Spirituality and Energy Medicine.

My Personal Odyssey

As a clinical psychologist with 34 years of experience in the field of medical rehabilitation, I have always looked for practical solutions to problems and have had little fascination with psychological theory. In my professional life, I have sought methods to assist people who were experiencing physical and emotional pain to transcend the physical circumstances of their lives and to achieve some measure of happiness and contentment despite their losses, some of which were catastrophic in proportion. When working within a hospital system and with individuals acutely disabled, I was usually able to avoid noticing the limited utility of many of our traditional psychological methods to produce effective change because the hospitalization was for a relatively short period of time and/or the person had limited insurance coverage for long term psychological support.

But having a private practice gave me a profound sense of frustration as I received referrals of individuals disabled for extended periods, often on workers' compensation, and the insurance companies were desperate to find a solution to the patient's problem, quickly. The insurance carriers had spent massive amounts of money on medical treatments, yet the patient continued to complain of pain. Most of the people who came to me were dispirited and an interview revealed that most of them were dispirited even before onset of their physical difficulties. By this I mean that they were out of contact with what their true Self was really saying to them about how they were living their lives. Well, this predicament is certainly not limited to people with major medical or disability problems but also applies to most of the people on this planet. We have been culturally and socially shaped to be "good" participants in our family, school, workplace, profession, community, and peer group. This shaping process involves the inculcation of an extraordinary number of habits, beliefs about proper and improper behavior, and judgments about other people's behavior and beliefs. Unfortunately, during this shaping, we learn to ignore our inner truth if it disagrees with the demands of the authority figures in our lives. While a certain amount of this shaping is necessary to allow a group of people to relate effectively with each other (manners and morals), a feature inherent in all such shaping is a lack of behavioral spontaneity so that many of our responses are nothing more than an automatic reaction to a situation based upon past conditioning. By the time we are young adults, most of us seldom notice any discrepancy between what our true Self would prompt us to do and what we have learned to do. It is that discrepancy, the automatic and mindless doing of what we are supposed to do rather than what we want to do, which gradually can lead to a state of being dispirited, to being truly out of contact with our true Self and the spiritual heart beat of the universe. During the childhood years, we learn to suppress, repress, and deny our feelings so that we do not express ourselves authentically. Consequently, it is the accumulation of our unexpressed emotion and the continued denial of our own truth which causes so many of our health woes in the decades of our adulthood.

My Personal Spiritual Crisis

This cultural shaping process is so pervasive that we do not even realize that it is happening. To use a personal example, I tried to be the "good" professional, the solid scientist, the excellent psychologist, the super woman of the latter decades of the 20th century. I had worked for years to present a model of medical rehabilitation which stressed the importance of the psychological, social, cultural, and environmental aspects of the disability experience as essential to complete rehabilitation, rejecting the notion that rehabilitation consisted primarily of units of treatments to bodies with mobility and sensory impairments. (Trieschmann, 1987, 1988). I wrote books, presented lectures at conferences and universities, served on federal and private grant review committees, and served on committees which designed research plans for federal agencies to explore aspects of the whole person who had acquired a disability. But over the years I saw the same faces, all of us experiencing a subtle sense of self congratulation as we met, year after year, at meetings and conferences, each of us, with the best of intentions, convinced that we were advancing the state of the art of medical and vocational rehabilitation. Yet, for me, the whole exercise began to seem like empty rhetoric, merely words, divorced from actions, communal power trips and ego stroking. This is not to say that we did not do some good. But the whole medical system, our phony health care system, was more and more obviously becoming merely a sickness treatment business establishment in which money became the primary focus of attention, getting more of it for some professionals, clinics, and hospitals, and keeping it for the third party payers. In the meanwhile, the actual socioeconomic and psychosocial status of people with physical disabilities was deteriorating nationally and I could no longer ignore the discrepancy between what we were proposing to do and what was actually happening. In the early 1990's, a friend of mine who was equally prominent at the national levels of rehabilitation was crooning that the golden age of rehabilitation had arrived. As I listened, I felt that I had entered the "Twilight Zone," that state when your sense of reality just does not fit with what other people seem to think is happening. At a deep level, however, I knew that I was not the crazy one.

Soon after that I resigned from almost all of my national rehabilitation activities because I could no longer maintain the charade; I no longer believed that what we were doing made much difference to the lives of people with disabilities or chronic illnesses. In essence, my heart was no longer in my work. I was truly dispirited because my work has always been a direct expression of my true Self. It was never a job, nor was it a career; it was an expression of me, someone who wanted to help and to serve the greater good. Did my ego take satisfaction at the nice words which were directed to me? Of course. But that was not the purpose of my work. I wanted to make a positive difference in the lives of people who were experiencing major difficulties after the onset of medical illness or physical trauma. But the operational policies of the health care system were working against all of us.

