The Faith Factor
The Faith Factor Mind/Body pioneer on the health benefits of spirituality.
Dr. Herbert Benson of Harvard Medical School was one of the first scientists to take seriously the claim that spiritual practice is good for your health. From his ground-breaking study of Transcendental Meditation, he went on to a courageous re-examination of the placebo effect and studied the health impacts of spiritual practice and belief. Today, he heads the Mind/Body Institute at Harvard and through books, conferences and studies, works tirelessly to convince the health care establishment of the vital impact of the mind on health.
The Shambhala Sun: Your first work on the mind/body connection was a study in the early seventies of the effects of Transcendental Meditation. At that time, neither the scientific community nor the spiritual community took TMís claims very seriously, yet you did.
Herbert Benson, M.D.: Well, I had seen in animal studies how high blood pressure was related to stress. The transcendental meditators claimed that they could lower blood pressure by practicing stress-alleviating techniques, and that just made sense to me, once I got over the hesitation of going into something so relatively unexplored.
I studied transcendental meditation and found that it evoked a response that was physiologically opposite to the stress response. Another way to describe the stress response is the so-called fight-or-flight response, and as historical accident would have it, the room where we studied people practicing TM was the very room where sixty years before Walter B. Cannon had first described the fight-or-flight response.
Then, it made no sense to say that TM was the only way to evoke this quieting response, so I looked for the basic steps that made up Transcendental Meditation. Ultimately, I felt there were two: Step one was repetition, of a sound, a word, a prayer, a phrase, or a muscular activity. The second step was that when thoughts came to mind, you tacitly disregarded them and returned to the repetition. When I looked for these two steps in the religious and secular literatures of the world, I was astounded to find that in every single culture of man that had a written history, these two steps were described.
The Shambhala Sun: You are describing the elements of all basic mindfulness meditation, in which you return from discursive thought to a simple object of mindfulness, such as the breath.
Herbert Benson, M.D.: Exactly, which is still repetition. So at that point we had a mind/body technology, because we chose other words, sounds or prayers and found the same physiology that occurred with TM. That meant this was a mind/body technology, which I have called the relaxation response. If you meditate in a certain way, measurable, predictable, reproducible physiological changes occur. So this is science.
The Shambhala Sun: I find the next step that you took even more interesting. That was to look with fresh eyes at what the medical profession usually dismisses as the placebo effect. Rather than dismissing it, you looked at the placebo effect as important proof of the mind/body connection and as a demonstration of the healing power of belief.
Herbert Benson, M.D.: The so-called placebo effect is extraordinarily powerful. We in medicine denigrated it because we didnít understand it, and it got in the way of our pharmaceutical ideas, you know, "Placebo is dummy pills," and "Itís all in your head," and so on.
Early on, people criticized the relaxation response as nothing more than the placebo effect, which led me to ask, just what is the placebo effect? That led to some thirty years of study of the placebo effect.
The Shambhala Sun: When you think about it, itís astounding that the medical profession could just dismiss something as "the placebo effect" when they knew it had a significant positive impact on many cases.
Herbert Benson, M.D.: The whole thing is so turned on its ear. Here we are ridiculing one of our most
powerful assets, rather than saying, letís have a look at it. I could never understand that.
The Shambhala Sun: Your thesis is that the power of belief, as demonstrated by the placebo effect, allows us to access what you call "remembered wellness."
Herbert Benson, M.D.: We are wired: all our memories, all our thoughts, are constellations of various connections in our brains, which are extraordinarily complex. So you can be wired to a certain configuration of your brainís connections that will produce a headache. If I were in front of you saying, "Headache, headache, headache," you would be reminded of a headache and indeed a headache would be produced.
Similarly, you have wirings of being without a headache. So if you take a pill, if you believe it will work, even though itís nothing but a sugar pill, you will then turn on that wiring of being without a headache and the headache will disappear. You have remembered what it was to be without a headache. You have remembered wellness.
The Shambhala Sun: Is meditating one of the ways to access that?
Herbert Benson, M.D.: Itís different, but immediately after you elicit the relaxation response your mind is quieter, and itís easier then to remember wellness.
The Shambhala Sun: From a Buddhist point of view, the sense of basic healthiness is found at the absolute, non-ego level, beyond relative phenomena such as the wiring of the brain. Is it your belief that our most basic experience of wellness is found at the level of biology or neurology, or is it beyond that?
Herbert Benson, M.D.: Thatís unanswerable now. Certainly, you can do experiments and see whether such influences do occur. For example, if you have an effect from intercessory prayer, when you do not know youíre being prayed for, then it canít be your belief system. It has to be, if you will, this other power, force, energy operating in your system. Are you with me?
The Shambhala Sun: Yes, weíve talked to Larry Dossey about this at length.
Herbert Benson, M.D.: Right, so itís studied. And if it does occur, then science will have to be redefined in terms of explaining this. There is no current framework in which to accept it.
The Shambhala Sun: Now you combine meditation technique, which you call the relaxation response, with the power of belief into what you call the "faith factor" in health. Letís talk more about the belief aspect.
Herbert Benson, M.D.: Belief can be translated into physical reality in the body. One can turn on a whole host of symptoms and diseases by simply believing them, and similarly they can be relieved. There is a whole list of diseases where belief has been shown to play a major role and itís a remarkable list, angina, asthma, all forms of pain, skin rashes, duodenal ulcers, rheumatoid arthritis, congestive heart failure, and on and on. One could even die because of belief.
The Shambhala Sun: But you talk not only about health beliefs, but also the power of spiritual beliefs.
Herbert Benson, M.D.: According to the work of Dr. Jared-Kass, people experience spirituality when, first, they feel the presence of a power, force or energy guiding them, and second, that presence is close to them. When those two components are there, people say itís a spiritual experience. For 95% of Americans, the most powerful belief is belief in God. If you want them to have the healing power of belief, their most powerful belief is the belief in something beyond themselves.
The Shambhala Sun: Then is the positive impact of spiritual belief on health the result of hope that people can get from religion, or is it from belief in a larger reality that allows them to be non-attached to a specific outcome?
Herbert Benson, M.D.: It could be both, or either. You see, if you believe, in one extreme, in a sugar pill, that belief can help you heal. It almost doesnít matter what you believe in, in a religious belief, in your doctor, in nature itself. We all have a belief in something and we have to tie in the power of the body to heal with what we believe in, which may be different from person to person.
The Shambhala Sun: How do you differentiate this power of belief from what we might just call the will to live, or love of life?
Herbert Benson, M.D.: Thatís part and parcel of it. Or look at the numerous examples of people who stayed alive for a wedding and anniversary, or willed themselves to die with the loss of a loved one.
The Shambhala Sun: How does a medical doctor have this kind of discussion about belief, which was traditionally the province of ministers or therapists, with a patient?
Herbert Benson, M.D.: Itís so easy in this context: Letís go back to the relaxation response, which will work whether you believe in it or not. Itís like penicillin. You carry out those two steps and youíll have these physiological changes. Now, when you are teaching a person a relaxation response, you have to have them choose a word, a sound, a prayer, or a phrase. You ask them, do you wish it to be secular or religious, and they will make a choice.
The Shambhala Sun: And theyíll choose something of meaning to them.
Herbert Benson, M.D.: Exactly. What they believe in. So the teaching of the relaxation response then gets you into a dialogue about beliefs. It becomes very natural.
The Shambhala Sun: And the technique produces not only the physiological effect, but helps them make a more powerful contact with their spiritual beliefs.
Herbert Benson, M.D.: Exactly. Then you have the relaxation response plus the power of belief. Thatís the combination I have called the faith factor.
The Shambhala Sun: So should this technique be brought into every MDís practice?
Herbert Benson, M.D.: To the extent that stress causes or exacerbates any disorder, the relaxation response is appropriate. If you look at the number of physician encounters that are due to stress or other mind/body interactions, itís an impressive number: 60 to 90 percent. Therefore, patients should be taught to elicit the relaxation response. In the vast majority of encounters between physicians and patients, the relaxation response is a most appropriate intervention.
The Shambhala Sun: Some of your literature is aimed at convincing HMOís of the efficacy of such mind/body techniques. I wonder if they might look at your work and decide to charge religious and non-religious people different rates.
Herbert Benson, M.D.: No, no, no. It is helpful for a person to be in touch with their beliefs, but to discriminate on the basis of what the belief is would be a gross misinterpretation of my work.
The Shambhala Sun: I understand that. But I wonder whether the insurers will look at the epidemiology and say, well, you go to church, youíre more likely to be healthy, so youíll be less expensive to us.
Herbert Benson, M.D.: There happens to be much data supporting that.
The Shambhala Sun: Finally, having pioneered this mind/body field, how do you feel now that interest in it is so widespread?
Herbert Benson, M.D.: Looking over these thirty years, itís so gratifying that Iíve been able to be around to see the corner turned.
The Shambhala Sun: Yet you are clear about the limits of the mind/body approach, while there are many extravagant and unproven claims now being made for it. How do you feel about the current state of the field?
Herbert Benson, M.D.: Itís virtually impossible to control what happens with a therapy; it will be used and it will be abused. We do that with medicines; we do that with surgery. But I think we can explain so much more by understanding the power of belief; for example, if we bring clarity to how some alternative medicines work. They may not be working because of the herb or what have you, and isnít it nice to be able to come to an understanding of what would otherwise appear to be mysterious mechanisms?
What I find very, very pleasing is that our work has been able to narrow the artificial separations that have been created between spiritual belief, healing and medicine. I truly believe that although there will be offshoots that are not particularly desirable or useful, ultimately this synthesis will be the most meaningful. People can use their own inherent capacities, combined with the awesome healing powers of our medicines. Iím rather optimistic.
A Year in the Whirlwind
A Year in the Whirlwind
"I am not a spiritually gifted person, but my years of practice and study gave me an understanding of the task ahead"
In October 1995 I went for a sigmoidoscopy. I had been putting the test off because I knew it would be a distasteful experience, but as a healthy, vigorous person, I did not for a moment anticipate that there would be a serious problem. I expected to be told I had some minor, easily corrected condition.
I remember the doctor, a tall, African American man, talking to me when the test was over. "When the growth is that big, weíre ninety percent certain itís cancer. Iím calling your doctor right now. We want you in the hospital for major surgery in a week."
So began a year in which every element of my life flew into the air and was blown around in dizzying swoops and dips. Lifted suddenly out of my usual routine and habits of mind, I was thankful that I could still turn to the lessons of the Buddhist practice I had been doing for almost twenty years.
