It has become clearer over the years that until I understand my own inner spiritual crisis I cannot begin to entertain a therapeutic space with my patients that allows for a spiritual healing beyond the physical symptoms and psychological barriers to health.
Crisis of Soul II
Crisis of Soul II
In my prior essay I claimed everything we know is embodied and cannot be abstracted without distorting its essential nature.
In this essay I develop the possibility for a neuro-anatomical basis for spiritual encounter within clinical practice based on recent science.
The Doctor's Soul in Crisis
The Doctor's Soul in Crisis
In my previous essay I described Moral injury in the context of healthcare, particularly as it relates to physicians, as a complex and increasingly recognized issue. This concept describes the psychological distress that results when individuals perpetrate, witness, or fail to prevent actions that transgress deeply held moral beliefs and expectations.
In this essay I want to describe the crisis as one of soul in the widest meaning of the term,
which I shall attempt to outline.
Suffering and the Soul
Suffering and the Soul
Since the inception of psychology as a distinct field of study in the modern West, it has been widely regarded as the only valid form of this discipline, supplanting all other accounts of the mind and human behavior. The modern West is unique in having produced the only psychology that consciously severed itself from metaphysics and spiritual principles. In this essay we deconstruct the borderlines between mind psyche and soul in an effort to support the need for spirituality to reenter the healing space.
Cartesian philosophy has significantly influenced modern Western medicine, in ways that have been detrimental to the doctor-patient relationship and holistic patient care. By reducing the diagnosis to what can be observed and measured the sum total experience of illness and pain often escapes the diagnostic taxonomies leaving the patient frustrated and doubting self without a ”label”.
The Cartesian Split Lives On
The Cartesian Split Lives On
Cartesian philosophy has significantly influenced modern Western medicine, in ways that have been detrimental to the doctor-patient relationship and holistic patient care. By reducing the diagnosis to what can be observed and measured the sum total experience of illness and pain often escapes the diagnostic taxonomies leaving the patient frustrated and doubting self without a ”label”. We expose the enlightenment model of mind body split and how this still informs the thought patterns of modern medicine to the detriment of the patient
The Cartesian Split
The Cartesian Split
Since the ancient Greeks, a binary opposition between the body and the soul has been a basic framework of Western philosophy. People tend to consider their bodies as matter without thoughts and as fundamentally different from their souls and minds. No matter what else ‘body’ might mean, it refers principally to a thing without comprehension, choice or judgement, contrary to self-determination and free will (Walter, 2011). According to René Descartes, although there is a close interaction between the mind and the body, they are two beings with different essences. The body stands for sensibility, contingency and uncertainty, whereas the mind represents sense, truth, stability and certainty. Thus, for much of the history of Western thought, the body has been in a hidden and obscure state.
Metropolitan Convalescent Hospital, Walton-on-Thames. Coloured wood engraving, 1854 (Wellcome Collection)
Between Illness and Health: What Happened to Convalescence?
Between Illness and Health: What Happened to Convalescence?
Modern medicine has forgotten the transition between sickness and health. Worse, patients are often discharged for reasons other than their own welfare and recovery. Governed by the profit motive, insurance reimbursement and government guidelines the last person on the list of priorities is the patient. However historically that transition between illness and recovery, sickness and health was recognised as critical in re-entering home and work spaces. What was this convalescent stage and how did it improve outcomes? Why did modern medicine sacrifice this integral part of the healing process.
The Patient History
A theory of illness that requires understanding the patient as a person in process, into whose reality we enter in order to understand how the personality interacts with the dynamics of the illness and refusing to interpret the illness apart from the person experiencing it. We review possible models to apply to an archetypal medical model.
The Use of Placebo Effect in Chronic Pain
The Use of Placebo Effect in Chronic Pain
In my previous article “ Effective Listening affects patient outcomes”, I reported three case histories where the placebo effect was part and parcel of my therapeutic strategy. In this essay I wanted to revisit some of the recent theories regarding the neuroscience behind the placebo effect and possible theories as to its effectiveness.
Panopticon, Invented in the 18th century by English philosopher and social theorist Jeremy Bentham
Coercion From All Sides
In my last essay I outlined the ways the medical insdustry abused the doctor patient relationship, but ignored the coercive nature of capitalism. In this essay I will explore a subtle but pervasive aspect of every interaction between actor networks in the healthcare space.
Capitalism and Health Care
In our ongoing attempt to create a new model and healing space for the future of healthcare, we need to revisit the prior systems that failed the poor and the responsibility of the state to care for its citizens with affordable care.
In this essay I review the literature including proposals that revisit Marxist theory in an effort to suggest an alternative model for affordable healthcare.
Effective Listening
The act of listening extends beyond a communication skill. It requires presence, engagement and has therapeutic effect, through acknowledging the dignity and personhood of the person speaking.
The Doctor, Portrait by Luke Fildes 1891
Medical Education following COVID, Challenges and Threats
Medical Education following COVID, Challenges and Threats
Dr. Ungar’s presentation to the Bora College of Health Sciences, Dominican University.
Music Harmony and Healing
Armed with the neurophysiology and imaging data reviewed in this essay, we can approach the need of integrating music as part of a new paradigm in healing.
Specifically in the spiritual non-left hemispheric interaction between healer and patient, I believe the use of this aspect of neural function will be vital in re-educating the resisting the normative adaptive responses in healthcare givers.
Spirituality, an innately human construct and force with pervasive influence across the expanse of human experience, organically and fluidly aligns with music as a similarly indigenous facet of human expression and experience.
When integrated, music amplifies and intensifies spiritual experiences such that new meaning for the client can emerge that transcends current modes of “being”. Spirituality in turn similarly infuses music and musicking with a powerful and resonant meaning distinct from other music experiences.
Remodeling the Space of Healing
Remodeling the Space of Healing
We investigate models that might move away from the traditional biomedical approach by emphasizing collaborative decision-making, patient autonomy, and considering psychological and social factors in addition to biological ones in the therapeutic relationship. Can a reconfiguration of architecture affect this therapeutic space?
Revisioning the Soul of Medical Practice
Health Care Delivery
A brain scan of white matter fibers, color-coded by direction Laboratory of Neuro Imaging at UCLA and Martinos Center for Biomedical Imaging at MGH
Intuition and Imagination in Clinical Decision-Making Process
A New Model For Integrative Diagnosis and Management of PTSD
The Doctor, an 1891 portrait by Luke Fildes