Medicine, Mind, and Meaning

Bringing Meaning and Medicine Together

An integrative model of healing

 To See or Not to See- That is the Question

It was 7:30 am on a weekday and a blind woman, dressed for work, was walking in Center City, Philadelphia with her Seeing Eye dog at her right side. As I crossed the street, walking towards her, I noticed that the dog had stopped dead in his tracks, refusing to lead the woman any further down the sidewalk toward Walnut Street. The woman, with a distressed look on her face, called out into the universe: "Is there something in front of me?"

By then, I was close enough to respond to her, "No ma'am. There is only the sidewalk in front of you."

She was confused and clearly distressed. "He won't go and he keeps behaving as if there is something blocking my way." I looked down at her dog and, as if on command, he dropped something from his mouth. I bent down to pick it up and realized immediately that it was the blind woman's earring-she must have dropped it-for there, on her other earlobe, hung its mate.

"Your dog had your earring in his mouth and just dropped it in front of me," I told her. "You are only wearing one earring. Perhaps he was waiting for someone to help him give this one back to you?"

She seemed relieved. "Perhaps he was," she smiled. After asking me if she was heading in the right direction, she and her guide continued on their way.

But as I continued on my way, tears came to my eyes; and except for my blurry vision, I could see where I was going. As I made my way to work, I felt intensely grateful for the gift of sight and for having had the opportunity to share in the loving support of a Seeing Eye dog for its master.

While many of us are blessed with the gift of sight, we all have psychic blind spots that we must negotiate, and each of could use a "Seeing Eye dog" on occasion. More often than not, we operate from our limited vantage points which- if they go unchallenged-become roadblocks on our path to self-actualization. Our biggest blind spots tend to encompass how we choose to look at things, what we choose to tell ourselves, or what we opt to believe. Like the blind woman on Walnut Street, we usually see the roadblocks as external. We suffer a job loss, or the death of a dream, and allow these experiences to become the cause of our misery. As a result, we are unable to productively move along the life-path. We allow ourselves to be done in or victimized by our pain. We permit our grief to overtake us, robbing us of the joy and fulfillment we are due. We are all, to some extent, tripped up by our own blind spots.

We can all learn a valuable lesson from the blind woman, though. She deduced that there was something blocking her way, but she was also willing to challenge her assumptions. She called out to the universe for help. In doing so, not only did she learn that her path was clear, she learned that what was blocking her continued passage was in fact a gift of love. Upon receiving the gift, she was able to continue along her path with increased faith and trust in the support available to her and in her ability to make good use it. If only we could all be as visionary and courageous as that blind woman en route to work.

Each of us has probably heard the expression, "There is none so blind, as he who will not see." As the following anecdote illustrates, to see is a choice.

Many years ago, I was at a two-day review course in preparation for the National Board examination in Psychiatry. One part of the examination involves having the candidate sit before two or three psychiatrist examiners, while a patient, unknown to the candidate, is brought into the room. The candidate is given fifteen or twenty minutes to observe and interview the patient. Once the patient has left the room, the candidate must discuss, in psychiatric terms, the relevant observations, diagnostic possibilities, and treatment ideas generated by the interview.

One of the teachers at this review course, whom I will call Dr. Z, had been a National Board examiner for years. He told us a powerful story about the choice to see-and this story has stayed with me ever since.

As is often the case, examiners such as Dr. Z have the opportunity of observing the same patient interviewed by five or six different candidates in the course of a day. One such patient seen by Dr. Z was a schizophrenic who had a neuro-muscular movement disorder called "tardive dyskinesia." Tardive dyskinesia is a common problem resulting from the long-term use of some of the medicines used to treat schizophrenia, involving abnormal and involuntary movements of the tongue and other muscle groups. Typically, a clinician will look for the condition by observing a patient at rest, as well as by asking the patient to perform a series of maneuvers, such as sticking his or her tongue out, or holding his or her hands palm-up. During these exercises, the clinician watches for the muscle twitching indicating tardive dyskinesia.

