Available Programs in Medicine and Psychology

 Here are programs that have been developed and offered for a variety of contexts and audiences.  All these programs can be fine-tuned toward more professional audiences or toward a general, non-professional audiences.  The length of time in parentheses represent the shortest and the longest durations for each of these programs that we have done.  Programs of more than three hours tend to have the second half focused on exercises and experiences related to the material

 Spiritual Transformation and Radical Empathy: Universal Experience in the Healing Process? (1 hour to 4 hours)

 This course explores the proposition that spiritual transformation and a capacity for radical empathy that often emerges from it are essential aspects of effective healing process in most healing systems. The anthropological literature contains abundant cases of how local or sectarian healers and shamans are initiated into their healing roles via a life threatening illness that resolves when an extra-ordinary being(s) (a spirit or god, or God) enters their life world and becomes an integral part of their being. How this translates into what appears to be a ubiquitous (or very common) healing process has yet to be fully elucidated. We utilize the case example of Puerto Rican Spiritism to develop a prototype of healing process in which spiritual transformation and the capacity for radical empathy are necessary, though not sufficient components. For the person who undergoes a profound spiritual transformation in response to a serious and disorienting illness, bodily and/or psychic incorporation of spirit can lead, in the appropriate context, both to the assumption of the healer role and to extensive changes in self and world view. Further, the acceptance and openness to confront personal “woundedness” linked to spiritual communion, becomes the foundation for the healer’s capacity for radical empathy. Radical empathy in the healing relationship, as defined in this formulation, refers not only to a deep understanding of, and identification with “woundedness” in the other (or in the alienated self) but to the creation of an inter-subjective sacred space where  differences between individuals are melded into one synthetic field of feeling and experience. Applications of the model of healing process for communities of persons are suggested.

Transcending Bipolar disorder: integrative and shamanic approaches to healing (1 hour to 1 day).

	People want alternatives to medication for bipolar depression and mania. We will review accumulated cases of people with successful strategies and unsuccessful strategies for managing bipolar disorder. We will present some of the successful strategies, including use of micronutrients, psychotherapies, yoga, biofeedback, neurofeedback, physical exercise, Traditional Chinese medicine, and chi gong and more. Success relies on multi-modal strategies, without reliance on any one approach, supported by family and community members with opportunities for feedback at signs of mania or returning depression,  associated with shared stories for plausibility of success, and are inclusive of shamanic or spiritual interventions.
	Learning objectives: 1. Participants will be able to summarize the key elements that lead to a diagonsis of bipolar disorder. 2. Participants will be able to discuss alternative approaches to the treatment of bipolar disorder besides drugs. 3. Participants will be able to compare an aboriginal/indigenous approach to the medical model.
	Content Outline I. What is bipolar disorder? A. Who defines it? B. Social construction of disorders.  C. Imaging studies. D. Biochemical studies. II. Alternative approaches. A. Micro-nutrients B. Psychotherapies. C. Spiritual healing and shamanism D. Yoga E. Meditation. F. Traditional Chinese Medicine and chi gong. G. The Conventional World of pharmaceuticals. III. Stories of healing bipolar: what do they have in common?  IV. Unsuccessful stories: what do they have in common? V. What is the neurofeedback approach to bipolar disorder? VI. How do shamans address this condition. VII. Experiential exercise in talking to bipolar disorder. VIII. Discussion followed by experiential exercise in energy medicine.

 

Aboriginal models for integration of Brain, mind, spirit, and body (1 hour to 1 day)

Western European civilization has evolved multiple models to explain mind and its functioning.  The only certainty is the lack of agreement among proponents of these models.  In this course, we will look at the various theories as stories about the world that hold prescriptive functions, maintain social relationships, order power relationships, and require audiences for their performance.  We will look at stories about mind that arise from indigenous and aboriginal communities -- these stories have different ways of knowing (dialogue with spirits, intuition, divine inspiration) as well as ways of knowing that are more observational and empirical.  These stories about mind and mental health produce different social relationships and meanings than conventional Western stories.  We will review what stories brain physiology can tell and the ways that story can interface with European and aboriginal stories.  We will conclude with the questions of what stories do we prefer and why?  Which are transformational, which are sustainable, and which are life-affirming.

 

Shaman’s Mind, Shaman’s Work, Shaman’s Dialogue (1 hour to 1 day).

In this course, we explore perspective shaman’s (indigenous or aboriginal healers) take on mind, consciousness, health, and illness.  We discus the dialogical process in which the healer engages the spirit of the illness, ancestral spirits, the person’s spirit, the healer’s own helper spirits, and the spirits of place and Nature, to gain information and to enroll them in the healing process.  We compare this aboriginal way of gaining knowledge with European-derived cultures’ insistence upon external expertise that is codified in categories and algorithms of practice.  Shamanic practice requires an open, flexible mind, attuned to several dimensions, in ongoing dialogue with residents of these dimensions, and aimed at finding help for the client – whether a person, community, or ecosystem.  Many Western mindsets would view this story about mind as preposterous, invalid, or even psychotic, yet shamans quietly go about their work in communities where there reputation and livelihood is based upon sufficient success as to be noticed.  We close by discussing what we can learn from shamanic practice to enrich our own practices.

 

PET Scans and Spirits; Techniques, Languages, and Styles of Healing and Shamanic Dialogue (1 hour to 3 hours)

What do PET scan results say about metaphor?  Once a spirit has appeared in our vision, how do we communicate? In this course, we will explore the craft of dialogue, shamanic and other.  How do we use language, music, dance, and other modalities to switch worlds?  How do we alter consciousness to remove the cultural blinders that prevent dialogue with ancestors, nature, and spirits?  Once those blinders are removed, how to we proceed?  How do we invite a spirit to present itself?  Is this literal or metaphorical or both.  Are there rules for encounter and engagement?  And where is this apparition?  In what reality does it dwell?  What are the results of these conversations and how do we develop them further for our own benefit and the benefit of others.

 

Culture, sleep, and pain (1 hour to 1 day)

Sleep is healing, yet it eludes many.  When sleep comes, the quality may vary for many people.  Pain, also, is elusive.  It raises the question of private sensations and what those may be.  We have no doubt that pain occurs and that noxious stimuli (heat, sharp, pressure) exist and cause us discomfort.  What confuse us are the very different levels of pain expressed by people despite equivalent or absent tissue changes, and how culture affects the perception of pain and its resolution.  We will consider indigenous and narrative approaches to sleep and pain.  Within these approaches we understand that there is an internal dialogue about sensation and that we learn how to have these internal discussions.  These internal stories are expressed to others who then form a community around the person in pain.  This community responds to the stories told about that person's pain and influences the further dialogues about pain.  Similar processes occur with the sleepless or even those with poor sleep.  We look at how processes develop for managing pain and sleeplessness within these narrative and indigenous perspectives.

 

 

Styles of hypnosis for use during pregnancy (1 hour to 3 days)

Hypnosis has been recommended for use during pregnancy and labor for multiple reasons, not the least of which is modulation of the experience of pain.  During this course, we consider styles of hypnosis found useful in published research for preventing and reducing pregnancy complications and improving of birth outcome.

We consider hypnosis for hyperemesis gravidarum, threatened and early premature labor, breech course, and hypertension of pregnancy.  We review different types of inductions and suggestions used with patients for each of these conditions.  We consider an indirect style that is coupled with post-hypnotic suggestions for reduction of vomiting, cessation of uterine irritability and contractions, and breech version.  We review the hypnotic style of obstetrician-hypnotherapist David Cheek and his use of ideomotor signaling, conversations with the unconscious, and resolution of high sympathetic nervous system discharge.  We discuss ideas about how language affects physiology in the hypnosis situation, including autonomic balance and as-if physiology.

Next, we consider how to use hypnosis to prepare women for labor, primarily to reframe the experience of pain as bearable and desirable.  We learn about “birth visualization,” a kind of hypnosis in which the woman is taken through the experience of giving birth after an induction of a trance state.  We contrast this approach with what has been called hypnobirthing, and discuss the advantages and disadvantages of the popular hypnobirthing approach to pain during labor.  We review the effectiveness of hypnosis during pregnancy to prepare women to avoid analgesia and anesthesia, and we end with guided practice of this style of hypnosis, which can be challenging for the leader and requires some physiological knowledge of labor and birth.

Learning Objectives:

Participants will be able to perform the ideomotor signaling technique.

Participants will perform a 15 minute hypnosis as anticipatory guidance for going through labor.

Participants will be able to compare and contrast the use of hypnosis for stopping premature labor with the use of hypnosis for starting labor in the face of pending post-dates.

Participants will be able to design a 5 minute induction appropriate for pregnant women.

Participants will be able to offer a theory for the mechanism of action of hypnosis in turning breech infants to the vertex (head-down) course.

 

 Shamans, healers, and neurofeedback (1 hour to 3 hours).

Cultures have different descriptions of the relationship between mind and brain.  In some cultures, neurofeedback would make no sense at all.  We review stories from several cultures that highlight the relationship between mind and brain, including indigenous North American culture (Lakota, Cherokee), traditional Chinese medical perspectives, and modern "scientific" North America.  The indigenous story is remarkably similar to that of quantum physics and places mind in relationships and outside of matter.  Mind arises as a story to link past, present, and future, in a way that creates meaning as motion toward a desirable end. 

We explore the mind and perspectives of shamans, defined as traditional, indigenous cultural healers.  We consider the question of how shamans define problems, considering concepts of dysharmony and imbalance in relationships, and looking at sources of problems within disruptions of relationships -- emotional, physical, and spiritual.  We explore the concept of dialogue with non-physical sources in finding advice for solving problems and look at shamanic descriptions of spirits and the spirit world.  We consider what happens in energy healing, ceremony, ritual, and the other methods available to shamans that are decidedly not verbal, but rather experiential.

 Learning Objectives:

1.  Participants will be able to discuss the differences in the ways that shaman conceptualize problems from conventionally trained psychotherapists.

2.  Participants will be able to compare conventional views of energy and spirit and spirit world with those of shamanic healers.

3.  Participants will be able to list at least three techniques for energetic healing.

Self-Assessment Questions:

I. How do shamans perceive problems?

   A.  Relational instead of individual.

   B.  Community ownership of problems instead of individual.

   C.  Connected to energy and spirit.

II.  Concepts of energy, spirit, and the spirit world.

   A.  How shamans ask spirits for advice.

   B.  What are spirits?

   C.  What is the spirit world?

III.  What is the relationship between spirit and energy?

   A.  What is energy?

   B.  How does energy relate to spirit and change?

   C.  What is energetic healing and what is spiritual healing and what are their relationships.

IV.  Techniques for energy and spirit healing (including demonstrations)

   A.  Ceremony and ritual.

   B.  Enactment of metaphor.

   C.  Channeling of energy.

   D.  More.

 

Brain as mediator between matter and spirit (1 hour to 3 hours)

 

In this course we review studies on brain changes observed during states of prayer in which the ceremonial prayer leader believes that spirits are communicating to the person who is the subject of the prayer?  We consider GDV and QEEG data on these phenomena.  The right temporal lobe is hypothesized to be important with increasing activity during prayer, coinciding with decreasing activity of the left temporal lobe.  Pre-frontal and occipital theta activity increases during ceremony but not in relation to being prayed for.  We use the data to speculate about the nature of the brain-spirit connection, including discussions of methodological holism, entanglement, and non-locality.

 

AGENDA:

 

I.           Introductions

II.          Brain states observed during prayer and ceremony

III.         Appropriate methodologies for assessing changes occurring during prayer and potential spirit communication.

IV.       Correlation with results from gas discharge visualization photography.

V.         Results pointing toward the importance of right temporal processing.

VI.       Speculation on the quantum nature of reality and the world of spirits.

 

2..  LEARNING OBJECTIVES:

 

Participants will be able to describe an adequate methodology to tease out the effects of prayer from those of ceremony.

Participants will be able to list three reasons why the right temporal lobe is important.

Participants will be able to list three attributes of left temporal functioning during prayer.

 

3.  POST TEST QUESTIONS: 

 

Right temporal activity increases during prayer while overall brain activity decreases.   True

Prayer is associated with increased activity in the pre-frontal and occipital cortex.  False

Increase left temporal lobe activity is associated with performing math problems.  True

  

 BIBLIOGRAPHY

 

1.       Mehl-Madrona L.  Coyote Healing.  Rochester, Vermont: Bear and Company, 2003.

2.       Taneli B, Krahne W. (1987).  EEG changes of transcendental meditation practitioners.  In B. Taneli, C. Perris, and D. Kamali (Eds.).  Neurophysiological Correlates of Relaxation and Psychopathology.  Adv. Biol. Psychiatry 16: 41-71.

3.       Tebecis AK, Provins KA, Farnbach RW, Pentony P. (1975).  Hypnosis and the EEG: a quantitative investigation.  J Nerv Ment Dis 161: 1-17.

4.       Tellagen A.  (1981).  Practicing the two disciplines for relaxation and enlightenment.  Comment on “Role of the feedback signal in electromyography biofeedback: The relevance of attention” by Qualls and Sheehan. J exp Psychol Gen 110: 217-226.

5.       Tellagen A, Atkinson G. (1974).  Openness to absorbing and self-altering experiences (“absorption”), a trait related to hypnotic susceptibility.  J Abnormal Psychology 83: 268-277.

6.       Ulett GA, Akpinar S, Itil TM. (1972a).  Quantitative EEG analysis during hypnosis.  EEG Clin Neurophysiol. 33: 361-368.