In meditation, I had learned to sit still while emotions raged in me, while my body clamored for relief, while my mind tortured me in myriad ways. I had learned to be there for it all, recognizing in each moment, no matter how painful, imperfect or frustrating, the ever-changing texture of what is. I am not a spiritually gifted person, but my years of practice and study had given me an understanding of the task ahead.
So when I received the diagnosis of cancer, I understood, Yes, what is required of me now is that I be fully present to each new experience as it comes, and that I engage with it as completely as I can. I donít mean that I said this to myself, nothing so conscious as that. I mean that my whole being turned, and looked, and moved toward the experience.
Driving home from the hospital where the test had been performed, I was just beginning to take in what had happened. In a crisis we have many choices of how to react. We can reject the experience hysterically; we can rage against the injustice of it; we can go into deep denial and pretend itís not happening; we can move into the future, imagining a horrific outcome; we can retreat into obsessive worry, or sink into depression, and there are other possibilities. But after all those years of sitting still and trying to pay attention, and perhaps because I am a rather positive and sunny person, I had none of those options. It seemed there was nothing to do but to be present in the moment.
This did not protect me from the usual thoughts and feelings, particularly in the initial shock. I remember a friend telling of hearing her own cancer diagnosis. "I thought I was on the mezzanine," she said, "and suddenly I was in the basement." Itís like that.
Coming from the test, with the doctorís voice echoing in my head, I walked up the back steps to my house. "Well, Iím fifty-nine years old," I thought, "Iíve published four books, Iíve experienced marriage and many intensely engaging love affairs, Iíve done honest political work, Iíve traveled, Iíve lived my life as fully as I could. If this is the end, that will be all right."
Then I walked in the door and told my partner the news, and the next moment I was crouching next to the davenport where she sat, sobbing in her arms, as both of us felt the enormity of this, the terrible sadness of the coming ordeal, the terror that my life might end. Buddhist practice does not prevent anything; it does not shield us from anything. What it does is soften and open us to meet everything that comes to us.
Because I am a writer, books always accompany me on any journey. This time, while I sought out the words of spiritual teachers and found them helpful, a book of poems by the German poet Rainier Maria Rilke fell into my hands, and it was his words, written within the Christian tradition, that particularly echoed and gave resonance to my experience.
I live my life in widening circles
that reach out across the world.
I may not complete this last one
but I give myself to it.
I give myself to it.
I was helped by the Buddhaís First Noble Truth, that we suffer. I understood that simply to inhabit a human body is to experience discomfort, dis-ease, dissatisfaction, pain both physical and mental. Suffering, I knew, was not an aberration from some mythic state of constant happiness, like a beer ad or a shampoo commercial, with the wind perpetually ruffling our hair. Suffering was simply a condition of life.
So when the cancer was diagnosed I did not imagine that there was something wrong or terribly unfair in my having this disease. I went to see my acupuncturist, who is a dear old friend, and we had a talk. "Itís not really surprising," she said. "Our environment is full of toxins, cancer is an epidemic. Why wouldnít you have it?" This attitude made my task easier.
Of course, one inevitably thinks about causes. Our air, our food, our water are laced with poisons, and nobody is doing very much about these, certainly not the so-called regulatory agencies set up to protect us. Weíve all read the reports of carcinogens in our gasoline and how pesticide use has soared in the last five years. In some parts of California, our soil and water are being seriously polluted by the illegal manufacture of methamphetamines! How could this not affect my vulnerable/permeable human body?
Another possible cause is lifestyle. Did I consume too many hot dogs and French fries as an adolescent? Then thereís heredity, is it my familyís fault? And how about all that suppressed rage or grief or other negative emotions just churning in me with no way to get out except to create a disease? This explanation I rejected, not just because it did not ring true for me, and I do grant that for some people it may be helpful, but because it seemed to ask me to take on a false burden of responsibility that ignored both the larger landscape of causality and my need to be in the moment dealing with the crisis.
Of course I thought about all these possible causes. Then I remembered the classic Buddhist story of the man shot by an arrow. Heís lying on the ground, seriously wounded. One person comes to help. She examines the arrow and speculates on who may have made it and who might have shot it. She looks at the point of entry in the manís chest and calibrates the angle of approach and the possible speed with which the arrow traveled. All the while the man is dying. The other person whoís come to help notices the victimís suffering and says, "No, no, what is needed is not this inquiry but to extract the arrow and treat the wound!"
While this story is a metaphor for Buddhist practice generally, it emphasized for me the need to stick to the demands of the moment. Yes, the network of causation does need to be addressed, and particularly the steady poisoning of our environment, but a patient preparing for major surgery and a long siege of chemotherapy has other priorities. I had other priorities.
I found myself, in the days before the surgery, talking to Kwan Yin. Kwan Yin is the Chinese female embodiment of compassion, the most venerated goddess in all of Asia. She was a being I had encountered many years ago in a museum in Kansas City where there is a famed statue of her, and she had fascinated me ever since. Goddesses compel me as female emanations of transcendent capacities and forces. Whether they exist actually in the world, independent of our minds and hearts, I sometimes believe to be true and sometimes doubt.
Kwan Yin was particularly present to me at this time. On my way that summer to the United Nations Fourth World Conference on Women in China, I had made a pilgrimage to visit Kwan Yin. I spent six days on an island in the South China Sea called Putuo Shan, a place dedicated wholly to Kwan Yin, or Guan Shih Yin as the Chinese call her. It is said that she resides there still, and I had a strong experience of her presence.
Now a month later I was in Oakland, wandering in the Mountain View Cemetery, a beautiful graveyard shaded by venerable trees, and as I walked I spoke to Kwan Yin. I told her my situation, and then I said, "Help me." I was facing the unknown. I had never even stayed overnight in a hospital, and in a few days I was to go in for a major operation in which they would open up my belly and take out part of my intestine and see whether the cancer had spread elsewhere in my body.
"Help me," I said, and tried to visualize a beautiful Chinese lady in flowing robes. I had seen many representations of Kwan Yin; I could imagine her hovering in the tree branches, looking down tenderly at me.
Who was I talking to?
Space and silence opened around me.
No comforting goddess appeared.
Who was I talking to?
I didnít know, yet there was a sense that my voice, my plea, my question, reached somewhere and was received. Perhaps it reached deep inside me, past preoccupations of self, and touched the silent place that exists before struggle and fear.
I sat on the grass, under a spreading tree, beneath a sky of perfect blue in which one cloud lazily sailed. I felt the livingness of everything around me, and felt my sharing in it. I felt my separation from it too, my imprisonment in this body that would soon be subjected to grotesquely intrusive maneuvers.
"Help me," I said again, and felt how utterly alone I was, like a tiny figure silhouetted against a vast horizon. Yet there was an answer, a resonance as deep in me as the core of the huge tree under which I sat. I left the cemetery that day feeling as if I had dropped into that place of resonance, and I found myself willing to experience what I must.
You, sent out beyond your recall,
go to the limits of your longing.
Flare up like flame
and make big shadows.
Let everything happen to you: beauty and terror.
Just keep going. No feeling is final.
In the hospital after the surgery I had an experience, sometimes excruciating, sometimes exhilarating, of community. Community, or sangha, is one of the important dimensions of Buddhist engagement, and I felt its expansion and its depth in those difficult days. I received the care of my feminist, political, theological, lesbian, neighborhood and other friends, who came showing me the very purest part of themselves, whose motive was simply love. But there were other dimensions of community.
Because, like forty-three million other Americans, I had no health insurance, I went for my surgery and subsequent care at Highland Hospital, the county facility located in East Oakland, one of the more disadvantaged sections of the city. Most of the patients are poor people; the hospital is overburdened and understaffed. There are no frills, very little space, no pleasant esthetic touches to soften the impact.
In this setting, after the surgery, high on morphine, I had no defenses. I was utterly vulnerable to the stimuli around me. The TV set on the wall above the beds erupted in loud violent cartoons, equipment clanged, and voices intruded. It was as if my skin had been peeled away.
But even in this chaotic setting, the community, my friends, the nurses and orderlies, my sister and brother patients, moved in healing, comforting ways.
The evening after my surgery, visiting hours brought quite a number of people to see my roommate, an African American woman. On my side of the curtain that separated us, three of my friends had crowded in, hoping to cheer me. The TV set blared and in the hallway doors banged and people talked loudly. I huddled in the bed, thinking to myself, "I cannot bear this," for the morphine made me feel besieged, unable to protect myself or to find a psychic place in which to rest.
A friend from the Graduate Theological Union, Kathryn Poethig, sitting quietly beside my bed, must have sensed my distress, for she took my hand and began to hum the opening notes of "Amazing Grace." Her voice was a quiet slow stream under all the din.
Suddenly the TV set snapped off. There was silence on the other side of the curtain. Then several rich, deep female voices joined my friendís, and the gentlest, tenderest version of that venerable hymn rolled out to fill the room. "Amazing Grace, how sweet the sound ..."
Kathryn and I gazed in amazement at each other. My other two friends stared at the curtain. The song went on, a rich blending, a heartfelt, holy rendering of this beautiful old hymn. I felt as if I were being rocked and held in nurturing arms.
When the last note sounded, Kathryn went to peer around the curtain. "That was so beautiful," she told the invisible singers, "We loved it."
In my scratchy, post-surgery voice (impeded by the tube that ran down my throat to my stomach), I croaked out, "Could you do one more?"
They did, a precise, original rendition of "He Leadeth Me," a hymn I used to sing as a child in my Methodist Church in Ohio. I knew it well.
When the song finished, the atmosphere in the room had been transformed. We existed now in a deep, comforting silence, and all the offending noises from the hallway seemed outside our bubble of stillness. I lay back smiling, relaxed for the first time since the surgery.
A beaming face looked around the curtain. "Hope youíll feel better soon," she said, and then I heard these women say a quiet goodnight to my roommate and walk out of the room. My own visitors sat in stillness.
(The next day my roommate, whose name was Charlene George, told me that the voices were those of her sisters, a singing group called the Webb Sisters. These three women have opened at the Monterey Jazz Festival to a standing ovation, and sing in African-American churches and religious gatherings regularly.)
Yes, always there was some ray of kindness or beauty available to me, if I could be there for it.
I want to unfold.
Let no place in me hold itself closed,
for where I am closed, I am false.
