It is this intangible thing, love, love in many forms, which enters into every therapeutic relationship. It is an element of which the physician may be the carrier, the vessel. And it is an element which binds and heals, which comforts and restores, which works what we have to call—for now—miracles.
—KARL MENNINGER, The Vital Balance
HAVING TALKED ABOUT how to receive messages from the inner self, I now want to explain how to send messages back to it. From the responses to Love, Medicine and Miracles, I have learned a great deal of practical information about how to direct symbolic messages and suggestions to the unconscious, and how meaningful they can be. The fact is, for better and often unfortunately for worse, we communicate with our inner selves all the time. And so do those around us—especially people in positions of trust, power or authority, like parents, teachers and doctors. We need to make sure that the message that gets through is a healing one.
Communications to the inner self take many forms. Our feelings are our primary means of communication with the inner self. Feelings aroused by the touch of someone’s hand, the sound of music, the smell of a flower, a beautiful sunset, a work of art, love, laughter, hope and faith—all work on both the unconscious and the conscious aspects of the self, and they have physiological consequences as well. Even the animals we take into our homes can play a role in our physical well-being. A recent report by the National Institutes of Health summarized findings from a number of researchers showing that pets can influence heart rate and blood pressure.
Probably the most direct and volitional of the communications that affect us are the words we say to ourselves. But how do they get through, how does verbal language get translated into physiological events? According to psychologist Jeanne Achterberg in her book Imagery in Healing, images are the bridge. Achterberg feels that messages in the form of words “have to undergo translation by the right hemisphere into nonverbal, or imagerial, terminology before they can be understood by the involuntary, or autonomic nervous system.”
Once we have formed a mental image of whatever the words we say to ourselves are naming or describing, these words can become meaningful messages to the internal environment of our bodies. Given that we have a lot of control over the word-inspired images we create, we should make sure that we always use them to paint affirming, life-enhancing pictures. The self-fulfilling prophecy is a reality that we might as well turn to our advantage. Sometimes we can make it a physiological reality.
In support of her ideas, Achterberg cites studies showing the impact of the imagination on physiological processes as varied as salivation, heart rate, muscle tension, skin resistance, blood glucose, gastrointestinal activity, blister formation, blood pressure and respiration. This catalog of effects includes both autonomic nervous system changes, which we normally think of as being outside conscious control, and musculoskeletal system changes. A comparable list of healing processes, expanding on the work of hypnotherapist T. X. Barber, appears in Ernest Rossi’s book The Psychobiology of Mind-Body Healing. All the changes listed can occur in response to the kind of imaging that takes place in the mind when it is asked to mentally picture (or hear, smell, touch or taste) some event or object. How suggestion puts these changes into motion remains unclear—perhaps by alterations in blood flow, as Barber suggests, or neuropeptide levels. But that they do occur is indisputable.
However, because most of us don’t really take the power of word images seriously, we often cripple ourselves with negative messages, from ourselves or our authority figures, instead of empowering ourselves with positive ones. Words can kill as well as heal, a fact more physicians need to be aware of. Cardiologist Bernard Lown tells two stories that illustrate this point in his introduction to Norman Cousins’s book The Healing Heart. They illustrate why communication is so vital and why it should be taught in medical school.
In one instance a doctor was making hospital rounds with his students and referred to a patient’s condition, tricuspid stenosis, by its initials. He announced, “Here is a classic case of TS,” for the benefit of Lown and the other residents in the room, and then exited. As soon as he left, Lown noticed that the woman was in great distress, her pulse elevated, her previously clear lungs filling up with fluid. When he asked her why she was so upset, she told him it was because the distinguished doctor had declared her a “Terminal Situation.” All reassurances to the contrary proved useless—the great doctor had spoken after all—and she could not be persuaded that her problem was relatively minor. By nightfall the woman had gone into acute heart failure and died.
In later years Lown was on rounds with his students when he pointed out a critically ill patient who had what he called a “wholesome, very loud third-sound gallop” to his heart. In medical terminology a gallop rhythm means that the heart is failing because the cardiac muscle is badly damaged and dilated. There was nothing further to be done for this man, and little hope for his recovery. Nonetheless he did make an amazing return to health, and explained why some months later: As soon as he heard Dr. Lown describe his heart as having a “wholesome gallop,” he said, he figured that meant it had a strong kick to it, like a horse, and he then became optimistic about his condition and knew that he would recover—which he did.
Perhaps most dramatic of all is the story a woman told me in a letter about her aunt. The aunt was diagnosed with a malignant brain tumor and given three months to live. In desperation she went to Mexico for laetrile, returned home and was doing beautifully a year later, having gone back to work and started driving a car again. She felt great. Then one day she ran into her original doctor, who expressed shock and surprise that she was still alive. When she told him what she had done, he indignantly proclaimed laetrile quackery and berated her for wasting her time and money and said he could show her proof. She died that night. What did he have against success and her being alive?
Obviously there is a moral here for doctors and all other people in the healing professions, and it certainly has nothing to do with the relative merits of laetrile. If the power of belief has enabled something to work for someone, I’m not about to use the authority of my profession to destroy its benefits. I know that hope and faith can sometimes provide patients with options that extend their lives when conventional medicine can do nothing. The quacks of the world are well aware of this, too, and have stepped into the vacuum that doctors, with their exclusive reliance on the mechanics of disease, have allowed to exist. Doctors need to learn the vacuum can be filled by them with a hope and a prayer.
Actually, doctors like the one described above do worse than leave a vacuum—they fill it with negative messages. When their medicines are ineffective and they can’t cure, they become frustrated and destructive. What do we as physicians have against success, and why must we kill anecdotes? I ask of every physician, please, when an anecdote walks into your office, don’t kill it. If people are successful doing things outside your belief system, accept them and love them, even if you don’t agree with their choices. In that way patients will feel comfortable and cared for by the medical profession and be able to make use all of the options available to them. They can tolerate disagreement, but not destructiveness.