7.       Walker J. The Seven Sacred Ceremonies of the Lakota Sioux. Lincoln: University of Nebraska Press, 1990.

Laszlo's Connectivity Hypothesis and Whole Person Healing: The Evidence (1 hour to 3 hours)

In this course, we explore the Connectivity Hypothesis of systems philosopher Irvin Laszlo, and how this hypothesis explains the non-local effects of whole person healing.  In this hypothesis, the quantum wave function for the larger system "in-forms" elements of the system, including people, how to be more coherent with other elements of the system.  We present evidence to support this hypothesis from neurophysiological research on non-local connections of two brains, including his own work on the brain as a sensory organ that differentiates (through EEG response) presence of absence of prayer, even when the subject cannot consciously tell the difference.  Other data is presented to support non-local connectivity, including twin simultaneous perception studies and so-called "psychic phenomena" of therapists and clients.  We consider Native American healers and how the connectivity hypothesis explains seemingly miraculous healing as documented by We.

 

Intra-cultural connectivity and its influence on the biology of healing and curing (1 hour to 3 hours)

We explore the ways in which social relationships within living human systems forge constructions about healing and curing which then feed back to "in-form" members of these systems about what to expect and what is possible.  We will review data on miraculous outcomes of selected AIDS patients with biologically inert therapies, the role of expectation in dramatic life extension among metastatic cancer patients, and the role of expectation and belief in predicting which women will respond to an integrative medicine program for shrinking uterine fibroids to support these concepts.  We will see how social relationships maintain systems and that changes in the constructions arising from these social relationships change the quantum wave function describing the larger system.  Through the drive of elements to improve coherence of relationships with other elements of systems, individuals become more and more alike in their beliefs about the possible.  The social construction then informs the biological system how to respond, so that cultures with constructions of possible healing through whole person methods have higher likelihoods of this happening and cultures sharing skepticism of these effects are less likely to demonstrate whole person healing.  The hypothesis further explains why Traditional Chinese Medicine is more effective among the Chinese and offers potential explanations about conflicting results of energy and spiritual healing studies referent to the local cultures from which these studies are drawn.

 

Diabetes as a psychobiosocial phenomenon (1 hour to 3 hours)

Diabetes is more than just a medical condition -- it is a psychobiosocial, cultural phenomenon.  For example, type 2 diabetes did not exist among the Native people of North America before 1920.  The first case of diabetes in Saskatchewan was diagnosed in 1937 among a sample of 1500 Native Cree with diabetes.  Today, the Pima people of Arizona have a diabetes prevalence of greater than 50%.  Cree in Saskatchewan have a prevalence of more than 25%.  Diabetes, is therefore, a disease of colonization.  A much discussed study from Phoenix showed that a control condition in which Pima people learned about their culture and spirituality, resulted in improvement in diabetes, while a treatment condition of best possible American Diabetes Association guidelines resulted in worsening of diabetes.  Traditional Native medicine is evolving to address diabetes and healers across North America are finding ways to approach it.  In this course, we will review what these healers are doing and how it is working.  We will explore how enhancement of cultural and spiritual fluency improves diabetes, through such means as changing self-esteem, changing lifestyle to more traditional modes, and perhaps also through direct spiritual healing.  We will explore how this developing indigenous knowledge can be applied to more mainstream populations.

 

 

 Integrative Approaches to Bipolar Disorder (1 hour to 2 days)

Patients are trying non-pharmacological approaches to managing bipolar depression and mania. There are case series of people who have made such attempts with special reference to successful strategies and unsuccessful strategies. In this course, we will review some of these successful strategies with special reference to the supplements that seem to be helpful (multi-vitamin formulations coupled with fish oil, pycnogenol, and inositol), to the role of various psychotherapies, to the use of yoga, biofeedback, physical exercise, Traditional Chinese medicine, and chi gong. Results for 250 patients will be presented. Successful strategies are largely multi-modal, without reliance on any one approach, supported by family and community members with opportunities for feedback at early signs of mania or returning depression, associated with shared stories for plausibility of success, and require life-long diligent application of practices. Unsuccessful approaches tend to involve only one or two modalities, tend not to have family or community support, lack early warning systems, and are often assumed to provide long-term cure from short term use (seemingly a set-up for relapse). Few of these patients were telling previous psychiatrists about their practices and it is incumbent upon psychiatrists to know what patients are doing and what seems to have more or less likelihood of success.

KeyWords  Bipolar depression mania integrative approaches

 

Native American Culture and Spirituality: Lessons for Psychology in the 21st Century (1 hour to 2 days)

           Psychotherapy clearly exists within the Native American spiritual and healing arts, although not formally defined.  In preparation for ritual and in spiritual teaching, psychotherapy plays a vital role.  The rules by which therapist and client interact are different, with the therapist/shaman demanding more respect than in the modern consumerist culture and also being more directive in telling the suffering individual what to do.  In this course, we will discuss the following areas in which mainstream psychology and psychotherapy can learn from Native American culture and can incorporate techniques from Native American spirituality:

            1.  The acceptance of spirituality within the practice of psychotherapy.  Within a respect for each client’s individual spiritual beliefs, we can work within that belief system to encourage spiritual growth and development during the psychotherapy process and to use the power and energy of spirituality to facilitate psychological change.

            2.  The use of “magical” procedures which transfer the therapist’s healing intention to the client in ways which remain between sessions.

            3.  The use of change of identity for healing in desperate situations.

            Following discussion of these specifics we will conclude with an overview of the joys and pitfalls in integrating Native American spirituality and modern psychotherapy.

 

Making Sense of Individual Differences in Carcinogenic Response for People of Equal Exposure (1 hour to 2 hours)

Critics of environmental medicine theories of carcinogenesis and cancer promotion argue that a consistent dose-response curve between xenobiotic agents cannot be shown. They criticize environmental theories based upon tremendous individual differences in response to potentially toxic agents.  This talk aims to present a model for individual differences in carcinogenesis through systems science and computer simulation modeling. Within systems medicine, carcinogenesis is embedded in culture and context. A complex system mediates the effects of toxic exposure. Systems that are far from equilibrium (out of balance) are more likely to transform than systems close to equilibrium in response to perturbations, including environmental toxins. Environmental medicine will advance from an understanding that the simple cause and effect relationships postulated by modern medicine are insufficient to explain the phenomenon of environmental carcinogenesis without a knowledge of complex systems and connectivity.  A computer simulation model is presented from environmental carcinogenesis.  Simulations of the model match a series of stories from individual patients, some of whom did not develop cancer despite large toxic exposures and some of whom, did develop cancer in the face of relatively small exposures.  The successful predictions of the model required knowledge of other aspects of the system.  Susceptibility to carcinogenesis is a function of the state of the total system and not just the amount and duration of exposure.  Modern medicine has few tools for assessing and describing total system state and this weakness is discussed, along with potential solutions.  Further reading includes Laszlo’s Connectivity Hypothesis and the work of Ilya Prigogine on Far From Equilibrium Systems.

 

 

Narrative Medicine: An approach to integrative indigenous healing and conventional medical practice (1 hour to 1 days).

Within the narrative movement, a storied approach to understand human behavior has emerged.  Narrative medicine represents a storied approach to the understanding of health and disease that is, at once, more recognizable to traditional healers from around the world, and at the same time, available to the conventional scientifically trained medical practitioner who has taken histories and written case reports, and understands the value in the story of a person-illness-family-culture.  I have collected narratives from people who have worked with indigenous healers in North America and who have experienced a range of results from no apparent change in the course of an illness to recovery from cancer when the conventional physicians predicted that this was impossible.   These stories are supported by stories obtained from family members, friends, the healers themselves, and the conventional physicians about the person and the illness experience.  The ensemble of stories reveals that dramatic healing is relatively unpredictable but emerges in association with sudden and profound shifts within people, often called transformations.  Spiritual transformations are especially important in predicting the likelihood that an encounter with traditional healing will have more beneficial physical impact than not.  Yet, the finding is decidedly non-linear.  Some people have especially profound spiritual transformations and die from their illness.  Consideration of these stories suggests that our usual linear framework needs to be abandoned when we ask questions about individual healing.  The conventional notions of odds ratios and relative risk become meaningless.  We are forced to move toward a view of the world that is more in line with both the wisdom of traditional healers and the view of quantum physicists – that we are connected to each other in ways that cannot be dismissed, that the actions of the one affect the many and vice versa, that we are entangled with factors that affect health and disease in ways that defy conventional adjustment for confounding or effect modification, and that the questions of who heals, who lives, and who dies require a storied approach to understanding phenomena that we currently are still struggling to find words to describe.  Among the stories that I collected, it appears more likely that people will have beneficial physical results when they become present-centered, when they believe the story they tell about their healing wholeheartedly, when they surround themselves with a community of believers, when they adopt practices that they continue on a daily basis associated with maintenance of their good results, when they accept the possibility of death and refuse to participate in denial or whitewashing, and when they experience dramatic shifts in the quality of their lives, relationships, and spirituality. 

 

Narrative Medicine: restoring story and dialogue to health care (1 hour to 2 days).

A narrative approach coupled with social constructionism allows us to view medicine from other vantage points, most productively those of indigenous cultures and their healing systems.  From these vantage points we can consider what has been lost from medicine in its rush to become scientific. These contrasts show the extensive information lost when all people are considered in accordance with an anatomically based diagnosis related to individual organs.  This unstoried approach to diagnosis and treatment ignores the person of the illness and the community/context in which the illness arose.  When we question people more deeply, we discover that everyone has a story to explain their illness.  This story is more or less shared by family members and may or may not relate to the medicine's official story of the illness.  Nevertheless, within these stories lie radical possibilities for restoring balance and harmony, an indigenous concept of healing which is largely neglected by medicine.  People's stories about their illness contain the seeds for stories about their healing.  What we do with these seeds can make all the difference for healing and transcendence and sometimes even for curing disease.

Overview of Native North American healing practices (1 hour to 1 day): These practices are based on the belief that healing has a spiritual aspect that must be addressed. Elders say that they heal both the body and soul, as well as restore harmony to the community and nature. Healers communicate with spirits in order to help heal. Some healers say they can heal spiritual, psychic, and physical wounds as well as communities and global conditions. Healers work in cultures that include other specialists such as herbalists, diviners, bonesetters, and midwives. Some healers are very selective in choosing which people they will treat because if they fail, they lose stature. What does it involve? Healers enter a trance to figure out what is wrong with the patient and what to do about it. The healer or an assistant may pray, sing, chant, dance, or drum around the patient. Storytelling and other art forms may also be used. During the trance, the healer's soul is believed to leave the body and travel to the spirit world in a search to help the sick person. This is where the healer communicates with the spirits thought to be responsible for the illness. Although the healer is in a state of trance, he is still conscious and aware. This allows him to bargain with the spirits who can help the patient's illness. The healer returns and shares his or her vision with the sick person. Each healer must complete rigorous training, especially in the ability to achieve the controlled trance required for communication with the spirits. Healers work both with individual patients and with groups. What is the history behind it? Traditional healing of this type may date back as far as 40,000 years. It is believed to have begun in the Altai and Ural Mountains of western China and Russia, probably in the form of a religion. In the Tungusu-Manchurian language, the word shaman means, "one who knows." Native North American healing emphasizes the role faith, hope, and belief play as they are embedded within a community and a culture. Traditional healing emphasizes the importance of relational and cultural elements in determining the effectiveness of complementary and alternative medicine and will reflect upon research methodologies to capture these phenomena. Native American Icommunity-based medical systems have a number of rituals and practices: sweating and purging, usually done in a "sweat lodge"; the use of herbal remedies gathered from the surrounding environment and sometimes traded over long distances; and shamanic healing involving naturalistic or personalistic healing. Tribes such as the Lakota and Dineh (Navajo) also use practices such as the medicine wheel, sacred hoop, and the "sing," which is a healing ceremony rite that lasts from two to nine days and nights and is guided by a highly skilled specialist called a "singer." Formal research into the healing ceremonies and herbal medicines conducted and used by bona fide Native American healers or holy people is almost nonexistent, even though Native American Indians believe they positively cure both the mind and body. Ailments and diseases such as heart disease, diabetes, thyroid conditions, cancer, skin rashes, and asthma reportedly have been cured by Native American doctors who are knowledgeable about the complex ceremonies.

 Cross-cultural healing dialogues (1 hour to 1 day):

Cross-cultural psychiatry requires different dialogues since other cultures perceive mind and mental health very differently.  Narrative approaches have emerged as valuable means for communicating with indigenous people.  Indigenous people conceptualize mind as existing between people within the relationships formed.  Identity is conceptualized as a meta-narrative, a story told by the person to make sense of all the stories he or she has heard about himself or herself.  In this symposium, we aim to present the narrative approach to psychiatry and to compare and contrast a narrative approach with conventional conceptualizations.  We will show how narrative approaches focusing upon objectionable behavior as arising from bad stories is more acceptable to indigenous people than conventional diagnoses.  Within this approach the brain is conceptualized as a story-generated, storing, and retrieving organ embedded within a network of social relationships.  Mind, then, is a story, in which the person is an heroic character enacting a plot within a frame or stage for an audience and making a point or demonstrating a value.  Brain becomes the infrastructure which generates and interprets story.  We will focuses upon the stories that people generate about their experiences with bipolar disorder and how these stories can be used to help them to ameliorate or exasperate their symptoms and condition.  We will focus upon how indigenous people use stories and storytelling as a means of teaching people values and roles and new stories that they are compelled to enact to belong to their identified culture.  We will continue this theme, showing how one can use stories and narratives to work with indigenous people, even within the context of prescribing medication, which is also simultaneously psychotherapy and the enactment of a story.  We will finish the discussion with the perspective of post-modern film and the storied philosophy of the Russian, Bakhtin.