There were other books besides Rilke that accompanied me in the hospital. I eagerly read Audre Lordeís A Burst of Light, the account by this African-American warrior-poet of her final battle with lung cancer. Through long afternoons I lived within the covers of Paula by Isabel Allende, in which the Chilean novelist describes the slow dying of her young daughter, who lay in a coma for many months. The Diary of a Zen Nun by Nan Shin held me with its luminous language, evoking in turn the thrill of horseback riding, the suffering of breast cancer surgery and treatment, the beauty of nature, and the rigors of Zen training.
Friends visiting me would peer at this short stack of supposed gloom and ask, "Donít these books depress you?" On the contrary, I needed the accounts of people who had gone ahead of me into this vast landscape of pain and disorientation. For I had been told that the pathology report showed Stage Three colon cancer, and that it was likely there were cancer cells still in my abdomen. The doctors were strongly recommending an extended course of chemotherapy. I was beginning to understand that the surgery was only one step in a long process, one which I might not survive.
I hated the idea of allowing poison to be injected into my veins. I was eating a macrobiotic diet, drinking Chinese cancer-preventing herbs and taking supplements recommended by an acupuncturist. Many people would say that I was sufficiently protected by this regime, but I wanted to know more about the chemotherapy. My friend Sandra Butler went to Plane Tree, a medical research center for consumers in San Francisco, and returned with reports of thirty trials of chemotherapy for colon cancer. As I recuperated from the surgery, Sandy and I read the many pages of medicalese. The statistics carried great weight. In the groups of patients studied, the recurrence rate without treatment was 50 percent; with treatment the recurrence rate dropped to 25 percent. Those numbers I found compelling.
The doctors had told me that colon cancer most often metastasizes to the liver, where it is difficult to detect until it has reached an acute stage. I imagined discovering, in a year, that I had liver cancer, and thinking, what if chemotherapy could have prevented this? It was not a scenario I wished to experience. I decided to accept the chemotherapy.
My first treatment was administered by oncology nurse Bill Shanks. Bill is a brown-skinned, gray-haired, nattily-dressed man whose smile lights up the room. I soon discovered that he was just my age, and hailed from Ohio like me. But it was his hands that were most reassuring: broad, warm hands whose fingers moved deftly as he inserted the needle, with the skill learned in years of this work and an innate gentleness that cannot be learned. Even so, I felt a sinking in my heart as the clear liquid moved from the vial through the needle into the vein on the back of my hand. It was the beginning, setting me upon this course from which I could not turn back.
In the following month I was hospitalized twice by my reactions to the initial strong dose of chemotherapy. Apparently I was more sensitive than other patients to these drugs. Then began the months in which I went to the hospital once a week to let Bill inject poison in my veins, and the rest of the week lived with the effects of that poisoning, and through herbs and acupuncture, meditation and other efforts, worked to support my immune system to withstand the assault of the chemotherapy.
But there were other projects during this extraordinary year. I continued to teach my writing classes: by sleeping for several hours before each class, I was able to manage. And I wrote a book.
I had proposed the book to the publisher and signed the contract before I became ill. Now the months were passing, October, November, December, January. I had recovered from the surgery, but the chemotherapy was beginning to make me ill. Finally, on January thirty-first I had a talk with myself. "Sandy," I said, "tomorrow morning I want you to go in your study, sit down at your desk, and write the first sentence of this book. And then I want you to continue."
The next morning, obediently, I did as I was told. And then for the next several months, no matter how I felt, I went into my study each morning and took up where I had left off the day before. The writing became a healing for me. Sitting at my desk, I was not a cancer patient, a sick person, a disempowered and gravely threatened person. I left that behind and entered the task fully. I became the action, and in this I was empowered.
That was a great teaching: that no matter how sick we may be, there is always a dimension of us that is intact and healthy. Whether through creative work, through sensitive contact with others, through spiritual practice, through appreciation of music or art, we can at moments access that other reality. Perhaps it is the place I touched when I called upon Kwan Yin in the graveyard.
In the pages of the Shambhala Sun recently, I found Joan Halifaxís attempt to describe this phenomenon, from the perspective of a caregiver. "We are … called to look deeper than suffering to the place where freedom from suffering exists," she wrote. And she speaks of "the unmoving truth within our own lives."
The writing of the book took me there. On the other hand, while I did not write about my cancer, all I was experiencing and learning during that arduous time informed what I was putting on the page. The hours at the hospital opened me to efforts and challenges I had never known before. The days at home with my friends who came to cook and clean and cheer me up softened me into receiving, into letting go and enjoying what I could. The difficult time with my partner, in which the relationship deteriorated into distance and pain, etched cruel lessons on my heart and let me know how difficult forgiveness is. Those days were a deep and rich passage.
As the weeks of chemotherapy wore on, I became more and more ill. Weakness took me, until I could barely stand upright and I had to take several naps a day. My sense of taste deserted me, leaving only one flavor, that of sawdust laced with chemicals. I lost weight steadily. Eventually I could not eat solid food and was existing on fruit smoothies. My eyes hurt so much I could barely read; my skin cracked and bled; I had sores in my mouth.
Twenty weeks of chemo. Twenty-five weeks. I had twenty-three more to go, for I was to do forty-eight weeks in all. How appalling!
"Listen to your body," said my acupuncturist-friend. Now this was something I knew how to do, for my meditation teacher, Ruth Denison, had emphasized the First Foundation of Mindfulness, the body. Guided by her remembered instructions, having had much practice over the years, I turned to focus on my physical sensations. I sat down and listened.
My body did not hesitate to give me the message: "This is too much poison for me. The chemicals have done their job and now theyíre killing me."
I was plunged into a painful confusion, for Dr. Cutting, head of the oncology department at Highland Hospital, had insisted that the forty-eight week set of treatments was necessary. It was simply what people did for colon cancer, with no adjustments or alterations even contemplated.
The implication was that to survive you had to stay the course. But then I thought of Ruth Denisonís urging us "not to injure life," and I knew that each successive dose of chemicals going into my veins would be stealing my vital energy and perhaps hastening my death. I suffered through several excruciating days of indecision. This not-knowing was worse than anything I had experienced before. But finally, as sick as I was, I could reach to my strength. I realized I had to stop the chemotherapy.
Now came the challenge of confronting Dr. Cutting. A short, truculent sixty-year-old, he did not take kindly to insubordination. I knew he would try to bully me into obedience, scare me with statistics, berate and intimidate me to make me continue the treatments. So I carefully prepared. I wrote out all my reasons for quitting chemotherapy, and I asked Sandra Butler to go with me, for I knew she was experienced in talking to doctors.
On the appointed day we went in to the oncology clinic at Highland, where I was scheduled to receive my next dose. I told Dr. Cutting that I had decided not to take any more treatments. I remember him leaning back against the counter, his eyes behind his glasses bulging in surprise. Then he pondered a moment, nodded, and spoke.
His words astonished me. "Well, if itís too much for you," he said, "then itís right to stop." And he went on to talk about how little the doctors know. "This forty-eight week duration is really quite arbitrary," he explained. "No one has done trials to determine if fewer treatments would work as well. We just donít know."
Apparently, my determination to follow my own perceptions and intuition gave him permission to drop his usual authoritarian manner and talk to me not like a patient but like another intelligent human being. I left his office feeling supported in my decision.
Gradually, over the ensuing weeks and months, my body began to recover from the assault of the poisons. I worked at getting well, building strength, hoping my damaged tissues would repair themselves.
A year and a half after quitting the chemotherapy, I find that some of its effects still remain with me. I have almost no sense of smell, and my ability to taste has been seriously diminished. I assume these changes are permanent, and I miss my former keen capacity to enjoy odors and tastes.
There is a deeper change. My identification with my body is seriously compromised. I have known its malfunction, its weakness; I have come close to losing this body to death. I had had experience in meditation of the impermanence of my physical self, its existence as flux, as a dance of energy. But now I sometimes perceive myself in quite ordinary social situations not as a solid entity but as a sheet of light passing through, or as unfocused vibration hovering in the scene.
In the fall of 1996, and again in 1997, I underwent a colonoscopy and other tests to determine whether I was free of cancer. Both times the results were negative. The news came, to use an image of Rilkeís, like spring rain falling on parched earth. But I have not left the ordeal and its effects behind. Having cancer is the door into a whole world, one populated by millions of patients, doctors, nurses, social workers, therapists, alternative practitioners, druggists and others. Some dimensions of it are depressing or frightening; other parts bring daily life into sharp focus.
The cancer support group I attended all last year had a special meeting recently. We gathered to honor our members who had died, five of them. I had been brought into this unusual group by Rick Fields, the Buddhist author/editor. Located in a church basement near the University of California in Berkeley, the support group includes professors and therapists and a second Buddhist, Rick Kohn, an academic whose specialty is Tibet.
Here was a place where explanations were not necessary, where I could talk about a proposed treatment and hear, from people who had experienced it, what it felt like to receive it. Doctors always minimize the effects of any procedure or drug; my friends in the support group gave me the truth about how I might feel. And we laughed a lot. Sometimes when things get too bad, they get funny. We would fall out over the non-choices offered to cancer patients: "Well, you can do this horrific treatment or you can do this other even more grotesque one. Of course neither of them may work. Now which would you prefer?" We giggled about the "side" effects of treatments and made bitter jokes about the sometimes appalling attitudes of doctors and other caregivers. The most egregious insults and instances of medical incompetence sent us into guffaws. Being among these people was wonderfully restorative.
For our memorial I brought a candle, and there was a meditation bell provided by Rick Fields. Our leader, a nurse and social worker, wrote the names of the deceased on pieces of paper and placed them around the candle. We reminisced about each woman (they all happened to be female). We brought them alive in the room: Rella there on the couch, chuckling as she told us about fainting in the parking lot from low blood pressure; Joyce hooked up to an oxygen tank, her feet on the lap of her husband; Henrika, small and wiry as an aged child and always intense, telling in a thick Russian accent about the walk she had managed to take that day despite the pain in her legs.
Then a woman new to the group talked. She had just been diagnosed with inoperable lung cancer, and the doctors had given her six months to live. "Strange," she said, "Iíve never felt better in my life; I have tremendous energy; and then I have to remind myself that Iím dying."
At lunch afterwards, Rick Fields and Rick Kohn and I talked a little about receiving and giving back in the group. Our Buddhist training has given us a slightly different perspective from others, for we had long been asked to contemplate our own disintegration, to allow for the passing away of everything we know and hold dear, to accept this impermanence as a natural part of living, even when we were most healthy. In a sense we are more at home with ideas of disintegration and death than others, and this perspective can be helpful in the group.
