Healing and Health: Physical, Psychological and Spiritual Levels Rev. Dr. JOE MANNATH, Ph.D.

President, Association of Christian Philosophers of India & Professor, Department of Christian Studies, University of Madras 8th ANNUAL DAY ORATION

INSTITUTE OF CARDIO-VASCULAR DISEASES

(THE MADRAS MEDICAL MISSION) 180, N. S. K. SALAI, MADRAS-600 026

HEALING AND HEALTH: PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL LEVELS by Rev. Dr. Joe Mannath SDB Introduction One night in March 1988, I was rushed to the intensive care unit of St. Isabels Hospital, Madras, with chest pain and discomfort that seemed to indicate a heart attack. I thought I was going to die. When you think that death is imminent, you see everything with new eyes. I remembered particular persons and what I wanted to tell them. I knew what I felt most grateful for. I also felt anxious and afraid. In this midst of all this, I had, as in a flash, a new and reassuring insight into what would happen to me after death, and what meeting with God would imply. I do not want to go into that now, but that truth has remained a personal conviction ever since. The chest pain proved to be a false alarm, and my anxiety lifted as well. What has remained is a deeper understanding of how others feel in such emergencies, as well as the insight into my relationship with my ultimate destiny. Last month, in Boston, a friend I have known for several years told me: I want to talk to you about my death experience. Keith, a fifty-year-old manager, had suffered a heart attack and was later admitted for surgery. During the operation, he was pronounced dead. After a while, however, he came to. On finding himself awake (and alive!), his reaction was like that of several others who had been through a similar experience: Why did you bring me back? What I experienced was so very beautiful! Keith went on to tell me how much his life and relationships had changed as a result of this experience. Listening to me preach, he would also tell what felt true. He knew the reality that matched the words. I start with these two experiences to underline a fascinating link more and more people are exploring today the intimate and undeniable connection among physical health and illness, emotional stability or turbulence, and what, for want of a better word, we call Spiritual experiences. There are many levels to this process we call healing; the interconnections are subtle and complex. I am sure that many of you know from experience the strong link between physical health or illness and a persons emotional state; after all, psycho-somatic illnesses are commoner than once believed. You are also

witnesses to the extraordinary spiritual resources some persons exhibit in pain and illness, which lead others to bitterness and despair. What I attempt below is to illustrate some aspects of this interface, with the help of a few real life stories. The accounts are all real; I have only changed a few names. The Miracle of Healing: Its Setting, Conditions and Agents 1. Healing: A Personal and Interpersonal Event Unconditional love is the most powerful stimulant of the immune system. The truth is: love heals. Miracles happen to exceptional patients everyday patients who have the courage to love, those who have the courage to work with their doctors to participate in and influence their own recovery. The quote is from Love, Medicine and Miracles by Bernie Siegel, M.D., a surgeon who teaches at Yale University. Siegel is one of the growing body of medical professionals who are impressed by the influence of spiritual and emotional factors on physical healing. Clinical evidence convinces him of the power of love to heal, of the power of bitterness to make us sick. We can think ourselves well or sick. Does that mean that all disease exists only in the mind? No. Siegel himself is dealing not with neurotics or hypochondriacs, but with cancer patients. But he brings case after case to show how deeply the doctor-patient relationship matters in speeding up (or impeding) healing, and how the patients help or block themselves by the attitudes they cultivate. To repeat a truism, it is a person who is sick or healed, not an organ. It is a person who meets the person of the doctor or nurse. Like many other central truths in life, however, this too is easily forgotten. It is so easy to see oneself as a detached professional who diagnoses a case or an illness, forgetting the way the total person is affected by, and affects, the course of the illness and of the cure. Healing seems to take place best in a healing partnership where the care-giver relates with love and genuine interest with the person who is ill, calling him/her forth to use untapped resources and look at other areas (such as fear or resentment) that affect the body. Our health is certainly affected by the way we feel and think, speak and act. While no medical practioner can cater to all our needs, medical treatment cannot be effective, unless it addresses the total condition of the human being who comes to us with a particular problem. We are not even sure how earnestly a person wants to get healed or live. (Isnt it true that not all patients want to get well?). We cannot measure how far a cure or improvement is the result of this particular medication or procedure, of the patients confidence in the doctor, of the atmosphere of the hospital, or of the inner strength gained through prayer. But we do know that all these (and other) factors influence healing. Dr. Herbert Bensons The Mind/Body Effect describes a group led by Dr. Lawerence Egbert at Harvard. It showed that patients who received a visit from the anesthesiologist the night before the surgery, as well as other explanations not given to a group of control patients, needed only half as much pain medication. They also left the hospital more than two and a half days sooner, on the average, than the control group. (Siegel, p. 44). Another striking study showed that ones attitude towards oneself is the single most I.