 

 

How  to  Construct  a   Mind-Body-Spirit Program  for  Cancer  Patients

 

This course will teach participants how to construct and provide intensive, comprehensive mind-body-spirit education for people with cancer.  We will list the reasons for intensive treatment over weekly, one hour sessions.  We will identify the necessary ingredients of any treatment program to cover all aspects of the person, including imagery and emotional therapies, movement therapies, spiritual practice, art therapy and symbolic psychotherapy, journal writing, energy medicine, and other psychotherapies.  We will describe the goals of education, as the student and educators developing a shared model for cancer development and for healing that includes plausible and possible directions for healing and curing.  We will define the differences between an educational and a treatment model, listing ways these models differ in liability, patient satisfaction, license requirements, documentation requirements, billing, and Medicare/Medicaid relationships.  We will identify costs of this education and compare benefits and disadvantages of individual education versus group experiences.  We will describe how the world’s indigenous cultures (Native American, Asian) have influenced our model, leading to concepts of rest and retreat.  We will define the key elements of retreat, including rest, absence of time pressure or expectations, avoidance of distraction and entertainment (television, radio, computers, internet, pagers), withdrawal from the outside world, and the creation of ongoing inner dialogue and exploration.  We will define appropriate tools for journal writing and discussion, including art and 3-dimensional recourses of the inner world (shields, mandalas, dream catchers, sculptures, dolls, wands, talking sticks, altars, etc.).  Participants will learn a series of imagery exercises to guide the initial exploration of the inner landscape.  We will borrow from ancient shamanic practices to “see” the illness as a creature, to dialogue with its spirit, to explore the immune system to find its weaknesses and bolster its resources.  We will borrow from St. Francis and from Wheeler’s Many Worlds Theory to explore alternate life paths more compatible with wellness.  We will learn how to create ceremony and ritual that draw from students’ earliest religious experiences but also connect to current symbols and sources of energy and healthy spirituality.  We will consider the importance of daily practice – including prayer, reiki, meditation, and movement.

 

Additional information related to this area.

 

Current state of the art. Besides Spiegel’s study showing doubling of survival times for women with metastatic breast cancer coincident with membership in a support group, very little formal research has been conducted on the effect of participation in a mind-body-spirit education program.  Mehl-Madrona has presented data (WISH Conference, 2001, UMDNJ, New Brunswick, NJ) on 43 “miracle” cures from cancer occurring after participation in a treatment process with a Native American healer.  O’Regan has written about “spontaneous remissions,” in a report from the Institute for Noetic Sciences.  Mehl-Madrona has described the outcome of an intensive mind-body-spirit education process for twelve different illnesses among 107 patients, some of whom had cancer (Alternative Therapies in Health and Medicine, January, 1999).  Simonton and Simonton described an imagery treatment process as early as the 1970’s, and are still actively providing this.  Thus, this course places itself at the front of the state of the art, purporting to teach participants how to construct a program that can then be studied.

Description of successful treatment procedures, techniques, methods:  In this course, we will consider imagery therapy, reiki, spiritually oriented psychotherapy, ceremonial practice, meditation, and energy medicine.  All of these therapies remain “unproven,” though data continues to accumulate on their efficacy.

Specific conditions, patient characteristics:  This course will focus on cancer patients, creating a program that is primarily for ages 14 or older.  Children with cancer can be also treated, but that is the subject for another course.

Contraindications, recommendations:  Mind-body-spirit education is applicable to everyone, and no contraindications are known.

Direction as to where in the literature research support may be found:  Other than the studies mentioned already, there are few studies in the literature. 

Course syllabus

 

·         We will review the existing literature on mind-body-spirit approaches to cancer, discussing various programs that have implemented aspects of these therapies, including Commonweal, Carl Simonton’s Center, and Smith Farm.  We will discuss what has been written about individually oriented programs, including that of We.  We will talk about the difference between a treatment model and an education model, will discuss billing issues and professional relationships, and how to implement a program.

·         We will consider the inner landscape of the cancer patient, including the psychophysiology of cancer, the relation of the family to cancer, and will learn how to construct a treatment program, individualized for each person, that addresses the various areas of imbalance and disharmony in the person’s life.  We will develop a narrative model and explore how the educator and the student create a shared story for how the cancer developed and how it can change, improve, or go away.

 

·         We will review techniques inspired by Native American healing, Japanese Morita therapy, St. Francis, and others for using imagery to explore the inner world.  We will explore a program applicable to the first week of daily work with a student and will experience some of these techniques first hand, discussing technique afterwards with videotape.

·         We will learn about energy medicine and how to create ceremony and ritual within the intensive educational process.  We will discuss how to draw family into ceremony and how to maintain the retreat environment until time for the family to enter.  We wll conclude with relapse prevention, and the need for ongoing daily practice and refresher courses.

Experiential:

Participants will experience guided imagery techniques in accordance with the exploration of the history of a cancer, its personality and spirit, and the exploration of the many worlds of healing.

Participants will experience a group ceremony consistent with one that would be done with a cancer patient and his or her community.

 

Handouts:

 

1. Landscape Exercise:

Psycho-spiritual therapy cannot exist without the power of relationship and the commitment of the therapist to work with the patient regardless of what happens.  Within that relationship, we begin to explore the topography of the inner world.

 

I use a number of exercises to explore the origins of the cancer and to understand its causes and conditions.  If we are lucky, the cancer may speak, sometimes softly, sometimes with vehement tones in its diatribe.

 

We start with the landscape exercise in which the area of the cancer is seen as a landscape to be explored.  If you are the size of a red blood cell, your body is almost as large as North America.  There are many landscapes or habitats within a continent as disconcertingly large as North America.  Each organ is a habitat.  Each habitat supports certain life forms rather than others.  Sometimes the cancer appears as a mockery assailing that habitat.  Sometimes it rules like the tsar. Or it may hide obsequiously keeping to the shadows.  Sometimes it tears tissue like a bloody tyrant, a ravaging raptor.  At other times it kills with its shadow, merely blocking the light from the plants already living there.

 

Here is how we do this exercise:  We start with meditation as I have described elsewhere; the simple, present moment, mindfulness, pay attention to breathing meditation.  I like to talk in images, such as imagining as you close your eyes a brisk wind, smelling of the sea, blowing over your face.  Perhaps the wind holds the sweet scent of forsythia, flowering in the springtime.  Perhaps the wind holds the music of relaxation, carrying away your tension as it blows past your face, body, legs, arms, trunk, carrying away the thoughts, the rhyme and verse -- that you just don’t need to hold onto anymore.  Perhaps the wind gives you a gentle massage, caressing your face like the hands of a loving mother.  Perhaps it cautiously, carefully, brushes away that tension that you don’t need to hold anymore, softens that granite face that you wear to face the world, re-sculpts your countenance with a golden trowel, all the while molding you to its shape, the waxy flexibility of wind, making you feel as though you could travel anywhere, carry sound, carry the sea, carry the blossoms of springtime, lift up birds and planes upon your invisible back, travel across continents and oceans, both giant and dwarf, hurricane and dust devil.  The Lakota believe that the Wind is the messenger of God, the Creator.  On a day long ago, our destiny was delivered softly by the wind, and nothing can be done about it now but to read the words of the wind, to lets it music play softly upon our lips, to read its wisdom in the sounds of the natural flutes, the reeds the wind plays through upon river banks, the cattails at the lake shore.    This is the way I like to talk in a visualization.  I like to feel the atmosphere of the words, to strongly evoke images that take over my work, so that those who listen may hear the pictures instead of my voice, they may fly on the wind, rather than keep my more pedestrian pace.

 

As you observe your breathing, you cannot help but change.  It is not a question of relaxing yourself, for merely the act of observation slows our habits down, prevents certain ingrained reflexes from occurring;  causes the breathing rate to slow down.  When we observe ourselves eating, we eat slower.  When we observe ourselves walking, we walk slower, and as we read more slowly, we ponder that we are part of the history book we are reading.  Self-observation slows us down, rendering our usual disordered reflections more coherent, transforming that internal mental chatter, part thought, part image, into a positive scene, an event happening within us, like a dream, to be lived.  Revealing to us that we carry within our being that day of Great Wind when destiny was spread across the landscape like so many seeds, that past so palpable that it still controls our very lives, and apparently so unnoticed by so many.  Searching for the cancer’s origins and conditions for life is also an unearthing of that destiny.  Destiny hides its one view for our lives forever beneath our grasp, controlling from beneath awareness.  Nevertheless, it must be reckoned with.  We must learn to see as it sees.

 

Now, as you relax, as you turn your awareness to the window of your soul, to the doorway through which you can enter your inner landscape, the door beyond which may lay a snow-covered city, a quiet meadow, a ponderous mountain peak, a massive lake, a tranquil swamp, or the roaring seashore.  All of nature’s grandeur is contained within the inner landscape of our bodies.  Each of us sees things so differently.  I may see my kidneys as a swamp, the grasses filtering the water, purifying it, taking out what is not needed downstream.  You may have a different feeling for swamps, may take advantage of your past to conjure a different image, perhaps of a great dock or shipping port, preparing the boats to take what is being exported out to the sea.  You may see the heart as a wheat field, or the Old Faithful geyser, spouting rhythmically.  My image of health could be your image of handicap or blemish.  We must explore this without judgment, for I cannot presume to know the intrinsic meaning of your image.  In you have read Andre Gide, you know about the different images of tsar, one “a cruel tyrant,” the other, “redolent of lights, of sounds, of wind, of glittering chandeliers, of the radiance of women’s bare shoulders, of mingled perfumes, of the inimitable air of our Atlantis [Paris].”  My same image may hold this different a meaning from yours.  

 

Through relationship we create a common dictionary of meaning, we uncover those hidden images you have forgotten, those which once upon a time only provoked mockery from others, and now are buried like a corpse beneath frozen ground.  These hidden, buried treasures are the images which will reveal the landscape of the cancer and the potential landscape for healing.  This hidden meaning of words percolates to the surface like black gold, like oil waiting to be discovered from some prehistoric deposit, waiting for us to decipher the meaning and value of its appearance.  We slowly join what reminds me of the interminable queues at new exhibits, a path of shuffling people winding around an experience, slowly delivering awareness of each exhibit as we shuffle along its path, provoking patience and the necessity to study completely less we stand and be bored. 

 

Imagery is like this, like eating oatmeal every morning for weeks, only to discover a plate full of rare foodstuffs rarely seen in the winter.  Patience we gain from meditation, as well as a certain understanding that the going may be slow, may suddenly speed up, only to return to slow again.  The room of awareness is like an incredibly built chapel, pristine, quiet, while outside people are still stamping about noisily in muddy snow.  This capacity to tolerate muddy snow is what the therapist must cultivate.  At the moment of awareness, it is as if an angel comes to visit us, only to depart again, leaving us to our bland walls and drudgery of work.

 

Return to your breathing again.  As you read this, stop periodically to try the exercise.  Without warning, sudden emotions may be provoked.  Anger may worm its way into your awareness without warning.  Sadness may come pouring forth in the form of unanticipated, unexplained tears.  Boredom may coil up around you like a long snake contracting, preventing any enjoyment of the exercise today.  These things happen and must be expected, tolerated, perhaps even noted as a sign of movement, of progress.  Emotions are like brother and sister, sadness accompanies joy, anger holds hands with forgiveness, hope and despair skip along the road together.  Your rational mind cannot admit this knowledge.  It demands consistency and similitude.  So return to breathing when confused, when disoriented, when lost.  Breathing is the signpost of the road upon which we cannot be lost.  The Lakota call this the good red road, the road from north to south, the road from wisdom to compassion, knowledge to forgiveness, clarity to love.  The shrill voices of consciousness will utter indignant yells as sadness crosses the threshold of joy, but this is necessary and expected, and will also pass into other feelings.

 

Return to breathing.  If you are restless or bored, you can exaggerate your breathing, make a mass effort to push out the air, to take in what will come back to you.  In due time, you will relax again.  The snake of boredom will quiver with this breathing, and will depart.  You can notice the response of your chest to your breathing, the response of your abdomen to your breathing.  Feel the air moving in and out of your sinuses, past the serried rows of cells lined up within the nose to filter the air, to warm the air, to be sure that particles too large are trapped and kept out of the body.  Perhaps you will even feel the beating of your heart which changes with the rhythm of your breathing.  Perhaps the wall of shields that forms the rigid tension most of us hold around our hearts will slowly dissipate and you can breathe that much easier.  Perhaps the tension in your stomach, come of holding in real or imagined fat, come of trying to have the perfect shape, unconscious within most of us 20th Century people who have televisions and magazines, perhaps this tension can also relax.  As you pass through this tension, perhaps you will remember its origin, a time you were distraught, biting your quivering lower lip, trying not to show emotion.  Remember that time, or any time like that.  Tension is born of concealed vulnerability, and chronic tension emerges from those times in which we are particularly (sometimes unconsciously so) vulnerable.  It’s ok if you don’t notice that.  The mind is like a hard-boiled crowd that cannot permit too much vulnerability, too many insights to emerge in one sitting, in one session, in one opportunity.  You must gain its trust through repetition of these exercises.  You must respect that the mind must retain a degree of irresponsible, teenage aggression just to survive in our difficult times.  You cannot expect vulnerability to be exposed all at once, even of yourself to yourself.  Perhaps most especially of yourself to yourself, because you must remain who you believe yourself to be, you must change slowly even if you are to change completely and totally, lest the demons of chaos burst forth like the titans that Zeus battled, or the Unktehi, the  fierce sea monsters battled by the Thunder Spirits in Lakota cosmology.