Giving back: since 1995 there have been many opportunities to do that. Cancer, after all, is an epidemic in the United States. Very soon someone near to you will have it, or perhaps it will be you. The Charlotte Maxwell Clinic for Low-Income Women with Cancer in Oakland had been a place I went every Saturday afternoon. There I received free massages, acupuncture and acupressure, and guided meditation which allowed me to express my sorrow at the changes in my body.
The Charlotte Maxwell Clinic had helped me tremendously to withstand the ordeal of treatment. Now in the fall of ‘97, when they asked me to teach several writing workshops at a retreat for cancer patients, I readily accepted. Fifty cancer patients were bussed or drove to the hills of northern California for this three-day gathering. Among them were a large proportion of women of color, African-American, Hispanic, Asian. Many of these women and the low-income white women would never have been able, on their own, to get out of the city to the relative luxury of gracious old residences and a large dining hall with excellent food. It was a great luxury to be there, away from family responsibilities and jobs.
Many of the women were gravely ill, bald from chemo, walking slowly supported by canes or walkers. As I talked with these women I realized a major effect of my year in the whirlwind. I know now what it feels like to move slowly, with great effort, while others stride easily past; to look at a plate of food and have my stomach begin to rise up into my throat; to exist in a vague, energyless state, feeling vulnerable to the physical world, weighed down, inadequate. Because of this knowledge I was comfortable with the womenís illness and debility, able to see through the symptoms into the person who is always there, intact, as I was even at the worst moments.
Before cancer, I had been frightened by illness, had pulled away to protect myself. Now I understood there was nothing to protect, and I found myself capable of being attentively present with each woman there.
What I heard them saying was that as women with cancer we have lots of reasons to hide our feelings, even from ourselves. Sometimes we have to numb out in order to get through a particularly harrowing treatment. We pretend for our children or our partners or friends that we feel better than we really do, in order not to worry them or cause them to turn away from us. Weíre cheerful and "normal" with our boss and coworkers, just to make it through the day. Sometimes we find that weíve wrapped up our feelings and hidden them so deep that we donít even know they exist anymore. Writing can be a way to get to those hidden feelings, to bring them out into the light and express them. It was this opportunity I wanted to offer to the women in my workshop at the Charlotte Maxwell retreat.
We sat in a small lounge on couches and comfy chairs, and the women checked me out. I remembered dancer Anna Halprinís saying that the classes she most likes to teach are for people with life-threatening diseases: "Because thereís no bullshit. Everyone just gets right down to what theyíre feeling." I asked each woman to write a letter to her beleaguered body, to acknowledge the changes in it, with compassion, and allow herself to feel her reaction to the alterations.
As the women wrote, I looked around the room. Here was an East Indian woman with the short crewcut of someone coming back from chemo baldness, a young white woman looking energetic and healthy, a snowy-haired old woman reclining on a couch, an African American woman whom I knew was an organizer as well as recipient of services. Others. Everyone bent to her task.
When I asked them to read their letters aloud, I could feel them pull back. Their faces told me that the words they had put on paper would be difficult to reveal to others. Finally one woman read her short letter, her head down: "...the loving, touching men are gone." She struggled to maintain composure as she went on, "The women and children are still here. They love us for who we are, and just the way we are." Tears coursed down her face as she looked up at us in astonishment. "I didnít think I would cry!" she exclaimed.
For an instant I faltered. Had I made a mistake? Had I plunged these women into gratuitous suffering, for the sake of an exercise? It was a heart-stopping moment.
Then the African American woman spoke from across the room. "Itís good to let it out. Go ahead and cry." And she added, "I keep a journal. Every day I do this, and it helps me go on." Heads nodded.
Every woman in the room read then, some expressing grief at their losses, some detailing their determined coping with the effects of disease and treatment. Each letter began "Dear Body,"
, I see that your salivary glands are not moistening the right side of your mouth since the radiation. Here, keep this water with you always...
, Yes, youíre 70 years old now. Itís not just the numbers but what happened four and a half years ago when your cells kept dividing and you had surgery for breast and ovarian cancer. You recovered very well and didnít even cry until your hair fell out! Oh how vain we are!
, I do not like this body anymore...I used to feel sexy, attractive... Now I feel no one is looking at me...My body image, well what can I say? You have been chopped up so.
, In my teens you and I spent hours on mountains, under water, in gymnasiums, on tennis courts, in the woods. You followed through with me and my sometimes careless movements, but never broke. A strain or two but we never needed crutches or casts or slings. We had great fun together in pools, lakes and forests. I was so sure that we were indestructible. What happened?
, You are absorbing so much and I am grateful for all you have been able to take on. The flexibility you have shown me is beyond what I could have imagined you could do now that I look back on this journey....More and more I am listening to you and enjoying our newfound relationship...
More tears were shed as the women read their letters. I realized that this expression, heavy as it felt in its rawness and honesty, came as a relief to everyone there, that it cleansed and lightened.
I had been asked by the organizer of the retreat whether the material produced in my workshop might appear in an article in the newsletter. I was uncertain, wanting to protect the privacy of these women. She convinced me to propose this to them. When I did so, they thought about the prospect and then almost everyone in the room agreed to let her words be published, and some specified that they wanted their names used. I think they understood, more quickly than I, how useful these expressions might be to other women enduring the trauma of serious illness. Suffering, after all, is universal. Just as I had sought out the words of Audre Lorde and Isabel Allende and Nan Shin, these women knew the importance of communicating the truth of our experience.
My own truth? Well, more than two years have passed since I went for that fateful test. My love relationship is gone. I am learning to be alone in the world, to take full responsibility for myself. I have moved twice. In my new place I feel I have entered a new life. At age sixty-one I have a heightened sense of the shortness of the time ahead of me, and that unburdens me of much baggage from the past. There are some books I want to write, some places on the globe I want to visit. I hope to stay as healthy as I am for many years to come. But if next month I discover that my cancer has returned, then I will live that reality as fully as I can.
There was a Zen master whom I loved, who herself died of cancer. Maurine Stuart headed the Cambridge Buddhist Association. She had been a concert pianist, she had raised children, and she was a strong Zen teacher. "Whatever comes, good or bad," she told me, "donít make a move to avoid it." These words hold me steady; when I want to run off into worry or fantasy or denial, they pull me back into the very center of my living, where each day brings a new set of challenges, and joy often falls like spring rain upon me. ©
Quotations are from Rilkeís Book of Hours: Love Poems to God, translated by Anita Barrows and Joanna Macy.
Sandy Boucher is the author of Turning the Wheel: American Women Creating the New Buddhism, and Opening the Lotus: A Womanís Guide to Buddhism, both published by Beacon Press. Visit Sandy Boucher's web site at: www.sandyboucher.com
The Meaning of Dog
The Meaning of Dog
For the Monks of New Skete, the question "What does it mean to be human?" led them to ponder, "What does it mean to be dog?" In the process they made the raising of dogs an integral part of their spiritual practice and transformed our understanding of people and their companion animals.
It is one oíclock in the morning. Outside it is pitch dark and the ground still covered with snow. It is time once again to witness the miracle of birth. Father Marc, who will this night act as midwife, turns on the light in his cell. He has been roused by Kirka, the German shepherd who sleeps each night at the side of his bed. Making their way to the kennel complex with the aid of a flashlight, the expectant mother begins whining, restlessly churning up the nest prepared for her in the immaculate and roomy space. He stoops down to soothe her and it is clear that she accepts his presence. They have been through this before.
It will be hours before Father Marc is able to rest: nothing in this place is left to chance. He will stay until all the puppies are born and cleaned of the afterbirth, and until he is certain that the new family is enjoying their first meal. Although they do not know it, these small German shepherd pups are extremely fortunate. Their caretakers for the next seven or eight weeks will be the monks of New Skete.
In the late sixties twelve Eastern Orthodox monks purchased five hundred rocky and forested acres on Two Top Mountain in upstate New York near the Vermont border. Having their own land, they felt, would better allow them to put their monastic beliefs into practice. Here, surrounded on all sides by the Catskills, Adirondacks and Green Mountains, they began to explore the possibility of breeding and training dogs as a way to achieve economic self sufficiency.
Since then, over a period of almost thirty years, the monks of New Skete have built an impressive reputation as dog breeders and handlers. They have authored two best-selling books on the subject and have just completed a three-part training video. People throughout North America visit them, some bringing companion dogs exhibiting a wide variety of behavioral problems. Three weeks later, having passed through the monksí training program, the dogs will go home cooperative and happy companions.
In addition to all of this the New Skete community, which includes a sister community of nuns and one of lay persons, operates a number of successful mail order food businesses. Not surprisingly, they have recently begun making and selling gourmet dog biscuits.
The community takes its name from the word skete, originally a remote desert settlement of monks in fourth century Egypt. Later it came to mean any small, family-style monastic community with one spiritual leader. The name New Skete recalls the early Desert Fathers and a life of rigorous spiritual enquiry. In this way the group expressed from the outset its commitment to "the essence, the main and deepest principles of monastic life."
Pre-dating their dog breeding and training programs, the monks maintained a full scale farming operation. Surrounded by goats, chickens, pigs, pheasants and cows, they were, even in those early days, and without realizing it, "beginning to enter the psychic realm of animals."
Father Marc has been a member of New Skete since the beginning.
"When we first moved here," he explains, "we had a wonderful male German Shepherd whom we called Kyr, which means Your Eminence. He was a large, beautiful, and wonderfully tempered dog. He had been born at the Institute for the Blind but they had been unable to use him in their program. He was pretty much a member of the community and we began to experience what a dog of this intelligence and background could do for an individual and for a community, as far as enhancing the quality of our social and emotional life here."
Unfortunately the monks lost their spirited companion, who one winter day was lured away and mauled by a pack of domestic dogs running wild. In time, he was replaced by two females who eventually became the start of their breeding program.
Before initiating their breeding and training programs the monks were helped in their understanding of the canine mind by another member of the community, Brother Thomas. He trained the German shepherds to live in the monastery as a group, and in a way which was appropriate for the environment. Every new monk who entered the community spent a period of apprenticeship with Brother Thomas.
In their first book, How to Be Your Dogís Best Friend, they explain: "More than merely instructing (us) in handling skills and techniques... Brother Thomas tried to communicate an intuitive way of dealing with dogs. He emphasized Ďlisteningí to the animal and Ďreadingí the dogís reactions. His training and handling skills were passed on in an oral tradition that is still alive at New Skete."