It can take a very strong, self-reliant patient to reject the words of a destructive physician, and many people, like the woman you just read about, are unable to do so. But recently I heard from someone who had devised his own way of dealing with the negatives that the doctors and nurses kept sending his way. Diagnosed with a rare form of cancer and told he would be dead in three months to a year, he qualified for an experimental chemotherapy program. Instead of encouraging him, however, medical personnel seem to have gone out of their way to stress that his chances were small, the radiation he was undergoing useless, and he was sure to have terrible side effects from the chemo (this last at a time when he still hadn’t shown any, so a nurse went to the trouble to point out that “sometimes it takes longer for symptoms to show in some people”). In self-defense, he taped to his wall “Edwards’ Credo,” addressed to “any new physician on my case”:
I wish both doctors and patients would read “Edwards’ Credo”—doctors so they’ll stop undoing the potential benefits of their medicines with the destructiveness of their words, and patients so they’ll be inspired to defy those doctors who persist in sentencing their patients to death.
In case the spoken word isn’t destructive enough, the written word, as it appears in medical texts, statistical analyses and treatment protocols, might be enough to finish you off. A recent letter did a good job of describing the devastation that can be wrought when the medical profession launches this triple assault against a patient.
First there was the terror this man felt as he listened “to the sometimes hourly voluntary reports of the younger doctors” who insisted on trying to interpret his test results for him, and then his despair when he was given a diagnosis of metastatic oat-cell cancer of the lung, which would leave him with somewhere between ten and thirty days to live. To this he had a pretty normal reaction:
My main objective was to get home, straighten out my financial affairs, see to it that my will, insurances etc. were in order and properly organized so that my lawyer could see that everything was taken care of for my family. . . . I intended to spend those last few days with my family and friends, and then take a hunting trip to the woods, with my favorite 12 gauge and one Heublein’s Manhattan so I could depart this vale of tears without messing up the house.
Another case of a man sentenced to death by his doctors, until he was given a new lease on life by the good efforts of a friend and a concerned oncologist, who sent him to one of my workshops. And what was it he got there? “A purpose, a goal, self-participation, a chance . . . inspiration to control my destiny, perhaps to go on to help others, undoubtedly to gain more time.”
Now I’m no magician, and there are no mysterious ceremonies performed at these workshops; nor do I know what became of this man, because he wrote to me only one month after the events he described, so I certainly can’t claim a miracle cure or even, without knowing more facts, an impressive remission, though he says in his letter that he is doing well on his combined program of chemotherapy, guided imagery and meditation, diet and exercise.
The only thing I would lay claim to on my behalf is the ability to inspire hope in people. I gave the gentleman who wrote the letter a chance to be heroic and he accepted it. He decided not to give up, and he felt good about his decision. To me that’s miracle enough—especially now that we’re beginning to discover something about the physiological consequences of optimism. When you think of the fate to which this man had consigned himself after he was given his diagnosis, you have to wonder about doctors who worry about giving their patients “false hope.” This is another of those cases in which “false no hope”—the kind that makes you want to blow your brains out—is the real problem. I believe in using hope to facilitate change in the healing of lives. Years ago I felt like other physicians about “deceiving” people into getting well, and I almost canceled my first ECaP group. I told them to go home—they were getting well for illegitimate reasons. Now it’s ten years later and I have no difficulty using all the tools at my command, including hope, to help people live.
The negative messages in this man’s experience did not end with his prognosis. Like so many critically ill people, he was put on a treatment protocol that was described exclusively in destructive terms. The document in this case was a U.S. Department of Health and Human Services pamphlet entitled Chemotherapy and You. “That’s great reading to be handed to you when you have been told you have cancer; if that don’t send you over the edge, nothing will,” as this patient put it.
You might just try reading a chemotherapy protocol. There is not a single word on it suggesting that it will help—only destructive information. About the only thing on it that is even neutral is the physical description of the medication. It’s no wonder so many people feel they’d rather die a quick death than submit to the tortures described in these documents, and no wonder that those brave souls who do submit so often proceed to suffer from virtually every one of the possible side effects that have been so vividly described for them.
Any good psychotherapist knows how destructive such negativity can be. If the people who write these protocols were exposed to the works of psychiatrist and hypnotherapist Milton Erickson, they would know how to get across the same information while putting it in a context of positive affirmations and suggestions, so that not only the medicine, but the protocol itself, would be converted into an instrument of hope, therefore of healing.
(doxorubicin)
What it Looks Like:
Red fluid after dissolved.
How It Is Given:
Injection into vein.
Common Side Effects:
Nausea and vomiting may occur 1 to 3 hours after the drug is given and may last up to 24 hours.
Complete hair loss generally occurs 2 or more weeks after treatment begins and is not permanent.
Discolored urine (pink to red) may occur up to 48 hours after the drug is given.
Reduced blood counts occur 1 to 2 weeks after treatment.
Less Common Side Effects:
Heart muscle damage may occur so studies are done before the drug is given and at certain times throughout treatment to assess heart function. Report any shortness of breath or ankle swelling.
Fatigue, weakness, the “blahs.”
Mouth sores may occur.
The drug can be irritating to tissue if it leaks out of the vein. Tell the person giving the drug if you feel any burning, pain or stinging while the drug is being given. If the area of injection becomes red and swollen after the injection, notify your doctor.
Suggestion acts on the unconscious as well as the conscious mind. From my experiences with unconscious patients, I have long been a believer in the ability of people in coma, asleep or under anesthesia to hear meaningful words, and I always go on the assumption that anything said in their presence has the potential to affect them. Since hearing is probably the last of the senses to go as we lose consciousness, there is nothing farfetched about the idea that many seemingly insensate people do hear.
As explained by Henry L. Bennett, a psychologist in the Department of Anesthesiology at the University of California who has done much of the research in this area, “Even under adequate anesthesia, the auditory pathways in the brain may not be touched, up to and including the auditory cortex, where meaning registers.” Once they regain consciousness, people may not be aware of remembering what was said when they were under anesthesia, but that doesn’t mean that they didn’t hear it or that they aren’t affected by what they heard.
The same holds true for patients in coma. The information operates at an unconscious level and can affect subsequent behavior, attitudes and health. An interesting comparison of thirty patients that appeared in The Lancet indicated that talking to and otherwise stimulating people in coma may even make a life and death difference. All sixteen of the comatose patients who were spoken to and touched as part of an “environmental enrichment program” recovered, whereas eleven out of fourteen comparable patients who did not receive such stimulation died.