Sometimes you must skip carelessly along this queue of angry people, all of them you, all of them desperately waiting in line for some scrap of bread, all of them suspicious that you will try to usurp an unauthorized place in line, will try to take something from them that they have waited so long to get.  Then, in an instant, the line will vanish, and you will have that insight, that relaxation, to realize that the scarcity was only an illusion, an old memory born of sorry and pain, not present, not here, not now, now in this present moment.  Maybe then you find yourself outside in the melting snow again, cold, but a little wiser, aware that the queue of angry selves will form again, melt again, form again, melt again.  Slowly return to your breathing, and let the past evaporate.  Let the past disappear like snow in the springtime.  Desperate times will still bring the people flocking to the shops of scarcity, like the news flashes we hear of Muscovites waiting in long lines for small scraps of bread.  The soul is like this at times.  We must be patient for it is hypnotized by the anonymous power of the fear of pain.  With slow breathing, we help it to understand that pain is in the past, not in this present moment, not in this future moment which cannot be experienced because it is not hear and will never be here.  This future moment is always over there.

 

Don’t be afraid to breathe.  Enjoy yourself and feel the immensity of the landscape of the inner body opening to your awareness.   Feel the trembling release in your hands as you let go of the tension keeping you from seeing the inner world of your body, the plains and fields, the lakes and rivers, the mountains and deserts, the seashores and the swamps, the forests and meadows.  Visit the healthy habitats, and soon enough we will turn ourselves to those parts of your body inhabited by disease, perhaps heard only as the usual sounds of the body tinged with a hint of melancholy, perhaps heard as a cacophony of sound against the usual symphony of function.  However the awareness comes, you will eventually become aware of the parts of your body where illness dwells, and you can become aware of how that habitat is disturbed.  See what that landscape looks like, perhaps a strip mine, perhaps the woods after pigs have finished their ferocious digging for truffles, perhaps a field that has been over-farmed, perhaps a dry desert that was once a fertile valley.  Each of us has our different images and symbols for what is disturbed, for the organ that is weak.  You may laugh softly when you see that it is not as disastrous as you feared.  Our fears are usually so much worse than our realities.  You may see springtime everywhere in the land, but only winter in the affected organ, winter skies reflected on the frozen lake, nothing to see but snow and frozen ground.  How will we thaw it?  How will we find the agent that likes this winter, who wants it to stay winter forever?

 

Then the cancer becomes an animal roaming within that landscape.  It can be tracked and studied. 

 

We can learn how it survives, how it finds food and water, what its intentions are, and how it can come to an agreement to depart or to transform back into healthy cells.

 

2.  Example of storytelling for cancer:

 

Above all you must develop a deep interest in life.  This sounds simple, but it is not simple.  Not many know how to develop interest.  It may take enormous effort, but once you succeed, let your interest be of passionate nature.

                                                -- Andre Gide

 

Emily and I began our serious work in her room at the Pittsburgh Cancer Institute, where she was receiving chemotherapy.  We started with a Penobscot story about The Gatherer, a young woman who knows the plants so well that they recognize her as their friend.  She is captured by the enemy and must escape.  The story symbolizes being snatched from well-being and carried into the land of illness, paralleling the experience of how an illness suddenly grabs you and carries you away from everything that is familiar, your stability, your trusty projects, your sense of days going on and on forever.  Once in the land of illness, enemies struggle to kill you, and you must make friends and find resources to protect you until you can find a way to escape, find the path back to wellness, run down that path and get away from the illness.  With help, you can find that path and escape back to the land of well-being.  Spirits help the journey and remain trusted companions through the rest of your life.  The story sets a tone for the healing adventure that we are about to take.

 

I usually tell patients something like this before or after the story, whichever seems appropriate.  With Emily, I just said this:  “I’d like to tell you a story that might make you feel more comfortable, might mean something important or might not, and, if nothing else, might provide some entertainment in this boring place.”  After the story we talked about her immediate identification with The Gatherer.  The story gave her a vehicle to talk about her feeling of this sudden onset illness having snatched her out of her life, literally within 24 hours, changed the course of events forever.  Implicit within the story is hope -- the hope the character has that she will escape and rejoin her family, hope that is contagious -- for Emily, the hope that she will escape this nightmare and rejoin her life, just as the character in the story, returns to her village to live happily ever after.

 

Once upon a time, long before Europeans ever dreamed of this continent, in what is now Maine, there was a young woman whom everyone respected.

 

Just like everyone respected Emily, which I already knew.  Emily could always be counted on to do the right thing.  She never got in trouble, helped needy friends, and was the pillar of her peer group, just like The Gatherer. 

 

This young woman was about your age, and had a gift with plants.  The people said the plants liked her so much that they would part and make a path for her to find the best roots and leaves and barks to use for healing.  She knew where and when to find the ripest blueberries.  She was so courageous that she even carried a spear to ward off bears, who might get angry at her taking their blueberries.  People told stories of her poking them in the nose with the tip of her spear while she backed away with her basket full of blueberries.  She was really a courageous lady, able to handle anything that came her way, whatever it was -- different from many of the other girls in the village, who didn’t have nearly the strength or the will that she had.

 

I am giving suggestions for Emily to be courageous in the face of what is happening to her.  If she identifies with the main character, quite naturally she will feel courage and strength, just like the character.  She needs all those resources to brave the “slings and arrows and outrageous fortunes” of chemotherapy.

 

This young woman was loved by everyone in her village, and her parents were rightly proud of her.  She was always willing to teach anyone who would listen about plants and how to use them.

 

Just like Emily’s parents were rightly proud of her, just like Emily was always teaching younger children swimming or rowing or about crew or even how to read.

 

She knew where to gather the best acorns for making flour.  She knew where the wild turnips grew and when to pull them out of the ground.  She knew how to gather bloodwort to make poultices to heal sores.  She knew where to find wild parsley to strengthen weak minds.  And when she didn’t know what to do, she knew how to sit with the plants and listen.  And the plants spoke to her.  Perhaps not in the common language that we understand, but internally in a manner that The Gatherer could understand.  And idea would slowly form in her mind.  Suddenly she would see and understand what plant to use for the particular purpose she had in mind.  She couldn’t explain where this understanding came from, but she believed the plants had told her.  And probably they had.  So when she didn’t know what to do, or was troubled, she sat with her plants, and eventually they helped her solve the problem.   Maybe she even had a special garden where she could sit when she felt troubled, a special place where the plants can comfort her.  Maybe you could imagine such a garden right here among the plants and flowers that people have brought you to make you feel" better.   Maybe when you sit with your plants, ideas will come to you, too; ideas to make you feel better.

 

I want to plant the idea that merely having the plants in her room will make her feel better; also that sitting and meditating will help her solve problems when she doesn’t know what else to do.  The most immediate problem of course is the nausea and other side effects of the chemotherapy.  I am planting an idea that solutions will come to her.  She will figure out how to feel better, just as The Gatherer did.

 

Sometimes, of course, like anyone else, she would feel sick or depressed or unhappy, and, when she did, she would go into the forest and sit with the trees and they would help her feel better.  Then sometimes she would be drawn to a plant and would know how to make tea with its leaves or bark or roots, and the tea would help.  She never hurt the plants.  She always observed the rules for how to gather herbs.  She never took the largest plant, what we call the Chief.  She never took the baby plants.  She never took the only plant in an area.  She was careful to pull out weeds that might be choking or endangering plants she needed for healing, but even then, she would only take the weeds necessary to protect the beneficial plants, knowing that even weeds have spirits and usefulness to someone, including the bees and the birds.

 

I am suggesting that Emily choose her teas and remedies to make herself feel good from the many suggestions offered by those all around her, and that they will work.

 

One day the young woman was gathering herbs away from the village.  She had found a particular root that was difficult to come by and had finally found a place where several could be safely taken without angering the spirits or endangering the plants.  After having offered the plant people tobacco, she was happily digging up the roots she needed, when she heard noise in the brush just beyond her.  Still crouched on the ground, hunched over her roots, to her shock she saw The Enemy.  They were probably New Yorkers, maybe Onandaga, to be exact.  They raided her people from time to time, some said just for the pleasure of raiding, since no one had ever determined what her people had that the Onandaga did not have in their own territory.

 

She had a frightful choice.  She could cry out and warn the village, in which case she would surely be captured, or she could sneak away, in which case the raid might be successful, and others in the village would be harmed.   With a heavy heart and wishing it could be otherwise, she did what she knew she must and cried, “Help, help, the Enemy have come.”  The warriors in the village heard her and gathered their weapons, prepared to defend the village.  The Enemy saw that their plans were foiled.  Their War Chief was very angry.  They would have to return to New York empty handed.  Well, not entirely empty-handed.  “Grab her,” the Chief called out.  Four warriors came after our heroine and caught her as she was trying to run away.  Once grabbed each limb and carried her fighting back to the War Chief.  “You will pay for this,” he declared.  The warriors bound her arms and tied her so that they would lead her back with them.  Only her feet were free to march.  And the march was brutal.  They jerked her, this way and that.  They were almost dragging her by the end of the day.  Even thought she was in good shape and healthy, she was no match for the resiliency of the warriors.  By nightfall, she was bruised and battered.  Her muscles ached and cried out for relief.  Her stomach was nauseated.  She was retching.  [Just like how Francis is feeling.]

 

As they made camp, they untied her.   Even with the tingling and numbness in her hands [symptoms Francis was having from the chemotherapy], she was able to pull herbs out of her pouches and eat them to call her stomach and to help with her aching muscles.  The War Chief was so angry, however, that he wanted to torture her.  “Let’s see how she likes thwarting our plans,” he said.  They dragged her to the fire and stuck her hands in the fire.  The woman used all the meditation skill she could muster not to cry out as her fingers burned.  She kept silent and her face did not flinch.  When she did not squirm, her captors grew tired of this game.  They took her hands out of the fire and left her alone.  Quickly she covered her burns with herbs she knew to be beneficial for this purpose.  She ate herbs for sleep, and slept soundly.  In the morning her burns were gone.  The warriors were amazed.  She has arrowhead stone for fingers, they announced.  “We’ll see about that,” the War Chief said.

 

That day the march was as brutal as the first.  It was many days journey back to the home of the Warriors, and they were traveling as fast as possible, lest anyone from the Gatherer’s village follow them and attack them to rescue their prisoner.  They believed only they knew the way, and perhaps they were right.  Again, the young woman struggled to keep up, feeling as bad at the end of the day as she had they day before.

 

Again, the War Chief insisted on torturing her by putting her hands into the fire.  Again she stayed calm and did not flinch.  Again the warriors quickly grew tired of this, for there was no sport to be had with a victim who did not show pain.  They left her alone again and she used her plants again just as she had the night before, and felt better.  After another solid sleep, her burns were gone again.

 

“She is magic,” a warrior cried out.  “We will see about that,” said the War Chief.  “Maybe we will burn her whole body when we get home, to see if all of her is made of arrowhead stone.”

 

But they did not torture her again for the entire trip.  And each morning she awoke refreshed and gave the enemy no pleasure to see any of her pain.

 

[Here I am creating a parallel with Francis’ chemotherapy, which is a kind of torture.   We hope it is a more beneficial torture than burning fingers, but that remains to be seen.  Regardless of possible future benefits, the day to day experience is torture and the implication of the story is that Francis can cope with the discomfort and the pain through her use of the meditation techniques she is learning and through the herbs that are available to her.]

 

Finally the Enemy arrived at their village.  In those days it was customary for a couple that had lost a child to claim a prisoner as their own and to raise that person as their lost child.  An old man and woman had lost a child in another raid, and claimed their right to the Gatherer as soon as they saw her.  Hope sprang in the young woman’s breast, for they appeared to be kindly and concerned about her well-being.  The War Chief resisted.

 

“I think we will kill this one,” he said.  But others argued against taking such a hasty step since her hands had not burned.  “She may be a witch,” they said.  “Killing her or even trying to kill her could bring down a terrible curse on us.  We must talk about this more before doing anything.” This made the War Chief very angry, but he could not go against the word of the Council and the Head Chief.  Reluctantly he gave the young woman to the old couple, admonishing them that her gift was only a loan and that he might reclaim her at any time for torture and death.  The old couple acknowledged that he could do that, and that they would take her anyway.  [This is like Francis’ situation.  She has a reprieve that surgery has provided her while she is getting chemotherapy.  The chemotherapy may ultimately not work.  She may be killed anyway by the Enemy which is the cancer.  Nevertheless, even in this land of the Enemy which is the medical world where she finds herself, we are like the old couple, and are taking her in, to do whatever good we can for her, perhaps even to help her escape from this terrible land of illness and return to her home in the land of wellness.]

 

During the intervening months, the young woman became well loved by the people in the village.  She shared her enthusiasm for plants with everyone there.  Only the War Chief kept hatred for her alive in his heart.  Only he planned and plotted for how he would do away with her.  Several of his warriors, agreed, but not wholeheartedly, for they needed to please him, but secretly liked the young woman like everyone else.  For she had been kindly to them even though they had captured and tortured her, and she had given them herbs for their ailments and helped members of their families.  [This is just what Francis would have done in this situation, too.]

 

One day, the young woman was out gathering herbs, when she found several of the warriors coming toward her.  Though they had never harmed her, neither did they tire of threatening her.  She knew they would scatter whatever herbs she had gathered and stomp them into the ground.  Only one mattered to her -- the root she had carried with her into captivity, a root that only grew near her home.  Quickly she popped it into her mouth and swallowed it, lest they deface it too.  Some things were sacred, especially those things that reminded her of home.  True to their nature, the rest of her herbs were scattered, though eventually she was left alone and managed to return to her adopted parents’ lodge.

 

Life went on, but surprisingly enough, the young woman discovered she was pregnant.  This was truly magical, since she had not slept with a man.  But the pregnancy stopped all talk of torturing her, since harming a pregnant woman is an absolute taboo.  Of course, that made the War Chief really angry, and he didn’t hesitate to show that anger.

