mastered these techniques themselves are more effective in teaching them to be respants (Green and Green 1977). It is unclear exactly what makes this so.

Abbreviations
Internet users often use abbreviations in their quest for ever more time-efficient communications.

BTW - By the way
RUOK - Are you OK?
OIC - Oh, I see
KWIM - Know what I mean
Signing off with
BCNU - Be seeing you or
BFN - Bye for now

Medical charts are full of such abbreviations, as doctors maximize their use of pen on patients' charts in the interests of saving time. For instance:
COPD - Chronic obstructive pulmonary disease
CVA - Cerebrovascular accident (technicalese for having a stroke)
EEG - Electroencephalogram
EKG or ECG - Electrocardiogram

As hospitals move into more wholistic care, some of these become a liability. The Planetree hospital group is humanizing hospital care in a big way. Some Planetree facilities are in custom-built structures that may include healing architectural features, such as an atrium extending from ground to top floors, facilities for relatives to cook home-style meals, and places for family to bed down near their relatives who are being treated in the hospital. Live music may be played in the ground floor, audible through much of the hospital. Respants are invited to read their own medical charts and enter their own notes in the charts. When a doctor reads, "Dr. Smith was in a bad mood yesterday. He only peeked in and said, "Hello" but didn't give me a chance to ask about my lab tests!" there is likely to be more doctor-respant communication.

Doctors have learned to not use certain abbreviations where respants might review their charts.
ASVD - arteriosclerotic vascular disease (may raise anxieties that the lab tests showed venereal disease)
BS - bowel sounds
PET - poor exercise tolerance, or positron emission tomogram
PIG - pertussis immune globulin
PIGI - pregnancy induced glucose intolerance
PROM - premature rupture of (amniotic) membranes
ROT - remedial occupational therapy
SOB - short of breath (may be taken as a disparaging term)

Words can convey powerful energies for healing
Words impact us on many levels. We are taught in most of our education and training to focus on the content of what we say, but even more important are the emotional and vibrational energies.

People respond as much to our tone of voice and to the caring we express in our voice. Transactional Analysis, developed by Eric Berne and in popular use for thirty years, acknowledges the effects of how we communicate and suggests ways to understand it and shift into more productive modes when we're stuck. Simply asking, "Am I speaking from parent, adult, or child level?" can unblock and smoothe communications (Stewart and Joines 1991).

Not everyone has the emotional intelligence to be sensitive to these nuances of communication (Goleman 1995). Sadly, doctors are drilled in focusing on the content of communications for so many years that many lose touch with the emotional levels of communication. This is one of the reasons that many patients are seeking the help of CAM therapists such as healers.
More refined yet are the vibrational, energetic aspects of words. Healing intent and energetics can imbue words with powers to heal. You may consider such a statement too etheric for serious consideration, but there is a variety of evidence to support this view.

Particular prayers are reported to be helpful in healing different kinds of problems. Beyond placebo effects, it is possible that prayers accumulate healing vibrations with repetitions over many years - sometimes many centuries. Rupert Sheldrake (1987) has proposed a mechanism for such effects. It appears that there is a species-specific collective consciousness, into which members of a species contribute their individual experiences, and from which each can draw on the collective wisdom of that species. Various experiments present evidence in support of this theory.

Reiki healing includes symbols that convey healing. Reiki is used world-wide, but no research has been done as yet to support the claims for this aspect of treatment.

Si-Chen Lee (2001), a researcher from Taiwan, has reported fascinating evidence on the power of words that are used in testing the intuitive abilities of children. He has trained children to read words written on folded paper that is concealed from visual perception. With practice, the gifted among them can accurately reproduce pictures and words - even when written in a foreign language that is unfamiliar to them. When the names of holy men are presented to them, their responses are totally different from their responses to ordinary words. We will feature a full article on this research in the next issue of IJHC.

These reports of healing powers in words and symbols are echoed in reports of healing powers in houses of worship and special places in nature, but that is beyond the scope of the current discussion..

Anagrams and hidden meanings in words

The words silent and listen have the same letters for a good reason.
       - Michael Pritchard (2001)

Esoteric, hidden meanings in words form the basis for many mystical teachings. The Kabbalah is incredibly rich in pointing out cross-correspondences between passages in the Bible and Prophets. In addition, Hebrew (the original language of these texts) assigns numerical values to each letter of the alphabet. Words with identical numerical sums of their letters are believed to be linked with each other as well.
 

Unspoken words

Unexpressed emotions that fester
We may hesitate to say something that could lead to hurt or anger. Often this is actually when we are experiencing these same feelings ourselves. If my boss is asking me to stay late when I have family obligations, my emphatic response of outrage might be better off toned down, lest I lose my job. If I am feeling and hiding such emotions, it is likely that others I interact with are too. When words go unspoken and underlying negative emotions simmer, they often leave residues of unresolved feelings on both sides of the communications. Unexpressed feelings tend to fester, generating defensive, irritable, and angry interactions.