Of all the candidates that Dr. Z. observed that day, the only candidate who picked up on this patient's obvious physical abnormality was the one who was legally blind. All of the other candidates with full ocular vision missed it. None of them ever asked the patient to do the simple maneuvers necessary to detect the disorder. The blind candidate, however, was unable to see the muscles of the patient seated before him, and so he asked all the right questions, including, "Are you aware of having any abnormal tongue, hand or arm movements?" This candidate was rewarded with a full and honest disclosure by the patient, who volunteered having the disorder.

I am sure it will come as no surprise to hear that the blind candidate was the only one of the six candidates to pass the National Board exam that day.

 What do we choose to see? How do we choose to view ourselves and our experiences in the universe? What questions do we allow ourselves to ask? What assumptions or fixed beliefs do we carry with us wherever we go? What ideas do we allow ourselves to challenge? How much do we allow ourselves to grow?

We live in an imperfect and painful world. To live this earthly life is to experience fear, disappointment, abandonment, failure, loss, loneliness, death, grief, and even despair. "Happily-ever-after" is rather rare on this planet. Life can be brutal and unrelenting. There are no guarantees. Just when we think we can't possibly handle any more pain, the rug is ripped right out from under us again, and we find ourselves even further down than before.

So how are we to handle this monumental and overwhelming task of living-and still keep a song in our heart? As we sit with our rumps on the floor, knocked for yet another loop, how are we to find any solace? How can we find meaning in the pain, growth in the loss, and hope in a place of despair?

In my experience of over 28,000 one-on-one intimate hours with troubled human beings from all walks of life, I can tell you what I have learned about these questions. I have come to understand, beyond a shadow of a doubt, that how well you live is ultimately a reflection of how you choose to look at life in all its complexity. It is a function of whether you choose to look for lessons in loss, connection in loneliness, and opportunity in failure. It is a function of whether you choose to accept those things you cannot change, and work like the blazes to change the things you can. It is a function of whether you choose to forgive yourself and others for limitations, and look to develop yourself into the best person you can be. It is a function of whether you allow yourself to be grateful for the gifts you have been given and look for opportunities to nurture and share them. It is a function of whether you choose to look at yourself as an individual endowed with some innate value worthy of encouragement. It is a function of how hard you work to support and grow the unique, wonderful, gifted individual that you are.

As a child, I attended Hebrew day school and learned a very important lesson from Mishna Sanhedrin: "If a person saves one life, it is as if he has saved the entire world. And if a person destroys one life, it is as if he has destroyed the entire world." This sentiment, embodying all that really matters in the universe, continues to be my touchstone. With its simple eloquence, this lesson reminds us that every life is of infinite value and deserves to be nurtured. It advises us to respect the internal world of the self, as that is where much of real consequence in this world resides. It extols the virtue of self-love and love of others. It instructs us on how to find meaning and fulfillment in life: save yourself and save others, love yourself and love others, grow yourself and help others do the same. When any life ends we grieve, but at the same time, we must remember the value which all lives bring to the world.

In my work as a psychiatrist, I have had the privilege to be welcomed into the most intimate aspects of peoples' lives. This opportunity to share in both the pain and joy of many brave souls remains a great honor. I have seen myself reflected in each one of my patients, just as each one of my patients reflects a piece of me. In this process, I have learned a great deal about myself and about the art of healing. While we are all unique and special individuals, we are far more alike than we are different. Each one of us has a story that is its own beautiful tale and we can learn a great deal when we choose to share our stories with one another.

Because of this, I have chosen to share my patients' stories and experiences in this book. I have learned that without focusing upon the human element of the healing endeavor, theoretical concepts are useless. Whether you are a practicing physician, a patient, or someone simply looking for guidance, you, too, can learn as you identify with my patients. You will see parts of yourself in their stories; and as you empathize with them, you will be supported in your own journey towards health.