 

Time went on, and everyone in the village was excited to see the baby.  Eventually her son was born.  That first night, however, she was awakened by her baby, who was already standing and talking to her, unusual even in those days.  Surely he was magical. “I came from the root you ate,” he said.  “I am a spirit of the forest.  I will grow faster than you can imagine.  So listen carefully.  The warriors have resolved, finally, to kill you.  It will happen in two nights’ time.  You must escape before hand.  You must go to my grandparents and tell them what will transpire.  Tell them I told you.  Tell them they must take care of me.  Tell them that I will grow quickly and will join you shortly.”

 

The young woman believed all this and told her adoptive parents.  They, too, say the baby walking and talking, and therefore they believed.  They counseled her upon how to escape.  “Go with all the other women of the village tomorrow morning to gather firewood.  Leave your baby with us.  We will care for him.  The men will never expect you to escape without your baby.  When you get far enough away, find the Eastern trail.  Run along that trail as fast as you can.  By the time the warriors discover your absence, you will be long down the trail.  Hopefully, they will not catch up. 

 

“I will make sure of that,” said her son.

 

So she did as her adoptive parents told her.  She went out with the other women to gather firewood.  Carrying sticks in her arm, she drifted further and further away from the main group, closer and closer toward the Eastern trail.  When she found it, she threw the sticks aside, and ran as fast as she could for as long as she could.  By nightfall, when she was completely exhausted, she slept inside a hollow log, ready to run in the morning.

 

The warriors mobilized to follow her, but could not.  As quickly as their temper rose, so did their illness.  All were having terrible diarrhea.  None could leave the village.  After a week of this, the old woman went to the War Chief.  “My young son is magical,” she said.  “He has cursed you, and surely you will die if you do not seek his forgiveness.”

 

“Impossible,” cried the War Chief.  “I will be fine.”

 

Meanwhile the young woman reached her home and her family rejoiced.  They had dreamed of her return, foretold by a young baby, who announced that she was his mother.  While not believing it, neither had they discounted it.  All rejoiced to see her home.

 

Meanwhile the warriors continued to waste away.  Vomiting and diarrhea.  Worse than anyone had ever seen.  Finally the War Chief came to the old woman.  “I believe you,” he said.  ÔI have been cursed.  I would beg your son’s forgiveness.”

 

“Be careful,” she said .  “He is no longer a baby.  Already he is a young man.”  And the warriors were amazed to see a youth of about 18 when they entered the dwelling place of the old woman.

 

The War Chief crawled on his belly into the lodge, begging forgiveness.  ÔI did not know your mother was magical.  I am forever sorry.”

 

“You are just scared,” said the young man, “but I will forgive you anyway.  It is as my mother would have wished it.   I had planned to kill you, but I cannot do so for you have asked my forgiveness, which I now freely give.”

 

“Be our chief,” cried all the men.

 

“No,” said the young man.  I am already chief of the plant people.   I do not need to be your chief as well.  I will teach my mother whatever you need to know and it will travel back to you.    But, I warn you.  If you ever attack my mother’s people again, woe unto you.”

 

And the War Chief promised, “Never again.”

 

Later the young man came upon his mother in they forest and called her name.  As accustomed as the young woman was to the unusual, she could not have been prepared for this.  Her son was already grown.

 

“Mother,” he said, “I am always with you, to give you comfort, to show you knowledge.  I know all the plants, for I am their chief.  I know which one is good for those who are sick to the stomach, which one is good for those who are scared, which one is good for those who have unwanted growths, which one is good for whatever ails a person.  Call upon me whenever you need help and I will tell you what to use.

 

And so it remains like this to this day.  The chief of the forest still whispers to use what herbs are good for you.

 

“Ginger, he said.  Let’s start with ginger.  We’ll put ginger tea by your bed, dried ginger for you to gnaw on, ginger ale, ginger beer, ginger everywhere.”

 

Emily laughed.  “I’m to smell like ginger?” she asked.

 

“It’s a nice perfume,” I said.  “Ginger would smell nice on you.”

 

“Better than vomit,” she said.

 

“True enough.  But I can see you wearing ginger when you are well.  The Hawaiians love to wear ginger.”

 

“I’m feeling better,” Emily said.  “I feel more calm.  My stomach is better.”

 

“Shhh,” I whispered with an exaggerated sincerity.  “They’ll hear you and bring back the nausea.”

 

“Who?” she said.  “Who?”  She was looking all around the room.

 

“The evil nausea spirits,” I said.

 

“You mean the nurses who work here?” she asked, smiling more.  I was starting to see the twinkle in her eye that would grow and grow, eventually becoming a burning flame.

 

“One and the same,” I said, and just at that moment, an enormous nurse entered the room, almost knocking me over with her butte, then succeeding in knocking over the IV pole, barely catching it before it fell, and then gruffly told Emily that it was time to take her blood pressure.  Emily’s smile burst into uncontrollable laughter.  I was chuckling too.  The evil spirits had definitely arrived on cue.

 

“What’s so funny?” the nurse demanded, then glared at me, “and who are you and what right do you have to be here.”

 

“He’s family,” Emily said, still giggling.

 

“Well you can’t just have anyone in here,” the nurse countered.  “This is a hospital.”

 

“Are you sure it’s not a zoo,” I muttered, under my breath.  Emily heard and laughed even harder.

 

“What did you say?” the nurse demanded, arms akimbo, planted on her ample hips.  “Are you being disrespectful?”

 

Emily kept giggling.  “Perhaps we need to provide mindfulness training for the staff here,” I said.  But at least we know that whatever we were doing, it wasn’t important.”

 

The nurse grunted and huffed out of the room.  As soon as she left, Emily erupted in laughter.  All our hospital sessions finished that way.  Coyote knows that laughter is the best medicine.  Laughter can make you forget your nausea, and can make you forget your illness.  If you forget long enough, maybe you’ll leave the hospital without it.  Leave it in the bed, while you walk out into the sunlight and smell the crocuses.  Just a thought.

 Spiritual enhancement and transformation and diabetes (1 hour to 1 day)

This course reviews community development efforts and their impact on diabetes.  We will review methods of organizing communities to enhance their spiritual and cultural fluency and how this impacts upon diabetes.  We will review what narratives from the people involved can teach us about enhancing cultural identification and spirituality to aid in the healing process.  When we review the narratives for commonalities and themes using several narrative analysis, modified grounded theory, and dimensional analysis and group the themes by readers and counts, some common elements emerged:  The more powerful and life-changing the spiritual transformation was, the more likely diabetes was to improve or even disappear.  Common themes included people becoming more present-centered; feeling higher quality in their relationships; feeling more connected to God, Creator, Nature, or Higher Power; feeling more peaceful; feeling more accepting of death and change; having a greater sense of meaning and purpose, to name the most common.  As an interesting side effect, people began to eat more traditional diets (which were far better for diabetes than the diets they had been eating) and to be more active.  They were not doing this to improve diabetes, but were doing so in order to be more traditional and to honor their heritage.  Stories across the centuries reveal that these are common effects of the search for the sacred and for spiritual connectedness which spirituality promises.  While individuals are unique in the details of their spiritual transformations, the quest and the benefits may be universal and appear to be statistically significantly (chi-square test) associated with health benefits.  We will conclude the course with exercises used to build spiritual awareness and facilitate spiritual transformation

Objectives:

 

1.       Participants will be able to describe three community efforts to change diabetes through enhancing community spirituality and cultural heritage.

2.       Participants will be able to identify three common elements to narratives told about dramatic improvements in diabetes.

3.       Participants will be able to name three universal benefits to the quest for spiritual fluency.

4.       Participants will be able to name two potential reasons why people who are more traditionally identified live healthier lifestyles.

 

Inspirational Techniques from Aboriginal Healing Practices for Spiritual Enhancement in the Clinical Office Setting (1 hour to 4 hours).

This course will address what we can do in an office setting to enhance the spiritual experience of ourselves and others who sit with us.  We will draw from We’s roots in aboriginal culture to find modern translations of these concepts that practitioners can use in contemporary settings.  First comes the concept of purification.  Most ceremonies are preceded by purification as a means of mental preparation, building focus, channeling energy, and being helpful.  We will review personal means for purification that can be done before, during, and after work and will perform a short purification for ourselves.  Then we will consider prayer.  Prayer can be powerful before, during, and after visits.  We will do a brief prayer ceremony.  We will move on to spiritual dialogue.  Through accessing trance states (altered states of consciousness), we become more able to put aside our conventional beliefs about the world (including our limitations) and enter into a dialogue with Nature and the spiritual domain.  This includes conversations with non-physical beings.  We will do an experiential exercise to gain deeper understanding of this concept and process.  We will discuss the need for continued dialogue, concepts of spirit helpers, and ancestral guidance, and how to allow these ideas to become ordinary.  We will conclude with the Lakota-style talking circle as a means to allow ourselves to more fully experience each other and will depart with a closing prayer.

 

Spiritual Transformation and Healing Process: (Near) Universal  Aspects? (1 hour to 4 hours).

In an excellent review of studies of ritual healing Csordas and Lewton (1998) note the complexity of answering the question, “What is healing about?”  The goal of this symposium is to  explore that perennial question by examining how and why  spiritual transformation in healers or  their clients is  frequently  highly significant in religious healing process. Spiritual transformation can be defined as a search for and integration of  a relationship to the sacred, which often comprises a cosmos of extraordinary beings. A plethora of descriptions of healer initiations describe severe illness and recovery as important events precipitating transformative experiences. This has lead to the formulation of the "wounded healer," who possesses a source of power and authority in the continuous relationship to his/her own wounded-ness. The courses in this symposium work on the proposition that spiritual transformation emerging from severe illness often results in the development of a capacity for a special kind of empathy toward individuals or communities in distress. This empathy facilitates spiritual communion between and among persons as well as the creation of a sacred space, as necessary conditions for effective healing. Studies of healing in diverse cultural contexts, Puerto Rico, Peru, Chile, Okinawa and an innovative psychotherapy in the United States, chart specific associations and variations on these aspects of healing process.

 

States of brain-mind; states of healing: speaking the language of shamans

 

In this course we will review studies on the neurobiology of healing, considering what is the correlation between brain wave findings and states of psychological and spiritual growth and change.  What changes occur in the brains of shamans and healers as they work?  What states of mind are compatible with healing and with illness.

 

We will consider the language of shamans as a metaphoric neurophysiology in which the workings of the brain are explained as the workings of the universe.  Shamans speak the language of systems through the stories they tell and encode complex concepts of how to transform and heal in simple plots and characters.

 

 

AGENDA: 

I.          Introductions

II.        Neurobiology of meditation

III.      Neurobiology of hypnosis

IV.        Neurobiology of healing

V.          Neurobiology of shamanic trance states

VI.        States of mind and states of healing.

VII.     The language of shamans

VIII.   Systems theory and the stories shamans tell.

IX.       The embedded code for transformation

X.          Experiential exercise

 

LEARNING OBJECTIVES:

 

Participants will be able to describe three QEEG findings associated with meditation.

Participants will be able to describe PET scan changes associated with hypnosis.

Participants will be able to describe QEEG changes seen during shamanic possession states.

Participants will be able to explain how stories are the language of systems.

 

POST TEST QUESTIONS: 

 

Meditation is associated with changes in theta rhythm.   True

Prayer is associated with increased activity in the left temporal lobe.  False

Balinese shamans show increased pre-frontal theta during trance possession dances.  True

PET scan findings indicate an executive function circuit that is down regulated during states of meditation and hypnosis.  True

  

BIBLIOGRAPHY

 

 Mehl-Madrona L.  Coyote Medicine.  New York: Firestone, 1998.

Oohashi T, Kawai N, Honda M, Nakamura S, Morimoto M, Nishina E, Maekawa T.  (2002).  Electroencephalographic measurement of possession trance in the field.  Clin Neurophysiol. 113(3):435-45. 

Qualls PJ, Sheehan PW.  (1979).  Capacity for absorption and relaxation during electromyography biofeedback and no-feedback conditions.  J abnorm Psychol 88: 652-662.

Radtke HL, Stam HJ.  (1991).  The relationship between absorption, openness to experience, anhedonia, and susceptibility.  Intl J clin and exp hypnosis.  39: 39-56.

Rilling J, et al. (2002).  A neural basis for social cooperation.  Neuron 35: 395-405.

Sabourin ME, Cutcomb SD, Crawford HJ, Pribram K.  (1990).  EEG correlates of hypnotic susceptibility and hypnotic trance: spectral analysis and coherence.  Intl J Psychophysiology 10: 125-142.

Sachdev PS.  Maori Elder-Patient Relationship as a Therapeutic Paradigm.  Psychiatry 1989; 52: 393-403.

Sachdev PS.  Maori Elder as counselor in a forensic psychiatry unit in Otago, New Zealand.  Presented at 22nd Annual Congress, Royal Australian and New Zealand College of Psychiatrists, Brisbane, Australia, 1986.

Saletu B.  (1987).  Brain function during hypnosis, acupuncture and transcendental meditation.  In B. Taneli, C. Perris, and D. Kemali (Eds.).  Neurophysiological Correlates of Relaxation and Psychopathology.  Adv. Biol. Psychiatry 16: 18-40.

Schacter DL. (1977).  EEG theta waves and psychological phenomena: a review and analysis.  Biol. Psychol. 5: 47-82.

 

The Hidden Power of Ancestors: Resources for the Modern World (1 hour to 1 day):

Conversation with a Coyote 

Once upon a time, long long  ago, the air was thick with stories.  Each tree, and rock, and stream and sky and bird.... all the creatures that walked the earth... each one had a song.  Each one had a story.  Even creation had a story.  More than one. The stories could be heard by anyone.  And a story could be told by anyone.  If something was wrong with me, if I was sick, I could tell a story about why I was sick, and my sickness could tell a story back to me.  Maybe a third person, a healer perhaps, would come and tell another story.  Maybe they would ask questions, or help the stories talk to each other.  The healer might give me herbs to drink, and do a ceremony.  We could ask my sickness, what do you want?  Why are you not at ease?  and my sickness might say “Make peace with your father” or “The darkness you absorbed has been stalking you for years.” The healer and others could join me in a circle of strength.  They could join me in my story, the new one...and the steps I had to take to tell it.  I could tell the new story, find understanding, and on that path I could be free.  I could even become well. 