Unexpressed feelings may produce physical tensions that cause or contribute to headaches, backaches, migraines, irritable bowel syndromes, chronic fatigue syndrome, fibromyalgia, and allergic diseases such as asthma and ectopic dermatitis (Alexander 1950; Goleman and Gurin 1993; Seguin 1950; Wittkower/Warner 1977).

Respants may feel unhappy or upset with doctors' interventions. For instance, respants often complain that doctors take too little time to listen to respants' explanations of their problems, don't actually listen to hear what might lie behind the problems, and prescribe treatments without adequate explanations. This is often experienced by respants and patients as an expression of uncaring on the part of the doctor, leaving patients with hurt and angry reelings. Respants may then reject medical advice and ignore recommendations for treatment out of unresolved feelings generated in the treatment encounter. It is estimated that half of all the medical prescription that are written go unfilled - a reflection of these problems in communication.

Many people who come to doctors are not looking for treatment. They want to share their anxieties and learn whether a pain or other symptom is serious. As often as not, if they are simply asked, "What is your body saying with these symptoms?" they will be able to identify the underlying stresses that are contributing to or actually producing physical symptoms.

Joe, who had severe migraines, responded, "My headaches come on towards the end of the weekend, as I start to think of going to work on Monday." The obvious remedy of sorting out his job dissatisfaction dramatically decreased his migraines.

Frieda, who had been suffering excruciating stomach aches for years, with occasional bloody stools, was scheduled for surgery to remove part of her bowel. She was startled to be questioned about why her guts were in such an uproar. No one had ever asked her to consider the stressors in her life and how she was swallowing down her feelings. Psychotherapy, relaxation and imagery exercises, and careful attention to her diet relieved her pains and made surgery unnecessary.

When frustration and anger are stirred and not resolved between caregivers on a therapeutic team, treatment also suffers. At the physical level, adrenaline levels rise when we are upset. While this is helpful if a tiger is attacking, it has negative consequences in a therapeutic setting. Adrenaline makes us more alert to deal with attack, but at the same time makes us more distractible, so that we can focus on any shift in the attack. In an office, anger can lead to unhelpful distractibility. Where emotions are unexpressed, staff get distracted more easily. This is when phone messages and medical records go astray. Psychological mischief may also intrude. Unexpressed feelings can lead to unconscious or conscious manifestations of anger that are expressed through irritating behaviors, ranging from brusque or negative verbal and non-verbal interactions between staff, through passive-aggressive behaviors that release angers indirectly, and to displacements of anger towards other staff and respants.

In a film, The Inspector General, there is a classic portrayal of such interactions. In the first scene of the sequence, the wife of the police chief berates and belittles him and stalks angrily out of his office. He chews out the first sergeant, who reams out the corporal on duty, who shouts at the patrolman who is leaving his office. This unfortunate officer, having no one lower on the office totem pole to vent his angers on, storms down the stairs of the police station. Danny Kaye, an innocent bypasser, happens to be walking in front of the station at just that moment. The patrolman bumps into him and angrily shoves him into the gutter. Kaye, angered at his mistreatment, kicks at a passing dog.

Denial of death
Western medicine tip-toes around mention of death. Avoiding mention of what every person is going to face denies patients and respants the opportunity to deal with their anxieties and fears, to make their peace with end of life issues, and to say goodbye to relatives, friends, and caregivers. Most doctors are not trained to deal with psychological aspects of terminal care and therefore avoid them. This is worsened by Western society's general tendency to deny and avoid dealing with death, doing everything possible to prolong life at all costs. Unspoken words at the end of life are an avoidable tragedy. There is a wealth of literature on end of life issues and care.

Healing words
Words spoken from the heart are healing. A friend or family member who brings cheer to someone who is ill speaks from the heart. A caregiver who has a good bedside manner speaks from the heart.

We are taught little in our schools about this art of communicating on a feeling level. This is definitely something that can be learned and cultivated (Goleman 1995). I speak not only from extensive reading about this, but also from my personal experiences of learning to connect with and communicate through my heart. Those with highly developed intuitive perceptions can actually see heart-to-heart communications as energetic exchanges (Brennan 1988).

Words of prayer and the intentions that accompany them are healing.

Furthermore, those who pray, who have religious affiliations and practices, are more likely to be healthy. An enormous body of research confirms that various illnesses are less frequent in people who pray and attend a house of worship. These include cardiovascular disease, hypertension, gastrointestinal disease, respiratory diseases, pain, renal dialysis, cancer, and social/psychological health (Koenig 1997; 2001; Levin 2001)

Prayers sent to others are healing. Research confirms that healing from a distance can help in the treatment of cardiac problems on intensive care units (Byrd 1988; Harris 1999) and in AIDS (Sicher et al 1998). Distant healing has also been shown to be effective in studies of animals, plants, bacteria, and yeasts (Benor 2001a, b).

Words are essential to dealing with conflicts. Our global community is in dire need of words to heal the gaps of suspicion, distrust, and hatred that separate person from person, community from community, and nation from nation.

These musings will be expanded through future issues of the IJHC. The miracles of computer communications will enable links between discussions that will weave a wholistic pattern. You are invited to share your views in our discussion group.

*Gerrymander - political term for dividing election districts into parcels that favor a given political party.

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