When I decided to write this book, I knew that I had to share the most powerful, moving, intense, long-term, and amazing story of healing that I have personally experienced. It is the story of Gillie, who became my patient fourteen years ago. When Gillie and I met, she was one of the most shattered people I had ever seen-and yet, as time went on, Gillie proved to be far more emotionally distressed than I had previously imagined. She had been diagnosed with multiple personality disorder, or dissociative identity disorder. Those of you who know the books The Three Faces of Eve and Sybil  can appreciate what this diagnosis involves. After decades of psychiatric treatment and multiple psychiatric hospitalizations for serious suicide attempts, suffering from a pervasive inability to stay present in her own skin, and an absolute aversion to sharing her internal world with anyone, Gillie asked me to help her.

The story has a powerful lesson: the determination to heal can pay off.  Gillie now enjoys sound emotional and mental health. She no longer has dissociative identity disorder, and she is one of the most impressive people I have ever known.

Within Gillie's story there is another tale to tell. It is my story; I want to share that with you as well, to show you how my relationship with Gillie taught me profound lessons about the art of psychiatry and the wonder of healing. Gillie and I began our relationship at the same time as I began my psychiatric practice, and I learned from her just as she was able to learn from me. This remarkable woman forced me to reach down to the bottom of my soul to find a way to help her. In doing so, she taught me to be resolute in the face of amazing challenges, patient and hopeful in the face of continued despair, and dogged in my belief that, if she would let me into the deepest recesses of her internal world and allow me to guide her, I would be able to help her. I couldn't just hope that I would be able to help Gillie, I had to believe I could. I had to trust that I could help her move from a place of obsession with self-destruction and distrust, to a place of fulfillment, joy, and love.

Gillie's story is the ultimate demonstration of the power of faith in healing. For although I took advantage of every medical teaching and therapeutic technique I had ever learned in my attempt to help her heal, her cure would have been impossible had I left love, unity, empathy, and hope out of her treatment.

My work with Gillie led me to trust what feels natural. I had to quiet the rational side of myself, and draw on my inner-wisdom, capacity for empathy, ability to love, and faith that I would be given answers. I needed to become Gillie's guide through the labyrinth, and be her model of a happy, integrated, and reliable woman.

Through my work with Gillie I learned to integrate medicine, mindset, and the spiritual realm. I came to trust in the unconventional in my clinical work. I now know that in order to help my patients heal themselves, I must go beyond my medical training. I employ a body-mind-spirit approach that I have chosen to represent with the three-legged stool in this book. My goal in the coming pages is to show you that when it comes to healing broken psyches, we cannot separate body, mind, and spirit from one another. These elements depend upon one another just as the tides depend upon the moon, and the earth depends upon the sun.

The Three-Legged Stool

Perhaps you recognized the allusion to Hamlet's soliloquy in the previous section's title. "To See or Not to See," of course, refers to the line, "To be or not to be," in Shakespeare's Hamlet. Hamlet used those words to ponder life and death. For us, the choice is not only if we want to live, but how fully we want to live; fulfillment involves adopting an approach that integrates the body, mind, and spirit in one seamless, cohesive model.

Visualize in your mind's eye a three-legged stool: any size, shape, or material will do. The three-legged stool is a symbolic representation of my approach to life, wellness, and healing. Each one of the legs stands for an equally crucial piece of the whole. The legs are the body, mind, and spirit. Without one of its legs, the stool falls down. Without attention to each of these aspects of life, the human being will likely remain ill. This three-legged stool approach is fundamental to my work; it informs everything I do with patients, and I have come to regard it as a necessity.

The notion that body, mind, and spirit are fundamental aspects of human wellness is surely not new. In fact, its endurance over time leads me to wonder why the three legs of the stool are not routinely considered in the Western model of healing. Unfortunately, we Westerners are like the blind men and the elephant. We are all experts in discrete aspects of the elephant, but forgetful that the parts do not represent the whole. We are cardiologists, gastroenterologists, psychiatrists, or neurologists. We are occupational therapists, physical therapists, or message therapists. We are personal trainers, herbalists, mystics, or spiritual leaders.