important factor in healing or staying well. In this study, psychiatrist George Vaillant followed the health condition of two hundred Harvard students for thirty years. Finding: Those who were very satisfied with their lives had only one-tenth the rate of serious illness and death suffered by the most dissatisfied peers. (p. 76). Another reputed psychiatrist who based a whole new approach to therapy (Logotheraphy) on having something to live for, is Viktor Frankl. During his harrowing years in a Nazi concentration camp, Frankl found that those who survived were not the physically stronger persons, but those who had (or gave themselves) something to live for. Hence his statement: The one who has a why to live, can put up with almost any how. Question: Is the way I deal with my patients conducive to healing? 2. Central Role of Ones Belief System Harvard cardiologist Herbert Benson is a name that needs no introduction here. His books, The Relaxation Response and Beyond the Relaxation Response were best sellers known beyond medical circles. In a later book, called Your Maximum Mind, Benson lists and describes the essential requirements for physical fitness. To the surprise of nonmedical persons like me, the very first requisite he presents is ones belief system. That what we believe affects the way we feel, does not need proof. Benson studies the impact of ones central and basic beliefs on ones bodily health and highlights the importance of a positive belief system. He culls texts from the worlds religious classics and suggests that we use and repeat some such phrase. (As you know, Benson is known for his use of guided meditation with heart patients; but this is not what I am referring to here). Our levels of serenity or anxiety, our fear or confidence, our readiness to let go of hurts or cling to them (all factors that affect health), depend to a large degree on our belief system. You who deal with heart patients are more aware than I of the effects of type A behaviour on health, especially if it includes hostility. Resentment and bitterness have a way of wrecking ones physical health as certainly as ones moral calibre. We care-givers need to clarify our own belief system before we can help care-receivers to clarify theirs. Our real belief system may or may not correspond to the official religious doctrine we profess. My basic beliefs affect me the whole time, and affect the way I treat people or react to emergencies. Question: If I were to write down my most basic beliefs (about life, relationships, death, God, my own worth, the meaning of life), what would they be? 3. Death as a Reality to be Faced Medical personnel, like the rest of us, have ambiguous attitudes towards death. Its inevitability can appear to be the doctors failure. We know in theory, of course, that everyone has to die, and that medicine can only give us a little more time, with a little less pain. Our anxious or uneasy feelings towards death affect the way we face the approaching death of a patient and the need to break the news to (the patient and to) the relatives.