As time passed, new stories were told.  One of them was medical science.  This kind of medicine was powerful and had good things to say, but soon...nobody really knows how it happened...this medicine said “My story is real, and others are false.” “This is the way it is,” it said. “There is no other story.  Just this one” and people gradually closed their ears. The trees and sky, even our dreams, began to lose hope. They started dying off, one by one.  Some went to sleep and some went far away.  The incredible weaving of all the stories circling the earth, was being pulled apart thread by thread.  Today it’s so transparent you can almost see through it. 

We live in a culture where the ultimate symbols of power are the knowledge producers, and the story knowledge about how to live in the world is not valued.  Older people are not valued because anything you want to know you can find in a book anyway so who needs them? 

One of the problems in modern US culture is that there are no traditional teaching tales, so the wisdom of the ancestors is no longer available to people. T –

In fact in our culture, it’s considered embarrassing to get old. Not even a part of the natural process.  It’s practically considered a disease. 

There’s a story from Bhutan where a warlord on the move, decides to kill all the old people because they can’t walk fast.  But one son refuses to do that and carries his father with him hidden in a basket on his back.  When inexplicable and dangerous events take place on the trek, the son secretly asks his father what to do.  His father, of course, tells him what’s going on and the son tells the warlord. After three of these trials, the warlord becomes curious and asks the son how he knows these things.  The son answers that he didn’t kill his father, and his father was the one that figured it out.  There are stories in most cultures about that. 

In spiritual cultures elders are more important because they live the longest.  In aboriginal cultures, they are really valuable and powerful...if you need to find something that’s lost, for example.   A youngster couldn’t have the same kind of power that an old person has. T –

How do aboriginal people view ancestors

Present with us when they wish..

Ongoing sources of power and help.

Deserving of respect and honor..

Reincarnational beliefs

Lack of cycle of karma

Beliefs about coming back to complete work left undone

Reincarnation among families.

Differences from Buddhism.

How can we use ancestors to help our clients..

The use of traditional stories

The use of ceremony and ritual

Family reconstruction.

The creation of ancestral stories..

IV. Why does this embarrass most academics?

References:

Mehl-Madrona L. (2005). Coyote Wisdom: the healing power of story..  Rochester, VT: Bear and Company/InnerTraditions.

Mills A, ed. (2000).. Native American Reincarnation Belief. Toronto: University of Toronto Press.

Sonn CC, Garvey DC, Bishop B, Smith LM (2000). Incorporating indigenous and cross-cultural issues into an undergraduate course: Experience at Curtin University of Technology.  Australian Psychologist, 35(2), 143-149.

Duran E. Red Buddha. Sacramento, CA:

 

Introduction to Native American spirituality and culture (1 hour to 2 days)

Life before Columbus

Changes in Native American culture as a result of contact with Europeans -- Catholics, Protestants, Cavalry, and Golddiggers.

How Medicine People Work

Working with people until the job is done

Your home or mine?

The Seven Categories of Cherokee Medicine

Controversies in Indian Country

The Pure blood versus part blood struggle.

Problems with money exchange: frogskins versus barter

Teaching non-Indians

Tribal jealousies

Fundamentalist Christians and devil worship

AIM fundamentalists

What we can learn from Native American healers

Healing takes time and time is healing

Healing takes place within the crucible of relationship

Major illness requires major life change

The Divine is the Source for healing

Illness requires community intervention; the unit of treatment is the family and community; not the individual

Whatever we believe will come true (within limits imposed by the Creator)

God works in mysterious ways, outside of our control.

Teaching tales from Native America (1 hour to 1 day)

We'll pick two stories to tell.  These stories will explain the healing principles and culture.

Guided imagery/visualization ("putting them to sleep so that they dream like they're asleep but they're really awake")

"Creature Feature:" Techniques to greet the spirit of the Illness (1 hour to 1 day)

Creating personal ceremony and ritual (1 hour to 2 days):

Integrating Native American ideas with your religion of childhood.

How to make your own form for communicating with the Creator.

Ceremonies and what mainstream culture can learn from them (1 hour to 2 days):

Sweat lodge

Yuwipi

Pipe ceremony

Medicine circle

Hanblecheya (vision quest)

Sun Dance

Shaking Tent Ceremony

Spirit possession/exorcism

Christ, Buddha, Krishna, and White Buffalo Woman (1 hour to 3 hours).

Similarities among religions

Spirituality versus religion

Making effective inter-faith translations

Power animals, spirit allies, shamanic journeying (1 hour to 2 days):

Siberian shamanism versus Native American healing

Drumming and its effects

Differences of North American, Central American, and South American healing cultures and techniques.

Designing a healing ceremony that we will do together

Native American body work

Wrap-up

     This course can begin a healing process on many levels.  It is for people searching for a sense of peace and harmony in their lives.   It can be of great value and benefit to those suffering from a physical illness.  In the Native American Way illness is a path that rises out of a lack of harmony and balance in the way in which we walk upon the earth.  We are especially interested in healing the child within so that people can pass that healing on to their own children and their children's children.  We are the children of the future.  Our children are the future of the world. 

 

 

 

Introduction to Integrative Psychiatry (1 hour to 2 days):

          What is Integrative Psychiatry?  Integrative psychiatry builds upon medicine and psychology to create a holistic view of the human being in which well-being and illness can simultaneously be considered.  In its consideration of wellness and of growth and change, it becomes more compatible and communicative with indigenous concepts of mental health and mind, and more able to bridge cultures and celebrate diversity.

An integrated approach attempts to link multiple levels of explanation so that a diverse plurality of descriptions can be simultaneously considered.  Integrative psychiatry goes beyond a biological explanation as sufficient.  We cannot separate biochemical changes in brains from the sociological milieu.  Biology and culture are inseparable.  Culture necessarily has tremendous biological impact through its mediation of perception, even of what is considered to be threatening, how suffering is defined, what constitutes misery, what is intolerable, what is abusive, and the like.

Integrative psychiatry also considers individual differences.  We know, for example, merely on a biological plane, that tremendous differences exist in the activities of drug metabolizing enzymes, including differences among populations presumably genetically related.  One size does not fit all.  Individual differences are important, and integrative psychiatry emphasizes this.

Integrative psychiatry aims at a new conceptualization of biology and genetics in which they are interlocked with multiple other explanatory levels, so that we can appreciate the complexity of interactions that affect the worlds in which we live.  A fully integrated approach requires an understanding of the science of complexity, of ecology, and of the developing insights of systems theory and science.

Integrated psychiatry is concerned about people’s internal world and their inner experience..  These internal states are descriptions that widely vary from person to person and represent the operation of the perceptual filters of culture.  We are concerned with the relation of inner experience to outer experience and of an inner life.  The question of internal experience and mind leads us to psychology and its considerations.

We are concerned about the economic burden of mental health problems and about developing approaches that are user friendly, community based, and cost-effective.

In a developing concern for social justice, for underserved populations, for ethnic minorities, and for cultural diversity, narrative approaches have emerged as one potential approach to the psychotherapeutic concerns of integrative psychiatry.  These include collaborative language systems, solution focused therapy, motivational interviewing, and narrative and community therapies.  Other therapies of interest include cognitive-behavior therapy, group therapy, family therapy, and individual techniques of guided imagery, visualization, hypnosis.  Spiritual approaches are also of crucial importance to consider and incorporate.

Integrative psychiatry is concerned with all effective techniques, including relaxation training and meditation, lifestyle therapies, the world’s traditional medicines, and what is now being called complementary and alternative medicine.

Within this broad framework, integrative psychiatry can express a concern for nutrition and its role in mental health.  Medicine has long been criticized for its ignorance of nutrition and psychiatry is no exception.  While there are psychiatric effects of poor nutrition and even malnourishment, therapeutic regimens may be considered, including traditional dietary practices, micro-nutrients, and herbs.

On the other hand, nutrition alone may not predict mental health difficulties.  In any complex condition, multiple systems may have to be compromised in order for the condition to occur.  This can explain conflicting findings in research.

 

Integrative approaches to anxiety (1 hour to 2 days).

          Anxiety disorders are on the rise in our modern society.  Perhaps the modern financial uncertainties and stresses are more difficult to grapple with than our ancestors struggle to feed themselves from the land.  Medications are not the only answer.  We will review other ways to reduce and manage anxiety including diet, vitamins, herbs, meditation, chi gong, acupuncture, ritual and ceremony, biofeedback, energy healing, hypnosis, and more.  We will explore the stories told by people who have had anxiety problems and who have found creative ways to resolve them.  We will briefly review the medications available and their side effects.  The weekend will be both didactic and experiential with opportunities for information gathering, learning new techniques, and personal growth and development.

          We begin with an overview of the field of integrative psychiatry as it relates to anxiety.  What strategies work?  What are alternative approaches to the use of medication?  What is the evidence that these approaches are successful?  We will review nutrition and anxiety, supplements for anxiety, meditation, biofeedback, guided imagery, homeopathy, hypnosis, yoga, chi gong, Chinese Medicine, and Ayurveda, in terms of use and evidence.  We will conclude the evening with an experiential session.

          Next we will consider the neurobiology of anxiety and how alternative therapies affect that neurobiology, developing a rationale for justification of these practices to mainstream practitioners.  We will particularly explore vitamin therapy, but also consider the neurobiology of psychotherapy as it is explored through fMRI, PET scans, and other imaging techniques.

          Next, we will work in the round with patients or actors pretending to be patients (depending upon availability) and will practice integrative assessment, will consider how histories differ from the standard approach, will explore how to match the treatment to the world view of the patient(s), will consider the role of family and community in the process, and will make recommendations in collaboration with our patient(s) who comes.

Guided imagery for anxiety.  We will learn how to use meditation techniques and guided imagery in the management of anxiety, beginning with a demonstration, then discussion, then practice exercises to learn techniques. We will, if possible, use actual patients, who have volunteered for the demonstrations.  We will aim for basic skills to use guided imagery in participants’ practices following the course.  Dr. Madrona will be available for further trainings and supervision if desired.

Ayurvedic Medicine and the treatment of anxiety.  We will explore the principles of Ayurveda and simple approaches to depression, again using actual volunteer patients if available, with the aim of participants developing a basic skill that can be applied to use ayurveda in their treatment of depression. 

         

Integrative approaches to depression (1 hour to 2 days):

            We will begin with a review of the neurobiology, anthropology, sociology, and psychology of depression, including neural imaging studies results.  We will review conventional therapies for depression including their efficacy and risks.  We will review the evidence for non-pharmacological therapies in depression.  We will conclude the evening with an experiential exercise for participants to explore any personal experiences with depression in preparation for further learning (self-disclosure will not be required).

            Next we will explore in depth nutritional and supplement approaches for depression, herbal approaches, Traditional Chinese Medicine and Ayurvedic theories of depression, and how to create an integrative approach.

            On Next, we will work with a patient or an actor playing the role of patient to assess depression from the various vantage points possible within integrative psychiatry (traditional Chinese medicine, North American Native medicine, Ayurvedic medicine, conventional medicine, herbal medicine, and more).  We will develop a history or narrative of that person’s depression, including family members, and see how to develop an integrative treatment plan in collaboration with the patient and his/her family and community.

 

Cross-Cultural Approaches to Integrative Psychiatry (1 hour to 2 days):

 

Many urban environments present a potpourri of cultures and practices for mental health.  Most psychotherapists, by definition, have been trained in a relatively narrow Anglo-European model, in order to gain their licensure.  Historically, mainstream psychology has ignored the wisdom of indigenous cultures and has dismissed the beliefs and practices of these cultures as unscientific.

This course aims to remedy this lack of appreciation for the area’s indigenous cultures.  We are going to explore some of the major cultures of the greater New York area, including Latino, Native American (especially Taino), Southeast Asian, Korean, regarding their views of mind and mental health, and learning how to better serve people from these cultures within our psychotherapy practices.  We will explore the correspondences between these ways of viewing mind and mental health and the conventional psychological and psychiatric models.  We will look at indigenous ways of diagnosing and describing problems.  We will review how these cultures approach so-called mental health problems, and will learn techniques and approaches from these cultures that can be used for all of our clients.

This course fits within a broader movement that is being called Integrative psychiatry -- a global movement to combine biological studies in psychiatry with other fields, including anthropology, sociology, psychology, geography, economics, and more.  Integrative psychiatry is especially interested in integrating the insights of traditional cultures of long-standing duration, and of being inclusive of their indigenous knowledge systems.  This movement aims to return psychiatry to its original position of being inclusive and integrating of other disciplines and cultures.

Our aim in this course is for participants to begin to develop fluency in other cultures and their healing systems for mind and mental health.  We wish to build capacity to provide psychotherapy that is culturally useful and effective.  We hope that participants will start learning techniques from world cultures other than their own.  We aim to start the process of collaborating with others to advance cross-cultural understanding in mental health.

 

          :  Overview of Integrative Psychiatry and the subject matter of the course  

I.  We will explore the interactive, inter-relationship among mind, brain, story, and culture.  We want to explore the concept of mind from various cultures and perspectives.

II.  Narrative approaches to understanding mind, in which mind arises as an emergent property of pre-narrative awareness and the instantiation of internalized story which structures that awareness into interpretive thought with the stories that shape awareness into mind being highly culturally derived. 

III.  We will explore how brain structure and function constrains and supports what mind becomes and how culture modifies brain structure and function. 

Throughout our time together, we will be concerned with the aboriginal and immigrant cultures of New York City.  We will use their perspectives of indigenous knowledge about mind and brain for our examples.