Studies like this reveal that there are a variety of ways of communicating with people who are not conscious, including touch. Talking and touching are both forms of “environmental enrichment” that we can use to change the internal chemical and neurological environment in ways that are conducive to healing and growth.
I know this not just from studies I’ve read but from many firsthand accounts. One recent letter from a Methodist minister I found particularly touching. He writes about an eighty-year-old member of his church who had barely survived a house fire and was not expected to recover because of the damage done to her lungs.
Perhaps a week after the fire I found her in a coma, totally unresponsive. . . . I had a strong feeling she was dying and that I would not see her alive again.
Ruby was a grandmotherly type person who always baked cookies for the church to use with the children in Sunday School. . . . I suddenly got an inspiration. I took her hand in mine and in rather a loud and firm voice said, “Ruby, I think you’ve given up and you’re ready to die. You can’t do that! If you die, who is going to bake all those cookies at Christmastime for the children at Sunday School, and who is going to bake cookies for my children? We need you to get well and bake cookies.”
The next day she was more responsive and a little stronger. Soon she was eating. Eventually she got back home in time to bake cookies for that next Christmas. Several years later . . . my wife and I decided to call on Ruby. . . . She got to talking about the fire and how sick she had been afterwards. She said, “You know, I was so sick that I know I had given up and was ready to die. But I suddenly had the feeling, no I can’t die. I must get well and come back to bake more cookies.”
Though he never told her what he had said to her in the hospital room and was self-conscious about the episode for a long time, he now follows his instincts and talks to (as well as prays with) unconscious patients whenever he ministers to them.
Surgeon David Cheek has been studying the phenomenon of awareness under anesthesia (“unconscious perception”) for several decades. In a review of the professional literature on the subject, he cites such studies as the one in which an anesthetist delivered a customized message something like the following to each of 1500 patients as they neared the end of their operations: “Mr. Smith, your gallbladder has now been successfully removed. No serious disease was found. You will have no pain in the area of your operation. The tube in your nose is there so that you will not be sick. Therefore you will not be sick, and the tube in your nose will not bother you.”
Fully half the patients who received these messages required no postoperative medication for pain. Similar studies on smaller groups of people showed even better results. Other studies have shown the effectiveness of suggesting to anesthetized patients that they will not bleed during surgery, or that they will relax their pelvic muscles after surgery and have no difficulty voiding. A recent article in The Lancet shows that positive suggestions in the operating room lead not only to less discomfort after surgery but to earlier discharge as well. Anesthetists have begun to observe the value of making similar suggestions to patients in a preoperative visit, too, preferably the day before the procedure, then reinforcing them during the operation.
According to Cheek, for healing messages to be heeded by the patient under anesthesia, they must come from a meaningful source—that is, from the surgeon or the anesthetist—and must be delivered at the right moment, which would be as the surgery is coming to a close. I think that that is too limited. My common practice is to make use of what is known about patient suggestibility from the moment I enter the operating room. I talk to patients while they are still conscious. As the anesthetist puts the mask on the patient, I explain how we all wear masks in the operating room and that they are nothing to be afraid of. I heard about one woman who sat up on the operating table and asked everyone to remove their masks and introduce themselves to her. This was very effective in allaying her fear. Other patients may respond to a paradoxical approach: I had a woman in the operating room who kept saying how wonderful everybody was and how she was being taken care of by such nice people, until finally I leaned over and whispered in her ear, “I know them, and they’re not nice people.” At that moment she broke out into a big grin and her fear disappeared.
After my patients are relaxed, I instruct them to divert the blood away from the operative site so that they won’t bleed; I tell them that when they awaken they will feel comfortable, thirsty and hungry and will have no difficulty voiding; and I give them whatever other messages might be appropriate to their particular situation. When the anesthesiologist says, “You’ll be going out,” I may talk about going out on a date, so that the image becomes something positive. I stand by, holding my patients’ hands and gently guiding them into the anesthesia with soothing words and healing music. Afterward, some of my patients have even asked if I operated with one hand, because they had the impression I continued to hold their hands after they fell asleep.
I keep talking to patients throughout the operation, telling them how things are progressing and enlisting their cooperation if I need it. For example, I may suggest that they stop bleeding, or lower their blood pressure or pulse. People who have worked with me in the operating room know how effective these suggestions can be. One day, as I was preparing to leave after finishing an operation, the anesthesiologist tore off a foot or two of electrocardiogram and said to me, “Here, you fix it.” I looked and saw that the patient, who was still anesthetized, was having an arrhythmia, so I whispered in his ear, “You are on a swing. It’s going up and back, in a nice and steady, even rhythm. Up and back, slow and steady.” And his cardiogram reverted to a normal rhythm.
Often when a patient’s pulse rate is too high during an operation I’ll simply say, “We’d like your pulse to be 86.” I always pick a specific number because I want everyone to see the pulse go down to that exact number. How does it do that? Again, we don’t yet understand how the body converts healing suggestions to reality. But something in the body hears these messages and knows how to respond to them—if only we will give them to our patients (and ourselves).
It was ten years ago that I began using these techniques in the operating room to show how effective they could be. The first reactions of my colleagues were negative, because people don’t like change. They respond like addicts being asked to give up their addiction. But the nurses began to notice the difference in the patients, and they began supporting me and my work. Recently I had a great compliment from one of these nurses. When I walked into the operating room Kathy saw me and said, “Oh, I’m glad it’s you and not one of the other lunatics.”
If I had had any doubts about patients’ ability to register events when they are unconscious, they would have been dispelled by the experience I had with Bobbie when she was being operated on. I stayed with her while the anesthesia was being administered, and of course held her hand until it took effect. But when I wanted to leave so that I wouldn’t make the anesthesiologist and the surgeon uncomfortable with my presence, I discovered that I could not get my hand out of Bobbie’s because she was holding on so tightly. She has no memory of this because of the medication she received, but even in her unconscious state, our love for each other and the fact that we are meant to be a team was being expressed.
A recent experience we had during a plane trip shows how much awareness people have when they are asleep, too. It is our habit always to hold hands during takeoff, but on this occasion our plane was delayed on the ground a long while, and Bobbie had fallen asleep by the time it was finally ready to leave. I felt deprived that I was not going to have her hand in mine as we took off, but I didn’t want to wake her, so I didn’t reach for her. However, just as the plane started out on the runway, her hand came out from under the blanket and grasped mine. I thought to myself how nice it was that she had awakened in time for us to hold hands as usual. About an hour later she turned to me and said, “I feel sad. I was asleep and didn’t hold your hand when we took off.” I realized then that she had been fast asleep, but that her unconscious had directed her hand to do the appropriate thing, and I told her what had happened. And was she surprised.