Facing death and our mortality can do wonders for us. It is one of the most lifegiving things we can do. Are your surprised? Then, here are a couple of real life stories. Vera Gallagher is a woman in her seventies. She recently wrote an article entitled, What Death Means to Me. In it she tells us that as a teemager she was not at all religious. Then, one day, she fell in love with God. Just like that! From then on, Vera ached for God. She longed for death, to be with God. She became a teaching sister, led a very active and happy life, enjoyed her work enormously; but the longing for God and hence the desire for death remained strong. Paradoxically, this desire has kept her free of anxiety, a happy and productive person, still active as a counsellor. Doctors find that she is as fit as people thirty years younger. I have known two persons in spiritual direction who experience a strong desire to die and be with God. I am not talking of depressed individuals who have lost all zest for living. Both are happy, active, fun-loving, sociable individuals concerned about others and responsible about their tasks. Australian novelist Morris West met death when he had to undergo a heart operation, without which, he was told, he could have a massive heart attack that would be fatal. West came out of the surgery with a deeper appreciation of every day of life. After he delivered a lecture to university students, one of the audience went to him to thank him for the fine lecture, and for one more thing, namely, that I have met a very happy man. All of us are vaguely aware of death; but death seems far away. You will remember the story in the Mahabharata where each of the Pandavas is asked, What is the most astonishing thing in life? The right answer is: People die around us everyday, and we carry on living as if we will not die. Death becomes real for us when we feel close to death and someone very close to us dies. Then we discover our true feelings about death. As Stalin once remarked, One death is a tragedy; a million deaths is a statistic. The fear of death, like other basic, gut-wrenching fears, is overcome not through some complicated theory, but through simple faith and loving relationships. Take the case of Corrie ten Boom, a Dutch woman who inspired many, both during the Second World War, when she was imprisoned for helping the Jews, and later. As a little child, she one day told her father that she was scared of dying. Her father sat next to Corrie and asked her, Corrie, what do I do when you have to make a journey? You prepare my bag, buy my ticket, and come with me to the train. If I, your earthly father, do this for your train journeys, dont worry. When the time comes for your final journey, your Heavenly Father will provide you with all you need. Corrie was never afraid of death after that. In your profession, you see people face their death in many different ways. In some of these cases, at least, your own unexamined feelings towards death will come up. May such moments be life-giving for you; for death is a very wise teacher.

You will also find that people who have come close to the door of death and survived, have often had deep and transforming spiritual experiences. They have much to teach the rest of us. Such is the case with Barbara, a doctor with the U.S. State Department. Unhappy memories of her childood, including her church, had led her to reject the narrow Christianity she had brought up on. Later, almost dead from embolism and trombosis (I was practically defunct for six months, she told me) she had deeply moving spiritual experiences. Coming out of the illness, she is physically weaker, but a far more vibrant, loving, confident human being. The inner experience led to reconciliation with estranged relatives and to great openness to people of other backgrounds. One of the most striking accounts of death I have read is the last column written by British journalist James Harriot in The Tablet just a few weeks before his own death. In it he described the death of a French priest. As the old man lay dying, young seminarins gathered around his bed to pray. The old priest opened his eyes and gestured to a cupboard. They opened it and found a champagne bottle and glasses. He gave them a sign to pour it. They did, each taking a glass. Then he said, How about me? They gave him a glass too. The dying man said: I have lived a very happy life. Now Id like you to drink to a very happy death. They drank the champagne. In five minutes, he was dead. Harriot adds: But then, he had spent a lifetime forgiving his enemies. One evening in Boston, a friend of mine called John, who does massage and psychotherapy, and I were talking about meeting with a group of AIDS patients. They were acutely aware that their time was limited. One man wept because he would die before his mother. John and I thought: We fool ourselves into thinking that we have unlimited time. No one does. The real tragedy is not death, but wasting our life. As a young man dying of cancer told author John Powell, It is not tragic to die at twenty-five. It would have been really tragic to live longer and not learn to love. Question: How do I see my patients dying and death? How do I see my own? 4. Lessons from Our Patients A hospital is not just a place of illness and pain, medicines and equipment, anxiety and queries. It is also an arena of extraordinary courage and spirit. I am sure you have been impressed time and again by the lessons your patients teach you. As a priest, I have been deeply impressed by the aged, the sick and the dying I have been privileged to assist. I remember the hearty laughter of eighty-five-year-old Mary, who had cancer and was blind. Or 91-year-old Annie, who looked after her 94-year-old husband Tom with exquisite attention. Or the young man paralysed after an accident overcoming bitterness and learning to be independent. There is so much unsung heroism among the sick. Dont we all feel humbled at their greatness of spirit, at their resilience and serenity? Arent there times when we truly feel: What courage! In this situation, I would have been desperate? Havent we seen seriously sick people cheering up others? Or people in pain greeting you with a smile?