In medical school I learned a scientific, disease-based model. The focus was on how organ systems worked, what could go wrong within them, and what treatments could be used to fix them. By and large, body parts or organ systems were viewed as separate from one another. Patients were examples of diseases or organ systems gone awry rather than people who had particular illnesses. Even though the will to live has been recognized as crucial in physical healing for hundreds of years, body and mind were further split from one another. Mental health was not viewed as something related to the body; and the realm of spirituality or religion was never even mentioned at all. If a patient brought spirituality or religion up, the hospital chaplain was called in. Doctors did not deal with matters of the soul.

I was terribly depressed during my early years of medical school. I kept looking for the humanism that I naively expected to characterize medicine. I was disappointed again and again. While I knew that there was value in the scientific approach and intervention model, I was struck by the absence of what seemed to matter the most. People had the diseases, but people did not seem to matter very much at all. Their feelings, thoughts, and beliefs were disregarded. Even their physical pain was often under treated. My deep disillusionment with this approach led me to search for alternative models. I began to augment my medical school coursework with the study of Chinese medicine taught by alternative healers.

In my Chinese medicine courses, I learned about Chi energy and its pathways or meridians. I came to understand a model of wellness/illness that made far more sense to me. Chi energy is what we Westerners might call spirit, soul, or life force. The Chinese see the body as composed of a series of energy pathways called meridians, which need to be in balance for well being. When the Chi energy is out of balance, a person may feel ill. In my courses I learned to evaluate these energy pathways by taking a series of pulses. I learned how to promote healing by rebalancing the energy flow. I discovered that in Chinese medicine, body, mind, and spirit are inseparable. In the Chinese model, healers are also spiritual leaders.

I do not mean to present a treatise on Eastern medicine, nor do I use these Eastern diagnostic techniques in my work today. I share the model only as a counterpoint to the Western medical model of healing; and more specifically, because the ancient Chinese understood the importance of what I have symbolically called the three-legged stool. In fact, they have their own wellness and healing model that is very similar to it. We Westerners, on the other hand, seem to have thrown the baby out with the bath water. We have neglected to integrate all of the necessary parts. Unfortunately, like the blind men and the elephant, we continue to think that the trunk is the entire elephant!

It is important to pause here and clarify what I mean when I say I cannot imagine doing healing work without using a body, mind, and spirit model. What exactly are the body, mind, and spirit legs anyway? How do I conceptualize them and how do I actually work with this model?

First, the body leg of the stool encompasses your biology, genetics, inborn personality characteristics, feelings, particular vulnerabilities, and diagnosable medical conditions. We might think of it as the "who" question: "Who am I?" It is the stuff you came with. It is the wonder and the challenge of you. It is what needs to be nurtured and what needs to be worked with. It might be a passion to sing or dance, a love of numbers, or an aversion to organic chemistry. It might be a learning disability, a major depression, or a fear of public speaking. It is your constitution, your genetic fingerprint, and your medical conditions.

The body leg is the leg modern medicine tends to be most comfortable with; it is the leg that I learned the most about in medical school.

The mind or mindset leg of the stool encompasses your thoughts about yourself and others. It is dramatically affected by the models you are exposed to or taught, especially during your childhood or formative years. We might think of it as the "what" question: "What do I think?" It is the growth enhancing stuff you learned that needs to be promoted and the harmful stuff you learned that needs to be unlearned. The mindset leg might involve knowing: I am a gifted musician, a talented mathematician, or a spatially challenged individual. It would include thoughts like: I am a failure, there is no way I can succeed, or I am not so pretty, and I wish I were skinnier. It includes your perfectionism, judgmental nature, self-concept, and body image. It is the negative internal voice that criticizes your every move, as well as the encouraging internal cheerleader who says: Go for it! You can do it!

The mindset leg is the leg most therapists are comfortable with; these therapists could be psychoanalysts, cognitive therapists, behaviorists, or just about any others that are not predominantly psychopharmecologists. It is the leg that I learned the most about in my psychiatric residency training. It is the leg that is represented in self-help literature and on the covers of most popular magazines.