Blending intuition, research and experience, the monks embarked on an experiment that was itself a reflection of how they saw the rest of their lives. Since, as one member of the community expressed it, "monastic life is a search for the expression and realization of human perfection," it follows that they would approach their future as dog breeders and handlers with the thoroughness and inquisitiveness that marks everything they have undertaken.
"We studied our breeding and training plans carefully," explains Father Marc. "We acquainted ourselves with any and all information on the subject we could find. We contacted prominent breeders and trainers, asking for advice and counsel. Recognizing our sincere interest and our desire to learn, they shared their knowledge freely with us."
At the same time, the monastic experience calls one to go beyond words and to live, as Brother Christopher puts it, "a life without division." It is an important point, since only in this way can one appreciate the extent to which, in the process of raising and training dogs, the monks have also enriched their own spiritual practice. Frequently, for example, the monks speak about the discipline of "inseeing," a term they borrowed from their readings of the German poet Rilke.
Father Laurence, the abbot of New Skete, regards inseeing as the true meeting place of the contemplative mind with the natural world: "Inseeing is being willing to look at another living thing in a way that allows for seeing it in and of itself. It is respecting this Ďotherí for what it is, without trying to change it or own it. In this struggle to deepen oneís understanding one is enriched, given life, no matter how limited oneís success in this endeavor."
It follows, therefore, that in the creation of their dog training and handling programs the monks would begin with respect for what the dog needed and would approach it in a uniquely holistic way. While most dog training regimes are strictly utilitarian, limited to the sit, down, stay, come and heel commands, the monks approach each dog, says Father Marc, "as a unique creature." And further, "Instead of seeing training as our main approach, training is just one element that fits into the larger element of socialization. Training is certainly one means of socialization, one aspect of it. But we try to fill in other aspects too, which means the human-dog bond, the emotional bond, the working relationship, the dog and the human as fellow pack members."
The association of monastic figures with dogs has a rich history. The story of St. Francis of Assisi and the taming of the Wolf of Gubbio is probably the best known of all. In the case of St. Dominic, the dog became associated with spiritual enlightenment. The story is told that before St. Dominicís birth his mother dreamed she carried in her womb a black and white dog that would come forth, carrying a torch in its mouth and setting the world on fire.
In another story the Irish Brigit (453-523), asked to prepare a dish for a distinguished nobleman visiting her fatherís house, was given five choice pieces of bacon. A starving hound found its way to her kitchen and, evidently suffering greatly from hunger, was given three of the pieces of bacon. Each piece fed to the dog was miraculously replaced. Then seen as blessed food, the dish was offered to the poor.
The monks at New Skete gained understanding of the dogsí needs from their research into wolves, believed by many to be the domesticated dogís nearest relative. Dogs, like wolves, are pack animals and as such do not tolerate being isolated for long periods of time. In the domesticated environment, humans become responsible for providing the physical and emotional closeness formerly provided by the pack. Additionally, both dogs and wolves are responsive to leadership; in fact, without it they become unruly and emotionally chaotic. Brother Christopher, who is principally responsible for the training of outside dogs, explains:
"We really paid attention to what dogs are on a natural level through studying wolves and becoming more sensitive to what dog behavior really means. From that, we began to apply those lessons to our own situation of forming relationships with dogs and expanding on the pack concept.
"We saw for ourselves that dogs are very conscious of social hierarchies, that they require leadership. Because this is a sort of laboratory, we currently live with fifteen dogs here in the monastery itself, we had an experiential awareness of these principles. We were able to see how they worked in real life and how they not only enhanced our lives but how they enhanced the dogsí lives."
To be fair to the dog, I have to enter into a relationship with the dog as dog. I have to listen to the dog, to what the dogís needs are. I have, for example, to assume the role of leadership that the dog requires for it to really achieve its potential, to really flower."
This is key to understanding the principles which inform every aspect of their handling and breeding programs. From the moment a new litter of pups is born, and in all their interactions with their own and othersí dogs, the monks of New Skete work to bring the animal as close to its potential as possible. Through their breeding program, the German shepherd has been brought once again to the official standard of conformation, intelligence and emotional health.
From the first week of life, for example, New Skete pups are exposed to a moderate amount of physical handling. The monks say that this handling, although somewhat stressful, helps the dogs develop into adults with superior problem-solving abilities and a greater degree of emotional balance than counterparts raised in the absence of such stimulation.
In one such exercise, Father Marc lifts a four-week-old puppy into the air on the end of outstretched hands. For two or three minutes the small rotundity may voice its protest, experiencing for the first time a sense of height, the chill of the air, and its own aloneness away from the familiar warmth and sounds of littermates and mom.
In addition to increasing the heart rate, the monks say this also "causes an involuntary hormonal reaction in the adrenal-pituitary system, a help in resisting disease and handling stress. The overall effect of this is to prime the entire system, building it up and making it more resilient to emotionally challenging experiences later on in life. When puppies receive consistent, non-traumatic handling, they become more outgoing and friendly and show less inclination to be fearful once they are older."
At the end of the exercise Father Marc gently lowers the pup to his chest, where he will hold it and speak in a reassuring tone of voice. Eventually the pup will approach the whole episode with a totally relaxed and nonchalant attitude. The repetition of a simple action, stressful but not overwhelmingly so, and followed by reassurance and affection, is one of many that will, over the weeks remaining before they go to new homes, lay the foundation of confidence, trust in humans, and emotional health. To the enlightened owner, signs of emotional well being in their dog are unmistakable.
Thomas Merton once wrote that a monastic community "challenges the modern mind." At New Skete this has taken on new meaning. In their search for answers to the question, "What does it mean to be human?" the monks at New Skete have been led into a lengthy, experiential enquiry into "What is dog?" To speak with them is to be infected by the enthusiasm and warmth they express on all subjects, whether it is the dogs, the wholeness of the monastic life or some point of spiritual or psychological enquiry, as well as by the possibility that this harmony of activity and contemplation might be available to all of us. Listening to Father Marc speak, one is struck by the interconnectedness of all aspects of their life and work at New Skete:
"What we have tried to do here is to live a healthy spirituality. One that is life affirming, one that goes to foster the spiritual integration of the whole human being, and to live a religious life that is less preoccupied with negativity and more preoccupied with genuine spiritual health.
Spiritual practice is both a doorway leading into deeper understanding and consciousness and awareness, but also an expression of the joy of having that awareness. Just as when we train dogs, we donít train them to obedience just as part of an exercise: it is part of a bigger picture. It is not only a training like going to school or disciplining ourselves going to the liturgy. It is a celebration of life."
Ray Hunt: The Cowboy Sage
Ray Hunt: The Cowboy Sage
Ray Hunt changed the relationship between rider and horse from a battle for dominance to a dance of gentleness, communication and mutual trust. Gretel Ehrlich profiles an American sage, a cowboy who teaches riding as a path for both human and animal to realize their true nature.
"Truth is Ďoneí: clear water has no front or back.", Yosa Buson
They are all young horses, two- and three-year-olds, untouched, unjaded, incomparably strong and innocent as they mill around a high-sided round pen on a ranch made of big fleshy hills with morning frost on the grass and a breeze strong enough to lift the sun up over the ridge. Thereís a blue roan, a bay, and two sorrels, all quarter horses, and theyíre snorting, sniffing, flicking their ears, trying to understand what is going to happen to them.
"Theyíre a little troubled, see, and when their minds are troubled then it shows in the body," Ray Hunt says as he rides into a pen. "A horse will tell you what he understands and what he thinks about it. Heís telling you all the time, but you just donít see it, youíre just not willing to go that far in his direction. Thatís okay, but youíre not going to get too much back. To have a willing communication with a horse, youíll find that first, you have to develop awareness and discipline within yourself so that you can have it with your horse later."
Tall, raw-boned, leathery, Ray was raised on an Idaho farm with a father who used draft horses to plow, plant, and cut hay. He grew up the hard way and at various times, he picked fruit, hoed beets, and drove heavy equipment, anything to make money. But the work he was born to was cowboying: he rode the rough stock, the wild, untrained horses, on big outfits in northern Nevada where it was common to ride fifty miles a day. Now sixty-eight years old, he has given up the dream of owning his own ranch and devotes his days to teaching humans how to handle a horse, what used to be called "breaking colts."
At some point in the year you can find a Ray Hunt clinic in Montana, California, Alberta, Texas, or on a remote cattle station in Australia. A clinic lasts five days. Mornings are for green colts, young, unridden horses; afternoons are called horsemanship classes, for people with horses that have been ridden fifteen or twenty times or so. Within a very short period of time an untouched colt will accept being caught, haltered, led, saddled and bridled (snaffle bits only) and ridden, and will learn the rudiments of backing smoothly, sliding to a stop, turning on a dime, and changing leads, in an atmosphere so quiet and unhurried itís hard to believe anything has happened at all. When I asked Ray how he made this happen he smiled and said, "Oh, I just work with the mind."
What Ray teaches has nothing to do with breaking, riding styles, horseshow events, or communing with nature. Heís so self-effacing, heíll hardly admit that the best-selling book, The Horse Whisperer, and also the movie of that name, were based on Rayís work with horses, as well as his student, Buck Brannaman, and the elder statesman of horse training, Tom Dorrance.
You only have to look at Ray to see that he doesnít suffer fools gladly. "This isnít just some commercial thing," Ray says. "I wouldnít do it. This is life. This is reality. Thereís no rulebook on this and itís damned hard to grasp because it comes from deep down inside. Iíve been trying my whole life and Iím still working at it. But when you do get it, pretty soon it starts coming back to you directly from the horse, and from then on itís a continuous thing. Thereís no end to what you can learn."
Ray leans over and strokes a coltís face with a big, gentle hand, then does the same to another horse, every gesture soft, but never sentimental. He moves easily between the animals, neither slow nor fast but with an even keenness that tells you everything about Ray and what he thinks a proper relationship between humans and animals should be. A toothpick rolls from one side of his mouth to the other. "To understand the horse youíll find that youíre going to have to work on yourself," he says matter of factly, in the same voice he might tell someone to pick up a bale of hay.