I often receive news about a young man who lost the use of his limbs and needs a machine to help him to breathe. He can only lie on his back. All his dreams for the future crashed. And yet, other patients in the ward gather around his bed, not to pity him, but to be cheered up by him. It happens in all helping professions that the people we think we are helping, often help us. They frequently do more for us than they realise. It is truly a two-way traffic. There are no pure givers, or mere receivers. We all give and receive. In this, it is a bit like parenting, isnt it? Questions: What significant lessons have my patients taught me? Which patients do I remember best? How did the meeting change me? 5. The Enormous Resources We Have Compared to what we can be, we are only half-awake. We are making use of only a small part of our physical and mental resources. (William James) A simple karate demonstration can convince us of the tremendous strength the average person possesses, if only we are trained to discover it. This at the physical level. At the mental level, our resources are far greater. While teaching memory training, I ask students to guess how many digits a person can remember in the right order. (The average person can remember seven digits without difficulty, eg, a telephone number.) Students will tell me that the maximum anyone could remember would be 50 or 100 digits. Then I tell them of Rajan Mahadevan, who can recall the value of pi 93. 14.) up to some 35,000 digits. (I think his record has recently been broken by a Japanese.) Our spiritual resources are even greater. After all, isnt the Boundless living in us? Why say all this? To stress the fact that the human being is fare greater than what any science or technique can grasp. Each of us, care-giver or receiver, has an enormous storehouse of untapped gifts. At times, these resources shine forth in the most unlikely settings. At a workshop in Life-Span Clinical Developmental Psychology of Harvard, the resource persons gave us a number of case histories. Each person described came from extremely negative settings. According to normal expectations, they should have been emotional wrecks. Yet, each of them went on to live very productive lives. We cannot explain such success stories. There are hidden resources within each of us, far beyond what we have seen so far. There is one more thing which I know is ture, though I cannot prove it to you. When our desires are honest, and we want to do what is right, we are led by an invisible hand in the right direction. I know a well-known city doctor who once taught at Madras Medical College, a man of integrity and duty, who would start the day by taking time to listen to

God. He told me that so often in the GH he would feel the inner urge to go the bedside of a patient just when that person needed help. Your patients have resources, too. They are not organisms to be fixed, or passive recipients of medical care. They are meant to be your active partners in the healing process. May we treat them as partners, not as cases; talk to them, not at them; really listen to their feelings, no only to what the books tell us about their symptoms. Question: What are the unique gifts and talents God has blessed you with? How do you enable you colleagues to use their gifts? Do you see the patient as an active participant? 6. Resources in Our Setting Today: This is an exciting time to be alive. While it is true that human-kind possesses enough weapons to destroy the world many times over, and there is an unacceptable degree of cruelty, injustice and want in a setting of plenty, there are reasons for optimism. To list just a few: A realistic chance to banish most communicable diseases. The possibility of a achieving universal literacy. Enough resources to feed the world. The case and speed of communication. In addition to the technological advances, there is also, according to many, a clear spiritual renewal today. I do not mean that people today are better than people of other times. (Only God knows such things.) What I mean is that there is a greater awareness of the need to tap our spiritual resources, a sense that money and technology cannot solve all our problem; that the so-called progress is ambivalent; that there are many levels of questions and answers. Pilgrim centers attract increasing crowds today. Books on spiritual topics are best-sellers. Retreat and Spirituality Centres are popular. Several such centers report extraordinary healings. You will certainly be aware that in the treatment of addictions, for instance, the approach that yields the best results is the one that combines the spiritual, the psychological and the medical. Meditation practiced by many more people today than earlier by harried executives, by students, by artists. Doctors, like Los Angeles cardiologist Dean Ornish, treats heart patients with yoga, meditation and controlled diet, cutting down on medication. A doctoral thesis done by an Indian in Chicago found that Transcendental Mediation has effects comparable to traditional western psychotherapy, starting however from different suppositions about human nature. The growing secularization predicted by scholars in the 1960s has not taken place. What did take place is a growing influence of religion, greater recourse to people, centers and procedures which are considered spiritual.