The spirit leg concerns the meaningfulness and purpose of existence. It includes notions of a higher calling, one's sense of connection to something bigger and grander than the self, and the belief that we are here to share our gifts to help and enrich one another. We might think of it as the "why" question: "Why am I here?" It is the realm of religion, mysticism, and meditation. It is both the seed and the tree of hope. It is the root of life, and the source of the infinite within each one of us. It is the experience of connection and oneness that unites all creatures. It is the creative healing force that reverberates between two or more people who share a mutual, almost karmic connection to each other; and it is that very same connection between a single soul and the universe-at-large. The creative healing force can be felt in that astonishing moment when it seems that the wisdom of the world has been revealed to us. It is the whole, which is infinitely greater than the sum of its parts. It is the miraculous in the mundane.

This is the leg that I learned the most about in Hebrew day school as child; and the ideas I contemplated during spiritual retreats and in solitude as I walked through the forests near my family's home. It is the leg most spoken of by spiritual leaders and their followers, and the leg least visited by most physicians.

As you think about my descriptions of the three legs, you will begin to realize that the separation of body, mind, and spirit is somewhat arbitrary. Each leg is, in some way, isolated. Yet, in many other ways, the legs blend into one another and continuously affect one another. While we can often pick out and identify which leg is prominent in a given expression of the self, we cannot separate that leg from its context. It is a fundamental part of one and only one human being. I like to think of this concept as the "separate-but-one principle." For purposes of diagnosis, treatment, and healing, it is necessary to tease apart or describe the characteristics of each of the legs individually; however, we also must recognize their interdependent natures.

Let's look at an example of the separate-but-one principle in action. I will use an example from my psychiatric practice to demonstrate the point. Although I will be focusing on psychiatric illness, keep in mind that the principles apply to all aspects of being.

If you think back to my description of the body leg, you will recognize that the diagnosis of major depression belongs in this category. Major depression is a common, serious medical illness with a high degree of morbidity and mortality. It is the result of a chemical or neurotransmitter imbalance in the brain. Its symptoms often remit when antidepressant medicines are taken, and they often return when the medications are stopped.

Major depression is diagnosed when someone experiences a persistent depressed mood or a loss of interest or pleasure in usual activities for at least two weeks. It involves symptoms of significant weight loss or gain, insomnia or excessive sleeping, physical agitation or slowing of motion, excessive fatigue or loss of energy, feelings of worthlessness or guilt, impaired concentration and recurrent thoughts of death. It is a medical condition often treated by psychiatrists, and other primary care doctors, with medicines. It is the focus of much drug development by pharmaceutical companies and the subject of many symposia and educational programs offered to physicians.

All told, major depression is a biological, or body leg illness, plain and simple, right? Many doctors would say so. They would look to make the diagnosis, start the patient on medicine, and ask the patient to return for a follow up medication check some weeks hence. Many of their patients would improve from this intervention.

And yet, the symptoms of major depression also include thoughts about the self and the universe. Doesn't that mean the mind and spirit legs are involved as well? A depressed woman's feeling of guilt reflects her belief that she is doing, or not doing, something she should be doing. A depressed man's recurrent thoughts of death reflect his experience of hopelessness in the universe. These ideas may stem from his belief that the world would be better off without him or that he deserves to suffer. Excessive guilt and recurrent thoughts of death bring the diagnosis of major depression into the realm of mind and spirit. It is not purely a body leg illness at all.

In fact, some cognitive therapists would tell you that negative thoughts cause depression. They would say that a series of negative distortions of life experience, like pessimism or self-criticism, are learned and lead to a depressed mood. They would approach the treatment of major depression quite differently from the typical physician. Rather than prescribe medications, they would work with their patients to identify and modify the negative thoughts involved in the genesis and perpetuation of their particular depressions. They would encourage a sharing of the self-defeating thoughts and then develop an active behavior modification program. They would instruct their patients to substitute specific positive thoughts for their particular negative ones. This mindset view and form of treatment tends to be extremely effective for some depressed patients.