IV.  Experiential exercises in understanding mind from other perspectives

V.  Introduction to the talking circle and exercise.

VI. Group demonstration of cross-cultural healing practice.

VII.     Native American concepts of mind and mental health (special reference to tribes living in New York City).  Cultural primer; relationships and interaction styles.

VIII.      Native American methods of approaching mental health problems.

IX.        Demonstration of Native American healing approach.

X.          Practice session using Native American tools.

XI.        Hispanic and Latino concepts of mind and mental health; curanoderos; Inter-relationships with Catholicism and traditional practices.

XII.       Hispanic and Latino methods of approaching mental health problems.

XIII.      Demonstration of Hispanic/Latino methods.

XIV.     Practice session using tools learned from Latino/Hispanic methods.

XV.      Korean and South East Asian Approaches to mind and mental health; Cultural primer on relationships and interactional styles.  What you need to know to work with South East Asian and Korean people.

XVI.     Korean and South East Asian methods of approaching mental health problems.

XVII.   Demonstration of Korean and/or South East Asian methods.

XVIII.      Practice Session with South East Asian and Korean methods.

XIX.     Caribbean and African approaches to mind and mental health.  Cultural primer on relationships and interactional styles.

XX.      Demonstration of Caribbean and African method. 

 

The Ancestors:

Introduction to the Ancestors (1 hour to 2 days).

In this course, we will explore the role of our ancestors in our modern life.  Going beyond the obvious roles that the ancestors have played in contributing DNA to our genetic code and building the world in which we live, we wonder if the ancestors still exist to enlighten and support us.  If so, where are they and how can we communicate with them?

On another note, we also carry the unresolved life patterns of our ancestors.  These can be source of discomfort in our lives.  We re-enact these patterns unless we consciously address them and heal them.

Most indigenous cultures honored the ancestors.  In Asia, families build ancestral shrines.  Native Americans and Africans made place at the table for departed ancestors.  Mediums purport to communicate with our recently departed ancestors.  Channels communicate with the great and the dead.  Television shows like John Edward’s Crossing Over are immensely popular.

In this course, we suggest that the spirits of the ancestors are real and that we can learn to communicate with them, to receive their guidance, and to use their presence for healing.  Why?  Because we need them!  We need their wisdom to guide us just as every ancient culture did.  Without them, we lose our perspective on the ages.  We fall into ecological and personal disaster.

Outline:

Introduction to Ancestors from various cultures: Native American, Asian, Middle Eastern (Judeo-Christian-Islam).  We will explore how ancient cultures viewed the ancestors.  We will observe how ancient and indigenous cultures respected and venerated the ancestors; and how the ancestors enriched their lives.  We will consider the difference between ancestor worship and respect.  How ancestors represent archetypal forms in our lives.  We will examine archaeological evidence and physical anthropology findings to build a picture of the ancient world of the ancestors.

Experiential exercises to meet our ancestors.  We will begin by tracing our ancestors to their various continents and countries of origin.  Following this exercise we will use guided imagery and visualization to find those ancestors who wish to speak.  We will record their messages in journal format and then will draw and further depict the faces and shapes of our ancestors.  We will end with a ritual to honor and respect the ancestors.

We will explore a journaling process for continued discussion and dialogue with the ancestors.  We will wonder who these ancestors are and where do they live.  For some, they are symbols within our minds and voices that we construct.  For others, they are living spirits, coming to speak to us from other realms.  Regardless, of the conclusion for where they come from (and each culture has its own beliefs about where the departed ancestors dwell), dialogue with these spirits offers fresh insights for modern life.  As Fred Wolf said, “Why pay a medium, when you call talk directly to your ancestors yourself.”  We will explore the history of mediumship and the spiritualist movement, showing how it culminates in our current awareness that we can each be our own medium.  We will explore evidence for accurate ancestral communication from the laboratory.

We will use exercises from theatre and from family therapy to further explore our relationships to the ancestors.  Using family reconstruction techniques, we will re-create ancestral families in their own historical periods using other members of the course to play our various ancestors and their contemporaries.  We will act their stories and then insert ourselves in modern form to hear their teachings.  Second, we will use techniques from improvisational theatre to establish closer ancestral connections using movement, contact, and spontaneous speaking.  Opportunities will remain for the shy and the “performance challenged” to do quieter activities within this broader context of discovery.

We will study ancestral rituals and the role of the ancestors in ritual and ceremony, from the ancient world through modern times.  We will explore stories created by the ancestors and passed through generations to enrich and nourish our modern lives. 

We will explore ritual and ceremonial means of encountering the ancestors, including construction of personal ritual and ceremony, and also construction of a group ritual for ancestral contact.

Bring pictures and stories.  We will set up an altar in the course space to honor the ancestors.  In time alone, they will continue writing, drawing, and reflecting.

Potential Extra Topics:

1.       Introduction to the Ancestors

2.       Dance of the DNA: do the ancestors still speak to us through our genetic code?

3.       Ancestors in Ancient Cultures

4.       Ancestors in modern indigenous cultures

5.       Be your own medium.

6.       Be your own channel

7.       Ceremony and ritual for ancestral communication

8.       Judeo-Christian perspectives on the ancestors

9.       Asian perspectives on the ancestors

10.   Native American – North and South – perspectives on the ancestors

11.   African perspectives on the ancestors

12.   Including ancestors in our daily lives and seasonal ceremonies; making place for them at the table of modern life.

 

 

Course: Alternatives to Medications for Fear and Anxiety (1 hour to 4 hours):

Anxiety is rampant in our modern society.  Perhaps the modern financial uncertainties and stresses are more difficult to grapple with than our ancestors struggle to feed themselves from the land.  Medications are not necessarily an answer.  We will review other ways to reduce and manage anxiety including diet, vitamins, herbs, meditation, chi gong, acupuncture, ritual and ceremony, biofeedback, energy healing, hypnosis, and more.  We will talk story about people who have had anxiety problems and have found creative ways to solve them.  We will briefly review the medications available and their side effects.  We will end the evening with an experiential exercise -- part of what I teach people to manage anxiety.

 

 

Coyote Wisdom:THE HEALING WAYS OF NATIVE AMERICAN MEDICINEA two day course with Lewis E. Mehl, M.D., Ph.D.

      This course can begin a healing process on many levels.  It is for people searching for a sense of peace and harmony in their lives.   It can be of great value and benefit to those suffering from a physical illness.  In the Native American Way illness is a path that arises from a lack of harmony and balance in the way in which we walk upon the earth.  We are especially interested in healing the child within so that people can pass that healing on to their own children and their children's children.  We are the children of the future.  Our children are the future of the world. 

 

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      We will begin with an overview of what indigenous healing systems, particularly those of Native North America have to offer us for our modern lives.  We will discuss the importance of ceremony and ritual in our lives, and consider how to recover those events in the modern world.  We will discuss the sweat lodge, the sacred pipe, prayer and other ceremony.  We will close with an imagery exercise to feel more connected to the earth.

 

      On Next we will explore the stories about our illnesses and ways that we suffer.  We will look at the stories we are living and the stories that are living us.  We will invite our illnesses and pains and sadness to tell their own stories.  We will see how story is crucial to ceremony and ritual and will hear some traditional stories.

 

      On Next, we will participate in a talking circle process in which we design and carry out our own ceremony for healing.  We will see how people of all backgrounds can create ceremony and ritual together that is respectful of everyone’s culture of origin.

 

            On Then, we will continue to explore the inner landscape of our body to discover the source of illness, draw on the resources of our spirit guides, helpers, and allies, and gain deeper insight to dialogue and resolve affliction.  We will commit to practices to continue in our daily lives and consider how our healing might continue after the course ends.  We will finish with stories of future wellness that will guide our steps after we leave.

 

The Language of Healing (1 hour to 3 days)

 

Hypnosis and Physical Illness

 

 

            In the beginning was the Word, powerful enough to create the world.  With voice, tonality, phrasing, and words we can change our body reality, transforming sickness to health, despair to hope, and misery to happiness.  Words have served healers, doctors, priests and shamans from time immemorial.  In this course we will learn the art of speaking the language of healing.  We will consider how words affect attitudes, change beliefs, and nurture faith.  Through our words, deep inner resources for self-love are kindled which become physiological changes.  Our words flow with pictures of mountain streams, armies of blood cells, and the eternal peace of the soul.  What words do we choose?  How do we breathe these words?  How do we learn to speak the poetry of the spirit?  With this attitude, we will flow between the analytic side of hypnosis technique and the experiential side of storytelling and poetry, striking a balance that will aid in the restoration of wellness for ourselves and our clients.  This course will aim at professional development through personal experience, combining self-healing opportunities with consideration of technique and method.

 

 

Training Proposal: Indigenous Healing Wisdom for Modern Practice

Goal: “To enrich your life and professional practice with the wisdom of the wisdom, medicine, culture, and spirituality of the indigenous world.  Our goal is to bridge the pre-modern world to the post-modern world, preserving, teaching, and honoring the wisdom of the ages and of diverse cultures, and incorporating it into our modern practice of the healing arts.”

Short Description:

In this training program, we will discover, explore, and teach how the insights and wisdom of indigenous healing and culture can enrich our personal and professional lives. 

Training Module 1:  Indigenous Culture, Post-modernism, social constructionism, narrative practices, and applied quantum theory.

How do these diverse areas relate and support each other?  Post-modern philosophy provides a basis for understanding and integrating diverse cultures with equal validity.  Social constructionism provides a way of understanding how we create our methods for healing and curing through our networks of social relationships.  It downplays the role of the expert or the idea of privileged knowledge, and supports the idea of local knowledge developed by particular communities for particular contexts and needs.  The wisdom of any particular culture arises from its context in geography, history, and networks of relationships to other cultures.  That wisdom may not be relevant to other communities and cultures except in the sense of learning how practices arise out of context and need.  Translation is necessary between cultures to consider what elements of one culture can inspire, aid, and inform another culture.  Dialogue is necessary for this to happen.  Through dialogue members of diverse cultures share perspectives and come to understand how local practices have arisen and whether parts or wholes of them can be useful to other cultures.  Narrative practices acknowledge that these powerful cross-cultural dialogues take place through the telling of stories.  Cultures maintain their integrity through their traditional stories.  The passage of stories from generation to generation represents the preservation of culture.  In our post-modern world of contact with multiple cultures, elements of culture pass across previously rigid cultural boundaries to enrich and inform other cultures through the global dialogue.  Applied quantum theory gives us a natural science framework to understand how cultures “in-form” their members how to belong and actually shape members to achieve better fits and to evolve in culturally desired directions.  Concepts of holism, non-locality, non-separability, and connectivity inform our understanding of how change occurs and practices evolve.

This course arose from a conclusion of dialogue of multiple people that the wisdom of indigenous cultures is in danger of extinction.  This wisdom represents a radically different view of healing and curing than modern biomedicine.  The biomedical perspective is exclusionary and dismissive in its insistence that it is the most valid and effective paradigm for healing and curing.  Multiple voices are dismissed by this dominant discourse.  A value and belief is emerging among a segment of health care practitioners that the wisdom of indigenous cultures and their practices are needed within modern health care in order to be more effective and compassionate.  We have encountered the limits of the pharmaceutical industry as well as some downsides to the exclusive practice of constructing problems as belonging to individuals and solving them with drugs.  While this method can produce results, we recognize that other ways of conceiving problems may be equally effective and more desirable.

Training Module 2: The healing wisdom of Native North America.

The essence of Native American healing is to conceptualize dis-ease and illness as resulting from imbalance and disharmony in relationships.  Cherokee culture, for example, envisions relationships as the essence of a life, rather than the self, as is frequently posited by European-American culture.  Relationships emerge with the plant kingdom, animal world, land and geographical landmarks, loved ones, family members, community, ancestors, and larger culture.  Our relationships with the plant and animal kingdoms involve what we eat, herbs that we use, how we obtain our food, and how we dispose of our wastes.  Emotions are seen as arising out of relationships with other human beings.  This perspective differs radically from the biomedical perspective of illness arising from biological-structural changes in tissues, often conceived as the result of genetic causes.  Therapy is directed at changing gene expression, usually through pharmacological means or surgically altering the effects of chronic tissue changes.  Native American healing is directed toward restoring balance and harmony among all relevant relationships.  Even the question of confidentiality is addressed differently in Native American life, since the relationship is primary and the person is secondary.

The medicine wheel and its spiral philosophy of growth and development provides a heuristic framework for diagramming and understanding these concepts of harmony and imbalance.  We will consider the 16 points of the medicine wheel and how they inform us to remain in balance as we address suffering and dis-ease.  We will

Training Module 3:  The Healing Wisdom of (Another Culture – to be announced).  This module resembles training module 2, but for one other indigenous culture, depending upon who is available.  It will be a culture from outside of North America.

Training Module 4.  Incorporation of Ritual and Ceremony into Health Practices.

Why are ceremonies and rituals important?  How does using dramatic (in the sense of acting physically) practices affect our conception of what we are doing.  We will consider the common elements of rituals and ceremonies from multiple cultures and will consider the usefulness in health practice of daily ceremonies.  These can include welcoming the dawn, greeting the twilight, removing adverse energy or entities, purification ceremonies, vision quests, and other specific practices of local tribes or groups.  We will explore the concept of spiritual entities and various concepts of how they interact with humans, especially in reference to health and disease.

Training Module 5.  Storytelling and Visualization.