Clinicians have taken note of this, too. Dr. Kenneth Pellettier, who made a psychological study of patients who recovered against great odds, listed their traits. The very first is: Profound intra psychic change through meditation, prayer, or other spiritual practice. Each of us inhabits many worlds. We influence, and are influenced by, forces larger and more mysterious than we commonly believe. Question: Does my experience tell me anything about the psychic and spiritual universes we inhabit (in addition to the material one)? 7. Our Reality as Wounded Healers: One of the hardest things for people in the helping professions (doctors, psychologists, social workers, clergy) to admit is that we need help. We are often confused and in pain, and need care. Recently, I met Meera, a generous and very self-giving volunteer who did commendable work among the poor and the sick. One of the hardest things she has ever been through is the therapy she is undergoing at the moment. I am in a mess, she told me. The therapy, while necessary and meaningful, is harder than the sacrifices she made living among the very poor or looking after the dying. I hate it, she says but admits she needs it. Peel off the mask of the successful helping professional and you will often find a hurting human being who is lonely, lost or suicidal. The famous specialist who is broken by an unhappy marriage, or the brilliant doctor who feels utterly alone these are not imaginary figures. None of us is as secure as we appear, or as sure of ourselves as we would like to look. Professional success is not the same as happiness, and acclaim is very different from being deeply loved. We are wounded healers. We need healing ourselves. It takes a special kind of strength (which not many possess) to be able to say: I have a problem; I need help. In India, we are probably less open about our need for counseling or therapy than people in some other cultures; but the need for counseling or therapy than people in some other cultures; but the need certainly is there. I am a priest. I know that we priests need help spiritual, psychological, medical. Some of finest priests I know are capable and loving individuals who are ready to say: I need to talk; I have a problem. I know that I need such help myself. There are centres in the West that specialize in treating clergy with emotional or chemical dependency problems. What about doctors? Going by what I read and hear, substance abuse (both alcohol and drugs) is high among doctors. The suicide rate among doctors at least according to U. S. figures is higher than among the general population. So, too, the death rate among those above sixty-five. Whatever profession we choose, whatever our main academic degree or further training, none of us escapes the pains of growing up, the ups and downs of life, the aches and pains that are a part of being human. No one is always strong. There are times when we

feel strong enough to hold others up; at other times, we feel the need to be held. This is nothing to be ashamed of, not a weakness to be given up. It is a part of our being human. So, too, is the helping professions, there is a great need to keep learning, not only the technical aspects of our professions (that is true of all branches of learning), but also and above all to gain deeper insight into human beings. For this, we need to look into the vulnerable areas of our own self. For some, this can be frightening. The fear is: What will they think of me if they come to know my weak side? Paradoxically, by looking into our fears, unmet needs and demons, we become better at understanding and helping other; for what is most personal is also most universal. Besides, what once seemed to be our weaknesses, may turn out to be our greatest strengths. The most useful part of your personality need not be the talent you count on greatly; it may be an unacknowledged quiet side which you ignore or consider unimportant. To some degree, you doctors are parent figures to your patients, to some a father professor in whom they confide, for others a family confident and for some a trusted guide and friend. Your presence in the lives of your patients is often far more than medical help. You can, and you do, give much. Now, you cannot be a non-stop giver. Nobody can. You need to pause, you need to feel supported; you need the occasional shoulder to cry on. The strong professional woman who is above such needs or the macho man unruffled by tender or anxious feelings, is a myth, or, if true, a likely prescription for a breakdown. There is a vulnerable, often lonely, occasionally frightened child within each of us. We need not deny its existence, nor pretend we are fully grown up. Grown up? Who really is grown up? We are at best growing up or maturing. So, it is perfectly OK to be imperfect, to admit that we make mistakes and at times even feel like a failure. We often seek a good word, a kind gesture, a welcoming presence in short, a bit of genuine love. A mentally retarded man in one of the homes in Madras asks every staff member and visior, Do you love me?: We, so called normal people, feel that question with equal urgency, but convention forbids us to be so direct.. Conclusion As a fellow pilgrim on lifes journey, and a colleague in a helping profession who often faces demands similar to yours, I have tried to share a few beliefs on what it means to be engaged in a healing profession. To repeat the main idea: We are in the vocation of healing human beings, not of repairing bodies or treating cases. Medicine cannot vanquish death or eliminate all suffering, but it gives us useful tools to reduce pain, increase our well-being and extend the time available for love and work. In the meeting between the healer and the patient, more things happen than what medical (or other) sciences describe; for we possess powers of healing (and damaging) far beyond what instruments and concoctions offer. To the degree that a life-giving human encounter takes place, it is healing and energizing for both patient and doctor. To the love that a setting