So if medication or body leg treatment works, and cognitive therapy or mind leg treatment works, what about the spirit leg in major depression?

It turns out that in reviewing some eighty studies that have been published during the last 100 years, McCullough and Larson found that religious/spiritual factors were often tied to decreased rates of clinical depression [1]. Religious commitment reduces the risk of developing major depression. Furthermore, several studies have shown that people whose religious faith is a central motivating factor in their lives, recover more quickly from depression than those who are not religious. Finally, therapy with religious content that draws on the patient's spiritual resources, hastens recovery whether or not the therapist is religious. Major depression is clearly a spirit leg illness too.

So major depression is a body leg illness, a mind leg illness, and a spirit leg illness. The disorder is an illustration of the "separate-but-one principle" mentioned previously. Each leg is in some ways discrete, and yet the legs come together to support and affect one another.

Unfortunately, many doctors and therapists treat patients with major depression as if one leg were the whole stool. They prescribe medication or institute psychotherapy. At times they even recommend a combination of the two. However, it is extremely rare for them to include a spiritual approach in their treatment of depressed patients. A fully integrated model has not yet found its way into clinical training or practice. Even though it has been shown that religious commitment reduces the risk of developing major depression and helps in its recovery, this aspect of wellness remains somewhat taboo.

This is where I differ. I simply do not know how to separate body, mind, and spirit from one another. Truthfully, this is because I became a doctor for religious reasons; the Mishna lesson from my youth, to save one life is to save the entire world, has been the greatest driving force of my life. As a child I thought: what could possibly be more spiritually correct than entering the profession of lifesavers?

That said, I am a medical doctor who is particularly committed to making all appropriate medical diagnoses in my patients. I am grateful to be able to offer the best that modern medicine can provide to them. But, my treatment approach involves integrating all three dimensions, not focusing upon one leg to the exclusion of the other two. So, while I often prescribe medications to my patients suffering from major depressive episodes, I seem to be incapable of seeing anyone for "medication management" alone. I involve all of my patients in psychotherapy concurrently. I work with them to identify their particular vulnerabilities and the precipitants involved in the onset of their depressions. My goal is to help them develop life strategies and coping mechanisms that will minimize the likelihood that they will suffer recurrent episodes.

Each time I sit with a patient, I am awed by the sanctity and majesty of the life before me. I am inspired by the human being who is brave enough to seek counsel during such personal and often times, devastating periods. I can't help but identify with the pain and hopelessness each of my patients grapples with. Given this, I am routinely moved to share my own spiritual outlook with them. I don't speak in terms of the spirit, soul, or God, but rather share my spiritual beliefs as they relate to my patients' struggles. I believe there is a piece of the divine within all of us and that we are meant to experience fulfillment. I share my sense of hope in order to show my patients that they can, will, and are meant to recover. I tell them that they have unique and wonderful gifts that are meant to be discovered, nurtured, and shared with the world-and they are gladdened to hear that part of our work together will enable them to achieve just that. It follows that patients who stay in treatment long enough to arrive at a place of personal fulfillment, often leave my care far more spiritually connected or religious (in their own religious heritage) than they were when we met.

 Putting the Theory into Action

Now that you understand the three-legged stool concept, you probably want to know how to incorporate it into your own healing journey. What is involved in the process and how do you go about doing it?

While each of the legs is equally crucial to your healing process, I recommend addressing them in a specific order and manner. The first step is the body leg; the second step is the mind leg; the third step is the spirit leg and the final step is what I call process. This book is organized to walk you through each of these steps in a sequential manner. But remember, while the legs blend together and affect each other, you first need to tease them apart in order to define your healing path.

The first step of your personal growth journey involves identifying and working with the biological pieces you possess. It includes, but is in no way limited to, the importance of establishing proper diagnoses to enable you to move on. It also involves identifying and accepting inborn vulnerabilities, strengths, feelings, gifts, and limitations. Many individuals end up stuck in their attempts to heal because some of these necessary givens have not been appropriately addressed. When we get to Step One, I will show you how to identify and work with the biological issues that you need to confront in order to heal.