A recent study on how the mind and body react to unconsciously processed words supports what I’ve been saying—that what we know beneath the level of consciousness can have an effect on our lives. Yale psychiatrist Dr. Bruce Wexler and his collaborator Dr. Gary Schwartz used a special computer to enable their subjects to hear two paired words simultaneously, one emotionally neutral, the other positive or negative. The subjects did not know they were hearing two words, and half the time reported having heard the emotional word, half the time the neutral word. But often the words they were not consciously aware of having heard continued to live on in the unconscious. For example, one person reported hearing the word “door” when both “gore” and “door” were spoken. However, when asked to allow his mind to wander afterward, he described someone walking through a door with blood on him.
Brain waves and electrical activity in muscles that control smiling and frowning were also measured after the pairings, and according to Wexler the results showed that the “response to unconsciously processed negative words was just as great as to consciously processed negative words.”
Another finding in this study was that people classified as high anxious, low anxious or repressors (on the basis of personality tests) had different physical responses to the unconsciously processed negative words. Both low-anxious subjects and repressors reported feeling little anxiety after the negative words that they were not aware of hearing. This was in fact borne out by measurements of tension in the muscles of the low-anxious group, but not by muscle tension measurements of the repressor group. Repressors, like the high-anxious group, measured even higher in muscular tension when they did not consciously register the negative word than when they did. Wexler thinks that this evidence of physical tension may suggest ways in which repressed, unconsciously experienced emotions live on in the body and can lead to psychosomatic illness.
Some intriguing research conducted at Cambridge University may have a bearing on how certain experiences that don’t reach conscious awareness can nonetheless be a part of us. Psychologist Anthony Marcel studied people who were blind due to a stroke or brain damage rather than damage to their eye. When asked to point to an object placed in front of them, they would, of course, say that they could not see it, but once they were talked into trying, they could do it with amazing accuracy. This ability in certain blind people to locate objects is called “blindsight.” Marcel’s explanation, based on extensive research, is that their vision is in fact unimpaired, but their awareness of vision has been damaged. Somehow they don’t know that they can see, because the area of the mind that controls awareness is not getting the message. People with this condition, which relates to occipital lobe damage, can be retrained to see. The brain can relearn. New parts can be taught to assume the function of damaged areas. I know of one young lady who was blind and is now in college, seeing normally.
The phenomenon of partial awareness was noted in a completely different context by hypnosis researcher Ernest Hilgard. He observed a classroom demonstration of hypnosis in which a student who’d been told he would be temporarily deaf showed no signs of a reaction to a gunshot and other loud sounds. But when the instructor whispered to the student that perhaps “some part” of him might be able to hear and that if this was the case he could indicate it by raising one of his fingers, the student did so, much to his own surprise, as he had no idea why his finger had suddenly risen.
I myself witnessed a quite startling example of selective perception in my office one day. I was performing minor surgery on a man with whom I was having a very intense discussion on a subject of great interest to us both. After I was well into the surgery, I noticed that in the corner of the room the nurse was frantically waving her arms and pointing to the syringe with the anesthetic, which I had never used. When I asked the patient if he was comfortable, he said yes, so we kept on with our discussion and I completed the procedure without his ever feeling any pain, despite the lack of anesthetic. He had a 2-inch incision in his back but was so distracted by our conversation that the pain that would ordinarily accompany such a procedure never entered his awareness. I told him afterward that we both had been hypnotized during the procedure. We both laughed.
I’ve had a personal experience with this phenomenon too. There was a time when my back was giving me a great deal of pain because of an injury. On days when I had to be in the operating room, I would be terribly uncomfortable—until I started performing surgery. Once the surgery got under way, I became so absorbed in what I was doing that I forgot all about the pain, even during operations that lasted for many hours. As soon as my part in the operation was completed, however, my back would start to hurt again, and sometimes I even had to lie down awhile before leaving the operating room.
Unfortunately, the ability of the mind to block out certain phenomena may not work when we are under anesthesia, which can result in great psychological distress to patients when the surgical team refuses to acknowledge that it is possible to hear and process information while unconscious. It’s not just a matter of their failing to give the patient healing messages during and after the operation. They may do the opposite, wisecracking and even making abusive remarks about the patient who lies unconscious on the operating table, or offering their opinions about the patient’s dismal prognosis. In our conscious lives, selective perception often allows us to deal with material that is painful for us to hear. But under anesthesia, these protective mechanisms may cease to work, leaving us defenseless. Although most patients never consciously remember the destructive remarks that enter the unconscious at such times, a number of psychological studies have shown that they may suffer ill effects from them nonetheless, with results ranging from postoperative pain and slow healing to prolonged depression.
But change is in the air. Many times I’m asked how other doctors accept what I’ve been doing. One answer is that that doesn’t concern me; it’s how my parents accept it that concerns me. The other answer is that while there is still a lot of resistance in the medical profession to things not taught in medical school, the fact that I’ve frequently been asked to speak at anesthesia and general surgery grand rounds within the past year indicates to me that the resistance is dying down.
What I’ve learned over the years is that acceptance comes with success. You can’t convert addictive behavior or beliefs with statistics. So I don’t confront people, but in the course of my working day I show them techniques that are successful. One recent convert to these ideas, a cardiac surgeon, was introduced to them by his wife, who had attended one of my workshops. He called home one night to say that he wouldn’t be able to get back in time for dinner because the patient he had just operated on couldn’t be taken off the heart-lung machine. His wife said, “That’s probably because for hours she’s been listening to you worrying about whether she’ll make it. You go back and do what Bernie would do and tell her she’ll be fine.” She then went out shopping, and when she returned her husband was sitting in the living room with his feet up, talking to the children. “What happened?” she asked. “Well,” he said, “I took your advice and gave her positive messages, and she got better.” At a recent meeting I attended, an operating room nurse told me about the time she was participating in an emergency replacement of a ruptured aortic aneurysm and the patient continued to bleed. She asked the surgeons if they had ever heard of Dr. Bernie Siegel and they said yes. “Then why don’t you talk to the patient and ask him to help you?” They responded, “You do it.” So she went to the head of the o.r. table, told the patient the situation and asked for help in stopping the bleeding. “Within three to five minutes it stopped and he did beautifully post-op.”