encourages people to be human and to treat each patient as a human being, the institution itself becomes health and life-giving. May this institution and the way its members relate to each other be marked by such a human and humanizing current. The more healing our relationships, the better healers we become. As part of a help to achieve this goal, may I make the following three proposals? II. Three Proposals 1. Interaction among helping professionals from various fields: Where the good of human beings is concerned, there is no such thing as a purely technical question. We need to listen to one another, clarify matters of greater urgency, and supplement the limited vision of each one (and of each field) with the insights and chanallenges that come from others. There are complex medico-legal, medico-moral, and other delicate issues today that no one can fully master, and no one can responsibily decide on without competent input from other fields. No one can play God, or claim full knowledge about intricate questions involving the life and death of human beings. Mistakes and aberrations are possible, even in spite of our efforts, but we can diminish the margin of error. I think this is especially important in a country like India, where many people are illiterate and sub-servient, afraid of raising questions, and where there is greater chance of an M.D. acting as a Medical Deity. You know how different the situation is in countries where doctors have to watch their every step for fear of being sued. Linking up with other committed professionls helps us to serve the people better, to avoid costly blunders and find human and professional support in our work. 2. Interdisiplinary Study and Research: I am thinking of programmes like the Clinical Program in Religion and Medicine offered by the Medical and Divinity Schools at Harvard, in collaboration with Cambridge Hospital. Our own Department of Christian Studies at Madras University is planning a Masters level course on the different aspects of healing, to be taught by university professors and those from the medical field. It is most unfortunate that departments and colleges in Indian universities work in isolation, and offer very little choice or flexibility to the student. Even the recent attempt to introduce the credit system with core courses and electives met with opposition, and is being implemented only in some departments. Medical study can enrich, and be enriched by, strong courses in such areas as ethics, psychology, religious beliefs, and law. What do you say? 3. Health Education: The three channels that have regular access to large segments of the population are: the government, the mass media and education. As we well know. Education, especially education of woman is crucial to the state of health of a people. The oft-quoted Kerala model, for instance (a low income area achieving Indias lowest infant mortality rates and its longest life span) owes much to the education of women.

Professor Raman of BHU once told us what the great indologist Max Mueller once said. On being invited to come to India, this scholar who did so much to make Indias classical literature known to the rest of the world, responded, I am afraid that by coming to your country I may lose the great esteem I have of your culture. We, who call ourselves educated Indians, may not like such comments. How educated are we really? We throw garbage on the roads, litter our public places, spit in public, tolerate fly-infested eating places and shops. We cannot attribute all this to lack of means. It is no use saying we have an old civilization and things like that, if the average visior is put off by the squalor and the stench. You doctors know better than I do that many of the diseases you treat are really caused by the far from hygienic environment. My suggestion: Could we not include practical courses in health and hygiene, cleanliness and first aid, at all levels of schooling? Could schools and medical facilities link up to do this? What should we do together to prevent our cities from becoming even worse urban nightmares than they are now? To end: Thank you for your attention, and for the chance to share a few convictions with a group of qualified and competent professionals. There is no way for me to know how far you agree or disagree with my views, or even how clear or relevant I have been. As a speaker, I should also remember the sobering statistic that twenty minutes after the average lecture, fourty-seven percent is forgotten, by the end of day about two-thirds, and in two weeks nearly four-fifths. If some of you still remember something after two weeks, I hope the memory helps you to be happier and more committed in you healing presence with people, and more willing to seek help yourself when the hassles of life wear you out. Mother Teresas gigantic work goes back to her saying yes to an inspiration she had during a train journey to Darjeeling. It meant lauching out into the unknown, without security and support except Gods fidelity. The same humble woman says, We cannot do great things; we can only do small things with great love. Whether we call something great or small, is not the issue. There is greatness lying dormant within each of us, a call to reach out in love and heal. In saying Yes to the call of goodness right now, in love and heal. In saying Yes to the call of goodness right now, we parepare ourselves to be led to deeper and larger commitments. May we go where we are led. May we seek what is worth seeking. May our life be a blessing for many.