At the heart of Rayís teaching are lessons about giving, discipline, awareness, compassion, stillness, concentration, and intelligence, the Buddhist paramitas spoken in a western dialect. But how did a rough-hewn cowboy learn these things? Ray answers: "It didnít come easy. I didnít just scrape off the top and there it was. I dug and dug and tore my hair out. But I owe it to the horse to work this hard, because I used to do things the true grit way. Not out of meanness. Just ignorance. I guess I saw too many Charlie Russell paintings. I didnít know there was another way."
The true grit way looked like this: a green horse was roped out of the remuda, led struggling into a round corral, and tied hard and fast to a snubbing post from which he struggled to get free. Then his front feet were hobbled, and a cowboy would come at him with two or three gunny sacks, waving them in his face. More terror and struggling, then a saddle was thrown on, cinched up tight. The line to the snubbing post was cut loose and the rider climbed on fast. Around and around they went, bucking and snorting, the cowboy pulling hard on the halter rope which only made the horse buck more. "That word Ďbreakí wasnít used innocently. To break the wild, snotty, swift, flamboyant spirit of the horse, that was the whole idea." Domination and submission was the horsemanís goal.
A horse named Hondo made it necessary for Ray to change his ways. Hondo made it clear that Ray could be broken, but he, the horse, could not.
"Everything I know now started with that horse," Ray said. "Hondo was a sticking, biting, kicking, bucking tough colt who might have killed me. Hondo would tell me, ĎCome on and try to break me, and Iíll break in YOU again.í And he would have. But I had all winter to work on him. He was my only horse; without him, I was afoot. It was just him and me and I tried to put myself in his place. How did he get so afraid? What could I do to make him trust me? A horse thatís had trouble canít believe a human will quit hurting them. I felt sorry for that horse who had to hold up his defense. You canít blame him. I worked on him some and we got so I could get near him, then get on him. Iím not saying it was all love and kisses. You better believe it. Things could get pretty physical, pretty western. Iíd go to bed at night and think about that horse, dream about him, then go back to work with him the next day."
In the middle of the winter of 1960-61, Ray took Hondo to Tom Dorrance. "Heís a little old bow-legged cowboy, heís the brain of it all. He can fix a horse so fast you never knew what happened. And who taught Tom? He says it was the horse. As soon as Tom came around me, Hondo would act like a lamb. And as soon as he left, Iíd be riding a tiger again. I couldnít understand. Something was going on but I couldnít find it.
"See, I was too forceful. The timing was good but the mental feel of how it could be wasnít there. I couldnít visualize it and the yielding wasnít there. The horse was afraid of me. I thought I had to hurt him to get him rideable." Ray runs his wide hand down the neck of the horse heís riding. "I knew it wasnít right. And pretty soon, I learned that to get respect, I had to give respect.
Sometimes itís hard to figure out because a horse is so big and strong, but thereís a difference between firm and forceful. And thereís a spot in there, inside the horse, an opening where there is no fear or resistance, and thatís what I began looking for." By the end of the year Hondo was gentle, smooth, athletic, and kind to be around, a horse the grandkids could ride.
"You see," Ray says, sorting through horses until just one remains in the pen. "Youíre not working with just a machine, youíre working with a mind. The horse is a thinking, feeling, decision-making animal, and each one has a distinct personality. But the human always acts superior. He thinks heís smarter; he always wants to have things his way and right now. He wants to be boss. If trouble comes up, he turns it into a contest with the horse. But if you do that, watch out. You just may lose," Ray says, his horse moving so nimbly through the pen, it looks like heís floating.
"What Iím talking about developing with the horse is not dominating with fear, but more like dancing with a partner. Itís all balance, timing, rhythm, the kind of dancing where your body and his body become one."Day One, Ray Hunt Clinic. Early morning. Steam floats off the creek that runs by as Ray works a young colt in the round pen. She is loose, no bridle, no saddle, no halter. Never tied up or restrained, she moves smoothly, trotting first one way, then the other. He wants her to loosen up first, to travel freely. Then heíll get the mare to turn off the rail, stop, face the middle, look, and come to him.
"Iím doing some things now that will let the horse accept being caught. Itís awful hard to ride them if you canít catch them first," he says, grinning. The colt breaks into a lope, stops, tries to turn the other way, as a way of escaping, but Ray insists she keep going to the right. "See, Iím making the wrong thing hard and the right thing easy," he says, watching her. "A horse gets sure and unsure, scared and bold; she says maybe, all right, I donít know... But Iím going to show her that things can be all right." Terror increases. The horse pokes her head over the top rail of the round pen, trying to jump out. Again, Ray urges her to keep moving. "All I do is operate the life in the body, through the legs to the feet, through the mind," he says, never taking his eyes off her.
"Pretty soon sheíll come off that rail, sheíll turn loose and stop trying to escape." As soon as he speaks, the horse stops, moves her hindquarters around and points her ears at Ray. "Thereís a change," he says, meaning sheís beginning to relax with things as they are.
The young mare resumes trotting for a few minutes, and again she stops, turns, and looks. Ray walks toward her. "Iíll see if sheíll let me pet her." She stands as he strokes her head once, then she leaves. "Thatís okay. Iím not going to make her stay. Sheís still afraid I might hurt her and she needs to know she can escape. Sheís telling me that sheís not quite ready for anything more."
The colt moves off, traveling in the other direction. Her muscles are more relaxed and she has a calmer look on her face. "Pretty soon sheíll find out that things are going to be all right with me in here," he says, and, as if by magic, the horse stops, pricks her ears, and walks calmly to Ray: sanctuary.
Ray doesnít talk to horses, he makes each action count. He says, "It helps some people to talk to the horse but it doesnít help the horse. The horse is already whoa, and easy, thatís a boy, so why talk about it? She feels it. Itís all feel." When she gets frightened of his lariat as he puts a loop over her neck, Ray rubs her neck. Though he doesnít talk to them, he does talk for them: "Sheís saying, ĎIím a little unsure about you touching my ears,í so Iíll do it a few more times just so sheíll know nothing bad comes of it."
Then sheís out on the rail again and trots around the pen, obviously bothered by the rope hanging around her neck: "She was born with her mane and tail, so sheís not afraid of it, but sheís afraid of this rope," Ray says. Holding onto the coils, he slowly pulls on the rope to bring the colt to him. "Itís not a fighting pull, but a steady one." She lunges at Ray and strikes at him with her front feet. Ray faces her and steps back quietly, keeping the pressure on the rope firm. "Iím teaching her to yield to pressure," Ray explains. Not the brutal kind, but more like a telegraph thatís saying, Hey, come over here. The rope is taut, then she gives in. Her neck and shoulder muscles relax and, as she steps toward him, Ray throws slack in the loop. "Now sheíll see that itís easier to walk over to me." He strokes her head and her nose drops down onto his arm. Ray smiles.
For the next half hour he places the rope on different parts of her body, the rump, under the tail, around one front leg, around a back leg. She kicks, bucks, and squirms. "She canít find any good thing about the human right now," he says, patiently. "Sheís allowing these things to happen, but sheís still not sure and I donít blame her." Very quickly the mare accepts the rope.
With the loop loosely around her neck, Ray bends her neck around, strokes her head, bends it the other way, pets her, moves her hindquarters until her front feet follow through, backs her a few steps, leads her forward. "This is so sheíll yield and be flexible and Iíll move with her. You see, a horse is much stronger than I am, but if I prepare her for dancing, not fighting, I may survive."
He gets off his horse and gets a saddle blanket. He lets the horse see it, sniff it; he rubs her neck with it, under her belly, then puts it on her back. Next comes the saddle, not thrown on, but laid quietly on the horseís back. "I donít sneak my outfit on the horse, I put it on respectfully," he says, tightening the cinch smoothly. The horse is turned loose in the pen. "It might take her a few minutes to get used to that saddle," Ray says, his face and bearing unruffled when she lets out a few bucks, then lunges, strikes, bucks again, snorting each time. Ray watches calmly. "Thereís a change," he says, as she walks toward him working her mouth, a sign of relaxation in the horse.
"I give them a place where they can come to me. They see it in my body. But if they donít, I let them go by, because theyíre not ready for it yet." The horse stops, thinks about leaving. Ray watches her. "Thatís good with the mind, now here come the feet," he says, and she "turns loose," coming to him and standing quietly. He turns to the students watching him. "See, she had to check out a lot of things first. That doesnít make her wrong. You wouldnít punish a child for being afraid. Sheís a thinking, feeling, decision-making animal. She knows my mind and I try to understand her and she knows Iím her friend."
All morning he works in this way with six colts. Some are hard and resisting, spooky and fearful; others are quick to accept the rope, the human hands, the blanket and saddle, but have a more dulled sensibility. Ray picks up their feet, runs his hands over and under their bellies, moves them this way and that. Watching them, you begin to see that there is no "good or bad" behavior, and Ray is never critical. "I just keep trying to fix it up for them so they can find their way," Ray says.
By the end of the first day Ray has worked with each colt. He has taught them something about trust by getting them to accept what is being offered to them; about how to be caught by making it uncomfortable to run away; about yielding to pressure, which means surrendering pride; about how to find sanctuary with the human.Day Two. Boisterous thunder in the morning and smoke-like clouds streaming off mountain peaks: itís the scary day, the day to get on the colts and ride. Ray comes into the round pen on his gray mare and gathers his students around for a pep talk. His voice is deep, gravelly, slow.
"The horse knows. He knows the human twenty to one. Itís amazing how much heíll get out of things, how heíll fill in for as little as the human knows about him. How that horse can handle it has always been a mystery to me. Put yourself in his shoes to live your whole life where no one knows who you really are. Well, I havenít met a human yet who compares to a horse," Ray says. "A human couldnít take it. See, you can get a horse to do something if youíre tough enough, just like you can with a human. But a willing communication is a different matter. You fix it so the horse can try, then you allow him to work it out. You have to give him that dignity. You make your idea his idea.
"I believe these colts, I trust them. I always trust they can buck too. Donít think they wonít.... Just keep fixing it up and let them find it. Donít try to make it happen. Prepare to position for the transition. The transition is the last thing that happens. And donít try to be boss."
Ray works with each colt much as he did the day before, bending them, showing them how to turn loose by applying a firm pressure and holding them there until he releases. The horses are calmer in his presence. He ropes a sorrel colt by the hind foot; the horse kicks and kicks. "Pretty soon, heíll stay put," Ray says, and the horse stops and pricks his ears. Ray throws slack in the rope. Releases him to go both ways. Where Ray finds resistance, he works with the colt until the body becomes untroubled.