If neither your surgeon nor your anesthetist is willing to talk you through your operation, I can only suggest that you take a tape recorder into the operating room with you. You could bring in one of my tapes to play, or a tape with specific messages appropriate for your particular circumstances. You can do the taping yourself or ask someone close to you to do it—any friend or family member whose voice would be meaningful and carry the weight of authority. Use music too, preferably soothing classical music, perhaps Pachelbel’s Canon (especially the version played by Daniel Kobialka, which you can find out about through ECaP) or something that has helped you feel peaceful in the past. Some patients have reported that when their music was played in the operating room, the medical personnel who thought it was nonsense changed their minds and said they would use it in the future because it made them feel less fatigued. At the hospitals in New Haven, every operating room has a tape recorder, and the atmosphere is improved.
Do not be afraid to assert yourself about something you feel will be good for you. A letter came the other day from a woman who said that when she was on her way into the operating room a nurse saw her tape recorder and told her it would have to go. “If it goes, so do I!” the lady told her, so she got past the first obstacle. But the nurse warned her to just wait until the surgeon arrived. When the surgeon came in he said, “What the hell is that paraphernalia!” When she told him it was her Bernie Siegel meditation tape, he ordered the nurse to get rid of it. The patient told him it was important to her to be able to keep it, but surgeons are used to getting their way, and he announced, “This is my operation and the tape goes!” The patient declared that it was her operation, too, and if the tape didn’t go in the o.r. she wouldn’t either—to which he replied, “Okay, but keep the volume down.”
If patients keep insisting on their rights, more and more health care professionals will come around, especially when they see the positive results. I love hearing from patients who say they went into the operating room and told the surgeon they were not going to bleed and were pooh-poohed—until they proved themselves under the knife. One woman said that her surgeon came in to see her afterward to tell her that he had been so impressed by her lack of bleeding that he brought six other surgeons in to watch the operation. “I’m going to tell my other patients to do that, too,” he said. “Well it isn’t that easy,” she replied. But many people find that if they take the trouble to prepare themselves mentally before surgery, visualizing a bloodless procedure, it is just that easy. Many surgeons I know have also used this technique when they themselves were undergoing surgery, and now they really believe. An example of this I met recently was a woman who had extensive transplant surgery and received three units of blood when someone else received two hundred after similar surgery.
Though we are still only beginning to understand the mechanisms by which mental suggestion is translated into physiological reality, the evidence is strong that there is some supervising intelligence within that presides over such changes. It tells the blood where to flow, directs the lymphocytes and phagocytes and gives whatever directions are necessary to get the job done.
We were built for survival, if we will just give and receive love messages. How did we lose the ability to do that? How did we lose our feelings of self-love? I think we lost them by listening to false messages from authorities. But our lovable nature is still there, buried deep within us. It is this perfect core self that presides over our healing processes. In Joan Borysenko’s eloquent words (from Minding the Body, Mending the Mind), this core self contains “an essential humanity whose nature is peace and whose expression is thought and whose action is unconditional love. When we identify with that inner core, respecting and honoring it in others as well as ourselves, we experience healing in every area of our lives.”
However, most of us are in touch with the inner self only intermittently, if at all. It’s not located in the conscious mind; in fact, it may be obscured by the fears and concerns of consciousness. For me, this superintelligence, this perfect core self, seems to fit in with the neuropeptide theories advanced by Candace Pert and other like-minded researchers. Neuropeptides as the locus where mind and body meet and cross over, the expression of the self’s DNA, the carrier of the loving superintelligence of energy—this map of reality satisfies both the scientist and the mystic in me.
I first got to know this perfect core self through meditation. But however you get there, you’ll know when you’ve arrived at that still quiet place at the center of your being where mind and body are unified. “It’s like coming home,” Larry LeShan quoted one man as saying in his book How to Meditate. And home is where the healing can begin—within your true, unique and authentic self.
I believe there are many ways of communicating with the inner self. Words, music, feelings, progressive relaxation, yoga, meditation, hypnotic trance, visualization and prayer can all help you find your way home. You can put some of these into action with little preparation beyond a basic commitment to do the work. Others, obviously, do require some special training, because they depend for their effectiveness on your reaching a particular kind of altered state—a state in which the unconscious can be accessed directly.
Some researchers believe that these states are “altered” in the sense that they reverse our usual reliance on left-brain logical thought in favor of right-brain imagery and immediacy of experience. They theorize that this switch facilitates the communication of healing messages from our conscious selves to the internal environment of our bodies. As Jeanne Achterberg explains, “The specific functions that have been attributed to the right hemisphere, and the connections between it and other brain and body components, support the premise that images can and do carry information from the conscious fore to the far reaches of the cells.”
Questions of left- and right-brain dominance aside, we feel altered in these states because in all of them, whatever their differences from one another, our everyday mode of thinking is abandoned. The ceaselessly busy conscious mind, which we normally identify as the “I,” is stilled, and in the resulting quiet we attend to inner rather than outer events. As we stop letting the external environment control us, we experience a trance-like absorption in the moment. Perhaps as a result of this change, we enjoy an access to the inner, unconscious self that routine daily life does not allow.
Methods for achieving altered states are described in the literature of most of the great religions and cultures throughout history. Dr. Herbert Benson of Harvard Medical School says he has found them in sources as varied as Chuang Tzu’s rendering of Taoist philosophy in the fourth century B.C., Mahayana Buddhist texts from the first century A.D., the writings of early Christian and Jewish mystics and, more recently, the poems and prose of the English romantic poets who aspired to what Wordsworth called “a happy stillness of the mind.” Sufis, yogis and shamans have their own versions.
But where the mystics and meditators of the world sought unity with God or a sense of oneness with the universe, the Harvard research project headed up by Benson in the late sixties was seeking only to lower blood pressure. Eventually, thanks to practitioners of Transcendental Meditation who were eager to submit themselves to scientific study in order to demonstrate the benefits of TM, the Harvard group discovered what Benson in his ground-breaking work of the same title called the “relaxation response.” This book captured the interest of a secular, scientific age by showing that the practice of certain spiritual disciplines that elicited the relaxation response resulted in a constellation of quite specific physiological effects.