We will learn how indigenous cultures use storytelling, imagery, and visualization as part of the healing and curing process.  One tribe, for example, uses a practice that translates literally as “putting them to sleep so that they dream like they’re asleep, but they’re really awake.”  Stories are crucial to indigenous cultures.  Some scholars have argued that our modern culture suffers in its loss of traditional stories.  We will explore how stories inspire people to believe that they can be healed or cured.  Stories revision people’s sense of what healing and curing means and how it comes to pass.  Within the modern world, Alcoholics Anonymous provides an example of the healing power of stories.  Through testimonials, other alcoholics learn to believe that they can stay sober also.  The Native American Church and other cultural practices also use stories to inspire transformation.  Storytelling requires the use of language as rhetoric, including the power of persuasion (often called hypnosis in the modern European-American world).  Evocative visual images make the story more powerful. 

Training Module 6.  Energy healing.

Energy healing is a common aspect of the indigenous world, largely dropped by modern biomedicine.  Multiple types of energy healing practices exist.  Cherokee culture, for example, uses hands on the body, hands over the body, the shaking of rattles, burning of herbs, use of crystals, and the use of feathers and feather fans to move energy.  Cherokee also practices an acupuncture-like process of inserting needles (thorns, porcupine quills) into specific points along meridians to remove energy blockages.  In this module, we will consider the concept of energy – what is it, how does it work, how do we work with it, what happens when we work with energy.  We recognize that these are constructions to guide us and not necessarily absolutely true, but rather models to guide our practices.  Energy healing is used to clear energy from ourselves, our sacred objects, and our dwelling places.

Training Module 7.  Manual Therapies.

Every culture provides hands-on therapies.  On Zuni pueblo, in New Mexico, for example, high velocity adjustment practices developed parallel to and preceding the development of chiropractic medicine in Iowa.  Apocryphal stories exist about chiropractic arising from the study of existing Native American methods.  Hawai’ians have lomilomi, Cherokee have a well-developed style of bodywork, as did Apaches.  In this module, we will learn one type of manual therapy from an indigenous culture, aimed at incorporation into local practices and also preservation of particular styles of practice that are in danger of extinction.

Training Module 8.  Large Group Experiences.

Within a narrative stance and a post-modern framework, and entirely compatible with the practices of indigenous cultures, is the idea that groups best solve their own problems.  Groups decide what constitute problems and what comprise acceptable methods for solving these problems.  We will consider the practices of healing circles, large group meetings to bring social networks together to discuss their constitution of a problem and to brainstorm about solutions.  We will consider the healing power of large group ceremonies for healing communities.

Training Module 9.  Natural Therapies (herbs, diet, water, hot springs, etc.)

In subsequent weekends we will explore plant spirit medicine, nutrition and herbs.  Indigenous cultures have different views of plants and natural therapies than the natural products biochemical point of view of European-American cultures.  We wish to explore and preserve these alternative points of view regarding herbs and plants and animals and their use in healing and curing.  These points of view include the idea of communicating with the spirit of plants to learn what the plants want to heal.

Training Module 10.  Bridging cultures; pitfalls, challenges, enlarging the global dialogue.

Training Module 11.  Integration and Theory Revisited; Modern Practices that Enrich Indigenous Healing.

Besides having time to revisit how our theories and ideas have changed over the course of the training, we will visit some modern practices that seem to build upon indigenous understanding of the world.  These include practices like hypnosis, biofeedback, neurofeedback, magnetic therapies, and electrical stimulation.  We will take time to explore some of these tools to wonder how they might be integrated with indigenous practices.  We will revisit the world of applied quantum theory to talk about the theoretical basis for our being connected with each other and being influenced by each other, sometimes in unexpected ways.

Training Module 12.  Group practice. 

We will form a community of practitioners and “clients” to interact as a community to implement the practices that have been learned.  We will explore non-expert

 

Innovative Approaches in Healing Native American Diabetes:

Diabetes is a serious health problem and especially so for Native American people.  Most efforts to improve diabetes have failed.  Spirituality is an important and understudied aspect of health and disease, both in terms of coping with illness, management of stress, and the possibility of direct spiritual healing.  Previous research among Pima Native Americans in Arizona showed that a control group condition consisting of education in Pima culture and spirituality was actually helpful in improving diabetes control compared to the treatment condition (best American Diabetes Association diabetes disease management education and accompanying clinical services), which resulted in worse diabetes control.  Addressing culture, heritage, and spirituality may be important for changing diabetes among Native North American people.

 In this course we will introduce participants to the social and cultural aspects of diabetes and diabetes management.  We know that the biological aspects of diabetes are addressed very well by multiple sources, but diabetes is more than a biological disorder – it is also cognitive, emotional, relational, and spiritual. Diabetes affects every aspect of a person’s life and is affected by all those aspects.  We will present programs implemented elsewhere that address these elements to improve diabetes management.

Agenda:

       I.  Introduction to Native American diabetes as a more than just a biological disease.  We will consider it’s cognitive, emotional, relational, and spiritual aspects, both from the scientific research and from the perspective of indigenous knowledge.

       II.  We will review programs that have been implemented successful to improve diabetes control that address diabetes in all aspects, using the medicine wheel as an organizing tool to consider all these aspects of diabetes.

       III.  We will use a talking circle format to explore with participants what is the heritage, culture, and spirituality of the community.

       IV.  For those participants who wish to continue, we will use an appreciative inquiry process to explore how diabetes could be improved in the community.

Appreciative Inquiry (AI) is an organizational development process or philosophy that engages individuals within an organizational system in its renewal, change and focused performance. Appreciative Inquiry is now a commonly accepted practice in the evaluation of organizational development strategy and implementation of organizational effectiveness tactics.

Appreciative Inquiry is a particular way of asking questions and envisioning the future that fosters positive relationships and builds on the basic goodness in a person, a situation, or an organization. In so doing, it enhances a system's capacity for collaboration and change.[1] Appreciative Inquiry utilizes a 4-stage process focusing on:

1.      DISCOVER: The identification of organizational processes that work well.
2.      DREAM: The envisioning of processes that would work well in the future.
3.      DESIGN: Planning and prioritizing processes that would work well.
4.      DESTINY (or DELIVER): The implementation (execution) of the proposed design.[2] [3]

The basic idea is to build organizations around what works, rather than trying to fix what doesn't. It is the opposite of problem solving. Instead of focusing your energy on fixing the 0.0001% that's wrong, AI focuses on how to create more of what's already working. The approach acknowledges the contribution of individuals, in order to increase trust and organizational alignment. The method aims to create meaning by drawing from stories of concrete successes and lends itself to cross-industrial social activities. It can be enjoyable and
natural to many managers, who are often sociable people.  There are a variety of approaches to implementing Appreciative Inquiry, including mass-mobilized interviews and a large, diverse gathering called an Appreciative Inquiry Summit (Ludema, Whitney, Mohr and Griffin, 2003). Both approaches involve bringing very large, diverse groups of people together to study and build upon the best in an organization or community.  AI has been used extensively to foster change in businesses (a variety of sectors), health care systems, social profit organizations, educational institutions, communities, local governments, and religious institutions.

In the context of indigenous diabetes, we use appreciative inquiry methods with communities to determine how to address diabetes within that particular community.  We identify what is working well for diabetes in the community.  We envision what could work well in the future.  We plan and prioritize what would work well.  We develop implementation plans for producing results.  What we add to the AI process is the awareness that diabetes in Native American communities is more than just a biological disorder. It is a disease produced by the lifestyle changes that occurred with colonization.  Lifestyle changes can be supported by addressing the culture, history, and spirituality of a community, whatever that is.  Discovering this is what the  Appreciative Inquiry process does, aided by Native American processes such as the talking circle.

 

Narrative Perspectives for Health and Healing in the Work Place

Introduction:  Regardless of our life’s purpose and activities, health is important.  Current research suggests that physicians today address only 15% of the determinants of health.  These other determinants lie within areas not typically addressed by physicians and are crucial for wellbeing. 

Work is an important part of health.  We spend most of our waking hours at work.  We have more time with our co-workers than our families.  Feelings of social injustice and powerless in the workplace have been linked to the occurrence and speed of progression of heart disease.  Stress-related conditions are primarily work-related, including the injuries occurring when people are stressed and less cautious in their safety protocols.

Illness matters to company, even in Canada, where the public bears the brunt of costs for sickness care.  Absenteeism is costly.  Loss of key personnel is difficult to compensate.  Costs rise with more workmen’s compensation claims.  Lawsuits can occur.

Overview:  We will explore how the culture of the workplace creates stories that become a local culture of practice and knowledge.  We will explore the role of leadership and workers in implementing, maintaining, and evolving that story and will see how the story is associated with feelings of powerlessness or empowerment.  We will link this to our own personal health and disease.  We will use lessons from indigenous cultures to see how stories evolve and achieve power.  We will apply these methods of inquiry to our own personal health (or disease).  We will ask how company and personal stories can be changed to achieve better health in the workplace.  We will explore the role of meaning and purpose in health and disease and the need for people to find meaning and purpose through their daily work activities, to feel part of a community, and to feel valued.

Learning Outcomes:

Participants will:

·         Understand the concepts of story, plot, narrative, meaning, value, and how these inter-relate.

·         Be able to enunciate their own personal story, describe what its plot is, discuss the strategies through which the plot unfolds, say what gives them meaning and purpose, and relate this to their own personal health.

·         Be able to state the company’s story, describing its creation, vitalization and re-vitalization, and relate this to the workers’ experience of meaning and purpose in the workplace, of valuation, and of belongingness, exploring how these factors can increase or decrease health, absenteeism, injuries, and workmen’s compensation claims.

·         We will explore how to collaborative re-author personal and company stories to pursue greater health, wellness, meaning, and functionality in our personal lives and at work.

·         We will consider how these developing stories compare to traditional stories, classical themes from literature and movies, and popular cultural stories.

·         We will practice how to develop a plot line or theme that shows us where the story will travel as it is enacted and to explore how to change story to maximize the movement toward health and wellness. 

Conclusion:  Participants will learn about the power of personal and corporate stories for health and disease.

 

Alternative Approaches to Treating Psychiatric Illnesses 

It is commonly known that alternative therapies can help depression, but what about more serious psychiatric disorders— severe anxiety, bipolar disorder, schizophrenia, and other forms of psychosis? In this course with groundbreaking holistic physician, Dr. Lewis Mehl-Madrona, we will explore these disorders and the alternative therapies that can help them. We will review nutritional therapies, vitamins, minerals, and amino acids; touch therapies such as craniosacral therapy and other forms of bodywork; neurofeedback; guided imagery and hypnosis; family and community therapies, energy work, Chinese and Native American methods and spiritual healing. Dr. Mehl-Madrona will also share a new way to understand diagnoses of psychiatric disorders to avoid stigmatizing people whose neurology and/or life experience are different than the norm, and give case histories of people who have recovered without medication. The last portion of the event will be experiential with guided imagery and/or other modalities and demonstrations

Wisdom of the Ancestors II"

Going beyond the obvious roles that the ancestors played in contributing DNA to our genetic code and building the world in which we live, we believe that our ancestors can still enlighten and support us.  Most indigenous cultures honor the ancestors. In Asia, families build ancestral shrines. Native Americans and Africans make place at the table for departed ancestors. Mediums purport to communicate with the recently departed.

In this series of courses, we suggest that the spirits of the ancestors are real and that we can learn to communicate with them, to receive their guidance, and to use their presence for healing. We need their wisdom to guide us just as ancient cultures did. Without them, we lose our perspective on the ages. We could fall into ecological and personal disaster.

We may also carry the unresolved life patterns of our ancestors. These can be a source of personal discomfort. We re-enact these patterns unless we consciously address them and heal them.

Course Outline

Introduction to Ancestral Stories: We will begin by exploring the cultural stories of our various heritages to learn about the messages for well-being and survival that our ancestors have passed down to us in these very formal means.  We will also explore family stories that are multi-generational through which ancestors communicate their wisdom.  We will reflect on the stories we wish to impart to our future generations and what we hope to accomplish through those stories.

Experiential exercise with ceremony and ritual:  We will develop a ceremony together to call our ancestors and will use a talking circle format to explore how to produce a conjoint ceremony that respects and incorporates the multiple cultures present in our group.  In the afternoon we will enact this ceremony and will explore the techniques of ceremony that build spirit power and call ancestors to communicate with us.  We will dialogue about the results of our efforts.  In the evening we will work together as a group to explore how to best design personal ceremonies and rituals to continue our efforts to build relationships of spiritual power with our ancestors.

Then we will continue our process of family reconstruction to facilitate another method for our ancestors to speak for themselves.

Bring pictures and stories. We will set up an altar in the course space to honor the ancestors. In time alone, they will continue writing, drawing, and reflecting.

 

Course: Wisdom of the Ancestors III

 

Going beyond the obvious roles that the ancestors played in contributing DNA to our genetic code and building the world in which we live, we believe that our ancestors can still enlighten and support us.  Most indigenous cultures honor the ancestors. In Asia, families build ancestral shrines. Native Americans and Africans make place at the table for departed ancestors. Mediums purport to communicate with the recently departed.

In this series of courses, we suggest that the spirits of the ancestors are real and that we can learn to communicate with them, to receive their guidance, and to use their presence for healing. We need their wisdom to guide us just as ancient cultures did. Without them, we lose our perspective on the ages. We could fall into ecological and personal disaster.

We may also carry the unresolved life patterns of our ancestors. These can be a source of personal discomfort. We re-enact these patterns unless we consciously address them and heal them.

Course Outline

Introduction to Ancestors from various cultures: We will begin with techniques from improvisational theatre to establish closer ancestral connections using movement, contact, and spontaneous speaking. We will use masks made in prior courses to create an ancestral drama or pagent among our group that may well last into Next.  On Next and evening we will participate in a Native American sweat lodge ceremony together.  The focus of this ceremony will be to call and honor our ancestors.

Then, we will dialogue through a talking circle process about the entire series of courses and what we have learned about ancestors.  We will dialogue about the communication that has happened and will make concrete specific plans for how each of us will keep this material alive as we return home.