The second step of your journey to health involves identifying and working with your mindset and attitudes-your thoughts about yourself and others. This leg of the stool is often dramatically affected by models you were exposed to in childhood. As such, addressing it may involve working to identify and resolve family issues. We will discuss how to identify and work on your mindset challenges at length.

The third step involves the spiritual dimension: your sense of purpose, value, and connection to something greater than yourself. In spite of the fact that spirituality is the cornerstone of emotional health, people tend to find that active involvement in spiritual pursuits is difficult for them in the earliest stages of healing. Step Three will not only show you how to identify your spiritual needs, but how to pursue a spiritual path that can further your recovery.

The fourth step of your journey involves learning to appreciate the nature of the healing process as a whole. Even though there are a series of steps to follow, the road to recovery can be anything but straight. Steps One through Three often need to be revisited. When we reach Step Four, or the chapter I have titled, "Putting it All Together,"  we will discuss how to stay the course in spite of the bumps you encounter along the way.

I want to help you put the stool legs together for your own healing journey. Perhaps you have been looking to heal for sometime, but sense that you are going around in circles. Or, perhaps you have experienced some benefit from a series of approaches and activities but don't know how to put them all together. Maybe you can't even seem to get started because you do not know what to do or where to go first. You may be stuck in your attempts to heal as a result of:

* Lacking a diagnosis * Carrying the wrong diagnosis * Inadequate attention to family of origin issues * Skipping over a key step in the healing journey * Lacking a comprehensive model of healing

But take heart, no matter what issues you face they can be resolved. And while this book is not intended to be a substitute for professional help, it can be your "Seeing Eye dog." Allow it to empower and guide you through the healing process. It is my belief that you can become the best steward of your own healing path if you are given the proper tools and guidance.

Before we move on, consider where you feel yourself to be in your healing journey and what you most hope to learn from this book. If you are feeling particularly hopeless and need a tale of inspiration to help you gain perspective, read Gillie's story and its lessons first. If you think you would do better by diving right into the step-by-step approach to healing, read those chapters before Gillie's tale. While it is important that you follow the steps in the order they are given, feel free to go back and forth between the steps and the stories this book has to offer

Now let's turn to "Gillie's Story: Where There's a Will, There's a Way," to see the three-legged stool and the "separate-but-one" principles in action. As you read, look for the body, mind, and spirit legs in Gillie's story. Ask yourself: what is the role of each leg in Gillie's illness and her healing? If you challenge yourself to see the theory in action, you will be amazed-not merely by what you will see, but how much you can learn from her powerful and inspiring journey.

 Endnotes

1. "The Patient's Spiritual/Religious Dimension: A Forgotten Factor in Mental Health" in Directions in Psychiatry by David B. Larson, MD, MSPH, Susan S. Larson, MAT and Harold G. Koenig, MD, MHSc-volume 21, lesson 21, November 2001 (a publication of the International Center for the Integration of Health and Spirituality).


Eve A. Wood, M.D. (http://www.drevewood.com) has devoted nearly two decades to the care of troubled individuals from all walks of life. Her therapeutic approach has attracted attention and acclaim from the nation's leading authorities in the fields of medicine, health and spiritual well being. She is the author of numerous articles for medical and professional publications and is a frequent speaker at national workshops and conferences, including the American Psychiatric Association. Dr. Wood has served on the faculty of University of Pennsylvania School of Medicine, the executive committee of the Institute of Pennsylvania Hospital and has most recently been appointed Clinical Associate Professor of Medicine at the University of Arizona Program in Integrative Medicine. With a concentration in neurobiology and behavior, Wood graduated cum laude from Cornell University with a B.A. in biology. She earned her M.D. at the University of Pennsylvania School of Medicine. She currently lives in Tucson with her husband and four children.  Dr. Wood wrote Medicine, Mind, and Meaning,

 

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