The physiology of the relaxation response is what distinguishes it from what we usually mean when we talk about relaxing. The body both feels and is in better balance when the relaxation response is evoked, because: Heart rate, metabolism, oxygen consumption and respiration slow down, blood pressure and muscle tension are lowered, and brain activity is characterized by alpha waves, which are slower in frequency than what is usual in a waking state.
Whether your motivation is partly spiritual or strictly physiological, relaxation techniques can be a great boost to your health, as well as your peace of mind, so I recommend them as preventive medicine. Don’t wait until you’re sick to enjoy the benefits of a stronger immune system and lower blood pressure. But if you are sick, you should know that there is an ever-expanding list of medical conditions in which relaxation techniques, with or without accompanying visualizations, have proved helpful.
Relaxation has been helpful for cardiac patients. Dr. Dean Ornish, a cardiologist who is director of the Preventive Medicine Research Institute in San Francisco, is conducting a study on the impact of life-style changes on heart disease. He has shown that relaxation training as one part of a program of overall life-style change is able to lower cholesterol levels and improve the flow of blood to the heart. This has been demonstrated by angiographic studies comparing a control group with a group that received the training. Relaxation heals from within; bypass operations may merely bypass the real problems in your life.
Joan Borysenko’s Body/Mind groups have shown that many diabetics are able to use relaxation to reduce their need for insulin. Relaxation training has also helped asthma sufferers, according to Dr. George Fuller-von Bozzay of the Biofeedback Institute of San Francisco and Dr. Paul Lehrer of Rutgers Medical School, and people with chronic as well as acute pain, according to more people than I can list here. You probably already know about the successes oncologist O. Carl Simonton and psychologist Stephanie Matthews-Simonton have had with cancer patients who used visualization to enhance immune function. This very brief listing doesn’t begin to exhaust the possible medical benefits of relaxation and visualization techniques, but it does give an idea of their range.
You can read about how to elicit the relaxation response in Herbert Benson’s book by that name or in his latest, Your Maximum Mind, both of which are excellent resources. Benson writes not only about transcendental meditation, which can create the specific mental and physiological state he calls relaxation, but about certain types of prayer, abdominal breathing and a number of other forms of passive mental concentration that focus the mind completely in the present. Other books on meditation and relaxation include Lawrence LeShan’s How to Meditate and Joan Borysenko’s Minding the Body, Mending the Mind. I have also provided some sample meditations at the back of this book, which you might want to record for yourself. Or you can write or call ECaP (at 1302 Chapel Street, New Haven, Connecticut 06511; 203-865-8392) for further information on audio and video tapes.
Many meditations begin with a progressive relaxation exercise in order to free the body of any physical tensions that might distract the mind. Progressive relaxation was first described in the 1930s by Dr. Edmond Jacobson, who based it on a yoga technique. It usually involves sitting or lying down and taking a five- to ten-minute tour of all the muscle groups in your body, during which you tighten and relax each one, beginning at the feet and ending with the face and neck (or vice versa). The idea is that, by consciously creating tension, then letting it go, you learn what both tense and relaxed states feel like, and can then use this sense memory to achieve simple muscle relaxation at will. Many people practiced in this technique can use it to achieve a relaxed state almost immediately. Progressive relaxation may be done whenever you feel a mounting sense of tension. It provides a wonderful respite from the pressures of the day. Instructions for this kind of relaxation were included in the appendix of Love, Medicine and Miracles, so I won’t repeat them here.
I suggest you have four to six healing intervals in your day to destress yourself, using either progressive relaxation alone or relaxation combined with meditation, prayer or music. Keep in mind that whatever technique you use should above all be a way of alleviating the pressures of the day, not adding to them. Performance anxiety has no place in meditation and relaxation; they are not something to grade yourself on. If you find that they are becoming just one more thing to fail or succeed at, then you should use other techniques to create a relaxed state.
It’s better not to do your meditations right after meals or before bed, as those are times when you are likely to slip from a meditative state directly into sleep. Ideally, meditation relaxes you but does not put you to sleep; in fact it leaves you much more alert and focused. The lulling of the conscious mind that you do in meditation is only for the purpose of awakening the unconscious. This “allows the science of being naturally right to occur,” as my friend chiropractor Jim Parker says. However, I know that many people go to sleep with my tapes, and that practice is not to be discouraged if it is difficult for you to relax enough to get to sleep without it. You will hear the tapes even in your sleep. I would only suggest that you use the tapes at other times, too, in order to get the full benefits of meditation.
For those nurses and doctors who are working in the hospital, I suggest going down to the chapel and sitting there quietly, several times during the day. This accomplishes many things. Among others, it changes the way you relate to the people you meet there as you deal with them later on: If you meditate or pray together with an x-ray technician, it is highly unlikely that you will berate that technician when you work together. So you change and relationships change.
The spiritual healing that occurs with meditation is at least as important as the physiological benefits, though more difficult to describe. Everybody’s experience of it is different, ranging from general feelings of peacefulness to very specific insights into the dilemmas of individual lives. One woman wrote me a moving letter thanking me for the healing that occurred in her family life after she and her husband participated in a guided meditation at one of my workshops. When she asked her husband afterward why he had been crying, he explained that, as he got to that part of the meditation where one visualizes opening a chest to find a message, their daughter, who had died twenty-four hours after birth nearly three decades before, had appeared to him as a young woman. Her appearance signaled the beginning of a process of reconciliation with their daughter-in-law, whom he had not spoken to in the months since a bad family scene the preceding Christmas. He called her and ended up telling her that he loved her as the daughter he had lost, which was the beginning of their healing. A woman who had been abused during her childhood visualized her mother about to strike her again. She reached up, took her mother’s hand and kissed it. They sat together and she learned why her mother had acted as she did, and healing occurred at that moment.
Ainslie Meares, an Australian doctor who specialized in a kind of intensive meditation work done with groups of cancer patients, described what he saw as the ultimate aim of meditation:
Not only is there a reduction in level of anxiety, and in some cases a regression of the cancer, but patients take away from these sessions a nonverbal understanding of many things, including, most importantly, life and death.