"I donít have a time limit on this. It might take a minute, it might take five years. Sometimes you have to keep offering different things. You donít want to drag it out of them and kill their desire and grit; you just turn it around, you turn it into life," he says as the young sorrel stops bracing against Ray and turns smoothly. "There he goes," Ray says, making sure the students see the change.
Now he lays the rope over the horseís rump. The horse kicks again. "He can live with that, he doesnít think so, but he can, because itís not hurting him." Ray makes the horse go, then stops him. "Let him explore the end of the rope for a second, itís part of the dance, and Iím leading." Again he throws the rope on the sorrelís rump; this time, no kicking.
Soon the colt is ready to ride. What makes Ray Hunt Clinics exciting is that the first day, the colts are ridden with no bridle. "It keeps you humble to ride a colt with nothing on their head," Ray says. "It forbids you to try to control the horse and the horse feels that, boy does he feel it, and thatís the beginning of trust."
The owner of the sorrel gelding, Jim, comes into the pen, catches halters, and saddles the horse. He stands in the stirrup. "If the horse canít take it yet, step off, then step on, and pet him on the neck. He likes that, he wants to know everything is all right and Iíll bet you do too," Ray says, grinning.
Jim finally throws his leg all the way over. Ray advises him: "You can pull that mane and tail out but donít pick up on that halter rope..." The horse stands with his front legs apart, bewildered by the man on his back. "There you go, good luck," Ray says, laughing. Then the colt blows up, jumping and snorting. The halter rein is flopping loose.
"If you pull on that rein, youíve got a contest going," Ray says, "and boy, youíll be teaching that young innocent horse how to buck every time you get on. This way, heíll get tired in a minute and find out itís easier to be quiet." Suddenly, the horse stops, trots for a moment, then hangs his head. Ray smiles.
The others start to get on their horses. "He says heís ready," Ray says, speaking for the horse, and hands a young woman the halter rope. A few crowhops, a half-hearted buck, then a slow trot over to the other horses. They stand placidly. "Is everyone fixed okay?" Ray asks. Everyone nods tentatively. He smiles, then turns them out into a big arena. The same rule applies: no using the halter rope for control. A few buck once, others hop, one runs to the end and trots back, others wonít move at all. "Thatís looking good," Ray says. Discipline, trust, tolerance, and respect have been put into practice. "Get them used to you, and theyíll accept you on their backs. You want to be just like the mane and tail."
He rides down to the far end of the arena where the colts have congregated and begins to work on giving and vitality, the dana and virya paramitas, asking the riders to pick up the halter rope, bend the head one way, pet them, then bend the head the other way, and pet them again. "That softness is in there, it goes through the body, down the legs, to the feet, and back into the mind. Itís there and you just have to bring it out," he says. "Get your colts to move now," Ray instructs them. "Have a lively feel in your body and theyíll get one in theirs too." The colts trot, lope, walk, then stop, as amazed as what has happened to them as the riders are. "Thatís enough for one day. You want to stop in a good frame of mind, not after theyíve failed."
At the end of the morning Ray gathers everyone around to tell a story: "A guy said, ĎThereís no use going to those Ray Hunt clinics, all he does is work with the mind.í Well what the hell else is there? I like to think itís 80% mind. You might have to do quite a bit physically, but once the mind is in tune, it takes almost nothing at all.
"What weíre doing with these horses isnít a miracle. Itís just there and you have to bring it out. I donít know how you are in your heart and your guts and your mind, but thatís where this comes from. Some of these colts had quite a bit of resistance in them. They had some hard spots and it was probably the human who put them there. You have to be patient. Do you know what that means? Respect and understanding. And sometimes you have to look deep inside the animal to see where the harmony is.
"Day Three. On this day the colts are ridden with snaffle bits. As Ray watches the students put the bridles on, he gives help here and there. "Here, warm that bit up a little, itís like an ice cube," he says, grasping the snaffle in his wide hand. He reminds them that although they now have a bridle on the horseís head, it is not meant for control, only to send messages. "Youíve got to be precise. You have to have something in mind before you pick up on those bridle reins," he warns them. The horses move out around the arena, first at a walk, then a trot with the bridle reins flopping. "Feel of the horse and for the horse," he says as the riders whiz by. Develop compassion.
Then he begins working on dhyana and upaya, concentration and skillful means: "The reins should feel like silk in your hands," he says. "There should be a float in them. You should feel weightless." Horses and riders go around and around. He asks them to walk, trot, lope, stop, back, turn, do a snake, weaving in and out. "See how little you can do," he keeps saying. "Bring the horse to a walk without using the reins. It should be in your body. See how slow and soft life can be without letting things die," he says.
Horses trot by. "Now pick up a feel and speed them up. Donít sit there like a gut shot bird," he says to one rider. Laughter. "Your legs are more important than your hands," he says, moving his own horse into a trot to demonstrate. He hardly moves in the saddle, yet the horse turns one way, then another, slows down, speeds up, stops. "When Iím on this horse he becomes my body, feet and legs. The reins are really hooked onto my feet and the horse is between my legs, arms, and hands. Donít brace in the stirrups or heíll brace back, and thereís a buck in his brace ...."
He continues to watch intently. "When I move my horse the impulsion comes from behind. Try to understand how important it is to know what is going on behind you, as well as what is going on in front of you. Ride the horse all the way through!" He lopes his horse forward, then around in a circle. The horse clamps her tail down as if sheís ready to buck. Ray grabs some mane, never the reins, and gives her something to do: ten figure eights, one way, then the other way, horse and man moving like a powerful engine. He stops her in the middle of the arena and she stands. "See she had something else on her mind so I took those ideas and turned them into something else without punishing her."
Things in the arena get slightly chaotic but Ray has eyes in the back of his head. He knows where everyone is and what each horse is thinking. He asks the riders to count cadence, to tell him where each foot is as they trot by, and the dance begins. "Itís one mind and one body," Ray yells out. A horse and rider pass behind him: "Thatís right," he says. But how could he have seen that horse and rider suddenly feel in harmony? She comes around in front of him: each rein seems to lift a foot and the horseís legs drive through the center of the riderís body like pistons, pumping up and down. They move as one.
Last Day. Ray gives us a farewell talk. He is stolid and straight in the saddle and his voice is raspy from dust and fatigue. He speaks pointedly, passionately, looking at every horse and every rider: "The horse is a mirror. It goes deep into the body. When I see your horse I see you too. It shows me everything you are, everything about the horse. I try to face life for what it is. Thereís heartache, but itís a good thing. Iím trying to save the horseís life and your life too. The human is so good at war. He knows how to fight. But making peace, boy, thatís the hardest thing for a human. But once you start giving, you wonít believe how much you get back."
He looks down, wipes dust from his eye. Giving, discipline, generosity, patience, compassion, skillful means, wisdom, harmony, thatís what Ray has been teaching. He continues:
"Donít present things that are too hard to learn, donít be arrogant. Allow the horse to learn in his own way. This takes discipline and maybe that will be the hardest thing for you. When youíre riding, try to do more by doing less and less. You have to be on the spot every moment because thatís where the horse is. Donít worry, heíll teach you if you let him. Fix it up and let it work. Turning loose means that when you reach for him, he softens. That goes for you too. It should be like silk all the way," he says, then turns his horse to go. He pauses. "Itís hard to teach what Iíve been talking about all week because the first thing you need to know is the last thing youíll learn. But I can tell you this: when you get to square ten, all of square one will be in it."
We Will All take This Journey
We Will All take This Journey
Dr. Rachel Naomi Remen on illness, loss and spiritual growth.
Shambhala Sun: What is the distinction between healing and curing?
Rachel Naomi Remen, M.D.: I believe that while curing happens at the level of the body, healing happens at the level of the whole person. Curing is the work of experts but healing is our birthright. We are all healers.
I have experienced healing not only as a physician but as a patient with a forty-four-year history of chronic illness. My own response to illness, my own healing, has been very much like a spiritual journey. Like any spiritual path, it has been necessary to let go of life-long beliefs, ideas and attitudes in order to have a greater wholeness.
Often illness is a powerful evocation of the soul. Thereís something in the nature of illness that can awaken people to experience beyond themselves, the sort of experience that all practice and all religion may evoke in us as well. Suffering is a great awakening.
Shambhala Sun: This journey you describe, illness and death as a spiritual challenge, is one we will all take.
Dr Remen:Yes. Life is about loss, and all growth is based on loss. When weíre not willing to let go of what is a part of our past, what has been used up, what no longer affirms our lives, thatís when we stop growing.
You see, nonattachment is one of the basic capacities which allows spiritual growth. Those people who are capable of nonattachment often are able to live most fully; they have moved beyond fear of loss to be more present in their lives. Therefore, they are able to be more deeply touched by their lives, to grow in wisdom and to learn how to live better. Sixty per cent of the people who have had near death experience report that the fundamental purpose of life is to grow in wisdom and to learn to love better.
Shambhala Sun: Though many people, when they hear the word "nonattachment," would assume that implies a certain passivity, which might not be helpful in conquering a difficult circumstance.
Dr Remen: Actually, nonattachment has little to do with passivity. Itís a very active position. When you are nonattached, it means youíre not attached to a specific outcome; you stand prepared to meet whatever the outcome will be, and therefore you are able to show up for whatever happens.
People who are attached to something fear loss, and itís very hard for them to be fully involved with life, to give themselves to it fully, because theyíre constantly guarding themselves against the possibility of loss. So they lose the very life that they wish to have by trying to hold on to it in that way. A lot of people do that with relationships. They are so anxious not to lose a relationship that they become inauthentic. They say only what they think the other person wants to hear; they do only what will please the other person. They may end up having the form of a relationship, but this is not an authentic relationship. It is an empty form. Often people are lonely in the midst of such relationships.
Shambhala Sun: So youíre saying that in dealing with illness and suffering, you have to engage your full being in the present in order to bring all of your resources to bear on the situation.
Dr Remen: Exactly. I think illness and pain and suffering have the potential to turn us into spiritual warriors.
Shambhala Sun: What would you describe as the attitude, in a broad sense, that best helps people deal with the difficult circumstance of illness?
Dr Remen: My work is with people with cancer and their families, so I work with people in a very extreme circumstance, many of whom are quite young. I think what can help people at such times is a certain kind of openness: letting go of expectation and meeting what is happening in their lives with impeccability.