It is a genuine understanding, but is quite different in quality from any intellectual examination of such matters. It is a philosophical understanding, but at the same time beyond the logical meaning of words. . . . In general terms, there comes a sense that life and death are simply different facets of an underlying process.
Although Meares attributed this understanding of the “mysteries of life” to the particular kind of meditation he had his patients do, I quote his words because I think they are such a good description of what any of us can hope for as the end result of our meditative practice, whatever it may be.
When Meares talked about the spiritual growth he had witnessed in his patients, he was talking about what he called the “onflow,” that is, the way in which the results of meditation spill over into one’s life. Though this is a natural process, I know many people find it a struggle to carry over into their workday lives the centered awareness that they achieve while doing their meditation. An article I came across recently by one of the directors of the Stress Reduction and Relaxation Program at the University of Massachusetts Medical Center, Saki F. Santorelli, gives twenty-one tips on how to achieve this integration. I’ll mention a few of them, each aimed at returning us for a brief moment or two to the kind of focused peacefulness attained in the meditative state:
In general, even if you’re in the best of health (especially if you want to stay that way), it’s a good idea to call a time out for yourself whenever you’re getting overwhelmed by the events of the day. A few minutes of quiet several times a day during which you relax and center yourself, focusing on the sensations you are experiencing in the present and the pleasures you don’t usually take the time to enjoy, is all that’s required.
From personal experience I know that these healing intervals can take many forms. They don’t have to be formal meditations; sometimes running, for example, can accomplish the same thing. When I am outside on my early morning run and it is totally quiet, the only things I hear are my own inner voices and the sounds of the trees and the winds and the birds, all of us talking to each other. At times like that it is easy to understand why the Indians, in their closeness to nature, were so spiritual.
Visualizations are particular kinds of meditations, which make use of imagery. You put your imagination to work to create images of what you are trying to achieve. These visualizations have been effective preparations for goals ranging from improved sports performance to natural childbirth, but readers of this book will probably be more interested in their application to health care, most specifically their potential for improving immune system function. Although relaxation alone has been shown to be effective in enhancing the body’s defenses, Harvard psychologist Mary Jasnoski has done research demonstrating that when students trained in muscle relaxation were also given instruction in guided imagery, their defenses were even stronger.
Dr. Michael Samuels and Dr. Irving Oyle have written books that also contain persuasive evidence of immune system enhancement through visualization. Dr. O. Carl Simonton and Stephanie Matthews-Simonton popularized the use of visualization techniques for cancer patients in the book they wrote with James L. Creighton, Getting Well Again, which has inspired many doctors and other health care professionals as well as patients in the more than ten years since its publication. My own work with imagery began after attending a workshop they gave in 1978. These ideas are becoming so popular now that there are even special interactive video game tapes that put the visualization on screen, where young patients can play at conquering their diseases.
Many hypnotherapists consider mental imagery to be just another version of hypnosis—self- or autohypnosis. In an interview with Ernest Rossi, psychiatrist Milton Erickson talked about the early experiences that led him to his lifelong interest—both personal and professional—in the uses of autohypnosis. After nearly dying of polio when he was seventeen, he spent the next two years training himself in what he later came to realize was autohypnosis, so that he could learn to move and walk again. In his self-induced trance state, he would delve into his sense memories in order to re-experience mentally what movement had been like when he had full use of his muscles. The imagined movement taught his muscles how to move again.
Erickson used autohypnosis for pain control as well. Once he realized that the fatigue he felt after walking would get rid of his pain, he discovered that if he just imagined himself walking and then feeling fatigued, he could reduce his pain. In later years he used visions of scenes from his childhood, the period when his body was still sound and he was beginning to enjoy the beauties of nature, to rid himself of pain. He also used images from married life for this purpose. When troubled by arthritis, for example, he would go into an autohypnotic state in which he imagined the warm pressure of his wife’s body against him replacing the pain. If you want to learn more about his philosophy and techniques, you might want to read My Voice Will Go With You: The Teaching Tales of Milton Erickson, by Dr. Sidney Rosen.
Few adults have Erickson’s immense capacity for imaginative work, but most children do, because they haven’t yet made the black and white distinction between “real” and “imaginary” that makes visualization so hard for many adults. At a conference sponsored by the Institute of Noetic Sciences, Dr. Karen Olness of the Children’s Hospital in Cleveland described some of the work they’ve done with children who have chronic problems such as cancer, asthma, rheumatoid arthritis and hemophilia.
One young boy with hemophilia so severe that he was wheelchair-bound was instructed in the use of imagery to control his pain and, as he said, “stop my bleeds.” He created a visualization in which he saw himself flying a plane through his blood vessels and dropping off loads of Factor 8, the blood-clotting factor that he was missing, wherever it was needed to control bleeding. Another child, a little boy who had to endure multiple operations, learned to use a biofeedback fingertip temperature monitor to help with pain control. Once he saw on the monitor that he could make his temperature go up by imagining himself sitting in the sun, he was on the way to understanding that he could control other body functions too. Besides pain and temperature control, the children have learned to control numerous autonomic processes, including galvanic skin resistance, blood pressure, transcutaneous tissue oxygen saturation and salivary immunoglobulin production.
Visualization can be hypnotically induced, under the guidance of a doctor, psychotherapist or hypnotherapist, or it can be self-induced. People with vivid imaginations who are familiar with meditative techniques will find that visualization comes very naturally to them. They may wish to purchase a tape with a guided imagery exercise suited to their needs, or to prepare such a tape themselves, perhaps using the sample visualization scripts provided in the back of this book. Information about where to order prerecorded tapes is also provided. If self-hypnosis seems daunting to you, even with the help of a prerecorded tape, you can check with the Milton H. Erickson Institute of Hypnosis for a referral to a qualified therapist who can help you find and evaluate the imagery that will work best for you.
Any visualization script or tape must leave room for you to supply your own personal imagery. As I mentioned in my first book, the warlike imagery of attack and assault against disease that the Simontons encouraged won’t suit most of us. Many people aren’t comfortable killing anything, even if it’s their cancer cells. One teenager was so distressed that she had her cancer cells saying “Help me!” On the other hand Garrett Porter, who was nine years old when he was found to have an inoperable and supposedly incurable brain tumor, used visualization skills he learned at the Menninger Foundation’s Voluntary Controls Program to create a Star Wars scenario for himself. He visualized his brain as the solar system, his tumor as an evil invading planet and himself as the leader of a space squadron fighting a successful battle against the tumor. The imagery of warfare worked fine for him—within five months the tumor had disappeared, without benefit of any other therapy. He’s now a young man in fine health. With his therapist Pat Norris he has written a book sharing his experiences, entitled Why Me? He also appears on the videotape Fight for Your Life, available from ECaP.
Approximately 80 percent of us are lovers, not killers, however. I base this figure on a study that was done on young men who had been inducted into the army and were asked if they could kill on the battlefield. More than three-quarters of them said they could not. For people who are not comfortable with the imagery of battle, I might suggest visualizations in which the disease cells are ingested as a source of growth and nourishment. A lady with oat cell cancer had mares and does eating her oats. Many people have enjoyed using this kind of imagery. Here’s one such account, from a woman whose mammogram indicated a recurrence of the breast cancer she had been treated for two years before.
I imagined small, delicate birds searching my breast for crumbs. To my surprise my imagery took the form of the cancer being golden crumbs, filling in their richness. Each day the birds would eat the golden crumbs. It was amazing to me that I visualized the cancer in this form, as being crumbs too golden rich for my body. After the birds had eaten their fill, I would then imagine a pure beam of intense spiritual white light entering my body. I would then pray to God for guidance, renewal and protection.
One morning after a particularly exhilarating bike ride, I sat down for my meditation and visualization. The white light suddenly appeared, immediately, and coursed down through my head, spreading like white heat through my breast and limbs. I felt the power take hold of me and I let go of it while my heart raced and pounded. After a short intense interval I slumped sidewise in exhaustion. I knew something extraordinary had happened.
The next morning, when I sat down to visualize, I could no longer find any golden crumbs. An inner voice whispered, “There isn’t anything there.” And each morning I had the same experience. I told my husband, “I wish they’d take another mammogram. I bet they wouldn’t find anything.”
And a week later, when she went in at her surgeon’s request for a second mammogram, they didn’t. Whatever had shown up in that earlier mammogram, noted as a “spiculated area, suspicious for malignancy,” had disappeared.
People’s imagery is as varied as their fingerprints. One woman saw her cancer cells as garbage, and since she didn’t want to burden her white cells with anything nasty, she used pigs to eat up the garbage. Another woman turned her household chores into healing meditations by imagining, for example, that her dishwashing suds were washing away her disease. Jim Wood, one of our ECaP members, imagined a great ocean wave, with foamy whitecaps, continually sloshing over his cancer. After he got about halfway through his chemotherapy, he went through a ten-day period in which he felt a tremendous internal itching in the area where most of his cancer was located. He feels certain that this was when his healing occurred. In any event, exploratory surgery several months later revealed that a quite extraordinary healing had taken place, for there was no longer any evidence of his mesothelioma. A year later he still showed no signs of recurrence.
If you have a disease like multiple sclerosis or lupus, in which your immune system is attacking your own body, you might want to imagine your white cells as being like the seven dwarfs, who can be used to stop the self-destruction, go out on repair missions at locations throughout the body, or just suppress the attacking white cells.
Another thing to keep in mind when selecting your personal imagery is that it should appeal to your dominant sense faculty, whether it’s visual, auditory, tactile or olfactory. Everyone tends to rely more heavily on certain senses than on others. To figure out which sense is dominant in you, pay attention to the language you use. For instance, if you were buying a car what would attract you, its sleek looks, the hum of the engine or how smoothly the door shuts? This kind of analysis may help you to understand your own nature and patterns. I read about someone who needed to “hear” her immune system; she imagined it as the hero of an opera in which it and her cancer cells sang arias at each other until the hero prevailed. Another woman “felt” her immune system as a rushing stream washing over her.
Some experts who do visualization work think that the images you use should be anatomically correct. That is, you should learn as much as you can about what is taking place in your body and the healing processes and then visualize them in detail, complete with the different kinds of immune system cells performing their specialized functions, or whatever else needs to take place. I myself believe that the superintelligence residing within us knows more than we do about self-healing, and that we do not need to know anatomy to heal. This is the Milton Erickson philosophy, too: You give the unconscious the problem and then trust that the unconscious will take over and solve it in its own way.
Intuitively and instinctively, the unconscious knows what is needed. Our job as individuals confronting disease is to set it free to do its best for us by giving it “live” messages. What confuses it is “performing.” “How are you?” I ask. “Fine,” you say. “What’s wrong in your life?” “Nothing.” It’s the repressors, the people who won’t admit either to themselves or to anyone else that something is wrong, who give their body “die” messages. If you refuse help, you are telling your body you really want to die. Please don’t do that. Share your needs. Reach out for help. Express yourself. If you love yourself, you will give your body all the help it needs, but that can only happen if you accept yourself and your needs. Let out the pain and love will fill the space.
Perhaps more powerful than any visualization or other specific technique you can use to alter the inner environment of your body are feelings of hope and love. I consider it my job as a doctor to give my patients both, because that’s what they need to be able to live. Since I don’t know what the outcome will be for any individual, no matter what the pathology report says, I can in all honesty give everyone hope.
I offer the doctors in my audiences a standing bet of a year’s salary. I will read a pathology report, and if they can guess the date of that person’s death within six months they get my salary, but if not I get theirs. Even though they have a total of twelve months leeway, I’ve yet to find anyone willing to take me up on my offer. When I challenge them, they say they can’t tell from a pathology report when a person will die. Then how can they use path reports to sentence people, as so many of them regularly do? You can’t tell the future from a pathology report, and anyone who says otherwise is wrong. There are differences between probabilities and possibilities.
I used to sit in my office wondering why I was spending all those hours with people who had diseases they couldn’t get over. But some of them did get over their diseases, and wrote me letters years later saying “Thank you for giving me the option to survive. I did.” So now it’s easy for me to pass that option on to others, people with AIDS, cancer, diabetes, heart disease, lupus, multiple sclerosis and amyotrophic lateral sclerosis. It doesn’t matter what the disease is. There’s always room for hope. I’m not going to die because of statistics. I hope you won’t either.