I remember one of the first patients I had, a lawyer, a very controlling kind of person. She was a person who took charge of everything and everyone around her. Through the experiences of her breast cancer, she became a far larger person than she was before this illness struck her. I asked her during the last of a series of the sessions if she had gotten what she came for in our work together, and she replied, "Oh no, of course not. I didnít get what I came for." I said, "What do you mean?" and she said, "Rachel, when I came here I didnít know that what I have gotten even existed."
Perhaps thatís what itís about. Real growth is always a surprise. Wholeness is a surprise. Itís about emergence, revelation, and a letting go of the ways we have defined ourselves that are too small. It is a recovery of parts of us that we have disavowed and even forgotten, because perhaps the culture disavows them. It is a recognition that our healing may be determined by those very parts that we have disavowed, the heart, the intuition, the soul.
Shambhala Sun: Youíve made a distinction between healing, a spiritual challenge, and curing, a medical process. Is there a relationship between the two, however: does this attitude of openness and acceptance that you call healing also help the process of curing?
Dr Remen: I think this attitude furthers the curing process also. Holding expectations is not often a good way to live. If your expectations are not fulfilled you become like Lotís wife, frozen into a pillar of salt, looking backwards at some place which used to be, unable to take hold of what is real for you now and move forward.
It is hard to make necessary decisions about treatment from such a place. For example, it took me many years to decide to have the surgery that allowed me to live more fully, because I was so attached to having the perfect body I had before I became sick. Attachment can interfere with care too.
Of course, curing can happen without our participation, except as a physiological being. Itís possible to cure people without very much of their participation, but healing requires a very active involvement. Healing is a form of growth, if you want to think of it that way; curing is a form of repair. These are very different things.
Shambhala Sun: Is there a connection between repair and growth?
Dr Remen: Repair may offer us a chance to focus our lives on something beyond our disease, but the nature of repair is different from growth. Repair is external, something I do to you. Growth is a capacity within you that I can collaborate with. Iíve been involved in both sorts of relationships. As a physician I was trained to be a highly technological curing person. Iíve been in curing relationships for many years, and Iíve also been in healing relationships. Itís a very different experience.
Shambhala Sun: The kind of approach youíre describing, which is not aggressive and goal-oriented, sounds very different from the way most people look at the medical process, and indeed from the way our culture views accomplishment entirely.
Dr Remen: Well, in both approaches one might take the same sorts of actions. From the outside it might look quite the same, but the experience of the person taking the action is very different.
A number of years ago I was listening to the radio when a football coach was talking about why his team was on a winning streak. He was saying he had got them into a state of mind where they were just as willing to lose as they were to win, where they loved the game unconditionally. He was basically talking about nonattachment. Nonattachment is what Olympic champions are trained in. They have imagery coaches and meditation coaches because theyíre aware that the physical body can actually achieve better if the mind relinquishes its attachments and gets out of the way. So there are these connections; perhaps we can recover from disease best when we love life unconditionally.
Shambhala Sun: When you work with people who have cancer, how do you help them?
Dr Remen: It depends on who the person is. Each person has cancer in their own way. Each person will heal in ways as unique as their own fingerprints. So itís important for me to listen to the uniqueness in the other person, and to help them to listen to their own uniqueness.
Shambhala Sun: But you have pointed to this theme of nonattachment, of being with what is happening.
Dr Remen: What helps varies from person to person; there is no formula. There are many people today who have never been attached to life, people whoíve never gotten involved in their lives at all. Itís like, "Whatever ..." You know, how teenaged kids say, "Whatever ..."
These people need to commit to life. They need to recognize that they do have preferences, that something matters to them. Nonattachment comes after you know your preferences and then you learn how to be free. Some people start much further back than that: they have no idea of who they are or what they want in life, and they need to experience this first in order to find a sense of meaning in their lives. So itís a spectrum; people are in very different places in this process of being human beings.
I hope I am able to support the people I work with in taking their next step, whatever that is. Often the illness itself will point to it. Thatís the interesting thing. Embedded in the nature of the illness, in what is being demanded of the person by the illness, may be the very next step in their growth, in the refinement of their humanity.
You know, you can view life as a movement toward the soul, that we may be here in these bodies for the education of the soul. Education is a beautiful word; itís a word thatís closely related to healing. Educari means to evoke wholeness, the evoking of a unique, innate wholeness. Perhaps all the events of our lives have this capacity to educate, this potential to evoke our wholeness, to show us ourselves and life in different ways, to make our perspective larger and wiser.
And this event of illness is a particularly pointed one.
Yes, illness gets peopleís attention more powerfully than most other things.
Shambhala Sun: Itís become a cliche, but itís the famous Chinese ideogram, crisis/ opportunity that youíre pointing to.
Dr Remen: Yes, a dangerous opportunity. Crisis is "dangerous opportunity." But thereís danger only if youíre attached. Otherwise, itís an adventure.
Healing is a process: people donít start from a place of nonattachment. I certainly didnít start there. For the first ten years of my illness I was enraged. I was fifteen years old and I had been cut off from the normal life of a fifteen-year-old. My illness was telling me what I could and couldnít do; sometimes it was actually telling me that I didnít have enough energy to walk up a flight of stairs.
I dealt with that with a great deal of rage, which is a very important reaction. Rage is often peopleís first reaction to limitation, and it is an expression of the will to live. It is an expression of the will to resist a distortion, and as such itís quite important as a first step. But it will only take you so far. Eventually you have to feel the will to live in you directly without feeling it as anger. You have to feel it as a love of life, a willingness to take whatever youíve been given and make the most of it. Anger can become a problem if you become wedded to it as a way of life.
Shambhala Sun: Iím reminded by what youíre saying of a phrase that my own teacher used. He described our "sad and tender hearts" as human beings.
Dr Remen: Oh, I love that. Who said that?
Shambhala Sun: Chogyam Trungpa.
Dr Remen: Oh, how exquisite.
Shambhala Sun: Well, we donít find it easy to feel our tenderness and vulnerability and sadness, and it would seem to be even harder when facing difficulty.
Dr Remen: You know, vulnerability is strength. Like many spiritual truths, this is a paradox. My sense is that itís actually easier to feel our tenderness and vulnerability in settings of illness. There are a lot of people who would never otherwise do it. Their attention would be distracted from such things for all their lives. Ultimately illness can reveal our common tenderness and vulnerability; the realization that all suffering is like my suffering and all joy is like my joy is the doorway to genuine compassion.
Illness forces the issue. It basically strips you of all your illusions, your masks and your roles, and eventually you discover something which cannot be stripped away, which is indeed who you are. I write poetry with people with cancer a lot, and the first time I conducted a poetry session with a group of eight people with cancer, I found a poem of my own, which goes like this:
for 41 years,
combined years of training
What seems to happen for people in the process of illness, if theyíre willing not to deny, if theyíre willing to be present, if theyíre willing to show up for their own lives, is that they have this precious opportunity to redefine who they are. They can discover what their strengths are and identify themselves in new ways. Often they move their locus of strength away from that which is impermanent, the body, toward that which is more unchanging. As I watch myself age, I turned sixty yesterday, I find that I seem to be having less difficulty with this than many of the people around me. Unlike me, they are used to running up and down stairs, even running up and down mountains, and they have defined themselves in terms of running up and down mountains. This turns out to be a very vulnerable way to define oneself.
Shambhala Sun: This healing process that you describe, of healing as connection with the soul or the absolute, would usually be conventionally defined as a spiritual task. Is this something that doctors can really address?
Dr Remen: Doctors are intimately involved with this; we are there with people at these times. You see, there is a new population of people who are now living with illnesses that twenty years ago they would have died of. Chronically ill people are one of the most rapidly growing populations, and they are raising new questions with their doctors, and with society in general. These people have very different needs.
The concept of healing, in the sense I have used it here, has moved into the teaching and practice of medicine far more than when I graduated from medical school in 1962. People see their task as doctors very differently than what I was taught to see it as then.
I teach a course at the UCSF medical school called "The Care of the Soul." Every year fifty or sixty students in the first and second year classes sign up for it; so now, after eight years, one out of every three students in the school has been through this course. Courses like this are being taught all over the country. The American Academy of Medical Colleges has just opened a division of spirituality and medicine courses, and American medical educators have submitted more than a hundred papers, each one representing a course or new approach to teaching the doctor-patient relationship.
Complementary medicine, the integration of what might be seen as more alternative approaches with what might be seen as the usual Western approach, is the hottest thing in medicine today. There are clinical and training centers in integrative medicine opening at medical schools all over the country, Arizona, the University of Maryland, Stanford, Harvard, Columbia, the University of California at San Francisco, to name just a few.
Shambhala Sun: Previously, much of what weíve been talking about would have been considered the province of religion. You would have gone to your minister or rabbi with questions about the soul and the absolute. Why is this now part of medicine?
Dr Remen: Actually it has always been part of medicine; it is the lineage of contemporary medicine. Curing has only very recently become part of the medical enterprise. Itís only in the last hundred or so years that people have actually cured diseases. Traditionally, doctors were healers. That was the original way of thinking of the doctorís role. Until very recently, the sacred occupied the place in medicine which science does today, as the point of referral for cause and cure. Medicine is a calling; for many it is still the opportunity to serve that calls them.
Shambhala Sun: Do you feel the need to reconcile the work you do with the scientific method; that is, to be able to prove the effectiveness of what you do by quantifying and reproducing the results?
Dr Remen: Actually I donít. Many of the things that are most true cannot be quantified, but only known. You canít duplicate a human life. Each one of us is unique. What we are talking about is a path, and each one of us will travel that path in our own way. There is a great deal that is mystery in it.
Shambhala Sun: So what you are saying is that a significant portion of the doctorís task is not scientific.
Dr Remen: Oh, science is only the most recent tool of healing.
Shambhala Sun: But science is now considered a necessary element in all medical work, is it not?
Dr Remen: In all medical work, no. Science has failed us in many instances, and many people have learned that in order to be a physician one has to go well beyond science. People really donít come into this work because of the science. People are drawn to medicine more by service than science. If we were drawn by science alone, weíd all be bench scientists, not physicians.
Letís put it this way: medicine occurs at the interface between science and human suffering. If you want to look at it that way, science is one of the tools of medicine, but it is not medicine itself. It is a tool which can be amazingly effective, but it is not an answer for all of lifeís issues, or even most of them.
Rachel Naomi Remen, M.D. is Associate Clinical
Professor of Family and Community Medicine at U.C.S.F. Medical School and co-founder and
medical director of the Commonweal Cancer Help Program. She is author of the bestseller, Kitchen Table Wisdom: Stories That Heal.
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