At the core of my despair was the growing realization that what I believe to be the greater good, providing kind and compassionate health care across the spectrum of life, with or without a disability or major illness, has not been specifically articulated anywhere within our culture. Rather it seems as if we have been living, increasingly, within a "value-free" vacuum in which expediency and eventually making money has become the greater good, by default. This vacuum has been fueled by the decline of the importance of spirituality and religious values in our lives and replaced by the new "religion of science," a religion which preached the dogma of objectivity, quantitative measurement, and reductionism, and which promised salvation through technology and rationalism. Kindness, compassion, caring, altruism, love, sharing, and healing were words not to be found in the literature, the legislation, or the lecture rooms of academia and American medicine.

As I sat and contemplated my life, I realized that the cosmology of our ancestors (that God, the Universe, the Earth, and all on the Earth were part of a divine plan, interdependent and ultimately responsible to a higher purpose than the comfort of our individual lives) was no longer evident in the values, policies and culture of American life in the latter decades of the 20th century. This cosmology had been replaced by the view that the Universe was a machine with no meaning or purpose, thus almost giving permission to people to idealize the values of expediency and greed for power, for money, and for material possessions. (Now we see bumper stickers that say, "He who dies with the most toys wins" and "shop til you drop.")

Gradually I realized that I had been living a sort of "schizophrenic" existence: trained as a professional who adopted the dogma of science, yet personally and philosophically committed to the cosmology of our ancestors. For decades I had been "preaching" that the person, the organism (body), and the environment (P, O, E) were a dynamic unified system that could not be isolated into its component parts for study and treatment. Yet with each decade the health care system was focusing more and more exclusively on physical reparations of bodies. Thus, by the early 1990's, I had fallen into a crisis of meaning, a spiritual crisis, in which I realized that the core values by which I lived my life were at odds with the trends of society at large. To save myself, I could no longer participate in what appeared to be a morally bankrupt health care system. I was depressed and I was angry. My energy had plummeted and I had a clear sense that I was at risk for some significant medical problems unless I made some major changes in my life and my outlook.

After resigning from major national involvement, I turned to my private practice as a means to express my true Self, my soul, wounded though it was. It was then that I was faced with the limited utility of the usual counseling techniques in eliciting the fairly immediate change which the insurance companies requested. Consequently, in an attempt to heal myself and find ways to heal others, I explored and studied a large variety of alternative medicine fields and spiritual practices from the East. In the decade of the 90's, I read, studied, practiced, and trained with spiritual masters within the Taoist, Zen Buddhist, Tibetan Buddhist, and Hindu traditions, with a healthy dose of Christianity as well. In the process I realized that I had never really lost contact with my true Self, but rather it was my true Self that had been speaking to me, more and more loudly, so that I could see the discrepancy between the philosophical foundation of my professional life and the operational policies of the health care system. During this decade of study and training, not only were my own health, energy, enthusiasm and sense of purpose transformed, but I had found a strategy to assist people with major physical illness and disability to live happier and healthier lives. Thus I have been able to guide my patients along a path which would help them to listen to their souls, their true Selves, more effectively with the subsequent benefits of improvement in physical function, overall health, and emotional well being. (Trieschmann, 1995, 1996, 1999).

Applications to Rehabilitation

The disconnect between the deep inner urging of one's true Self and the cultural shaping process is evident in individuals with and without physical disability or medical illness. However, living with a disability is hard enough without trying to become a pale image of who one might have been without the disability, i.e., trying to fit into a world designed by and for able-bodied individuals, most of whom are equally dispirited. Thus, the illness or disability experience becomes an opportunity for the individual to get in touch with the needs of his or her true Self, i.e., to use this opportunity to manifest the true essence of oneself that exists regardless of physical function. This will be immensely easier, however, if the professional who proposes to serve as a coach during this process has already embarked on such a personally transformative project as well. Just studying books or reading an article like this will not do it. There is NO substitute for the actual experience of a spiritual practice that involves centering on the quiet essence within. This can be contemplative prayer, meditation, Tai Chi, Qi Gong, Aikido, yoga, or other centering practices, often a combination of several.

The material to be presented represents some of the key spiritual teachings at the heart of Buddhism, Taoism, Hinduism, and Christianity. This is not a theology nor is it a theory awaiting confirmation of western science. Jesus Christ, the Buddha, Lao Tzu, and the great Hindu Siddhas and sages were able to experience high levels of consciousness which allowed them to understand the fundamental operations of the Universe. These are levels of consciousness that ordinary humans can only wonder about. However, in order to enhance communication of this material to a western professional audience, these teachings will be presented in the form of a set of methodological guidelines for personal transformation which have the mental, emotional, and physical benefits of improved mood and sense of well being, resulting in an improvement in physical function and health. It is important to note, however that basically we are dealing with two faces of the same coin. One face is the personal, experiential, subjective aspect and the other is the objective, behavioral, and physiological correlates of the practice. The subjective and objective occur simultaneously and are equally important. Although they cannot really be separated, the last 70 years within psychology has been characterized by the decline of concern about consciousness, awareness, and introspection and an increasing emphasis on the quantitative, behavioral, and objective aspects of human behavior as if that were the only truly valid dimension of human life. Thus, the custom is to mention the objective and behavioral components in order to establish some validity within the professional community (to have a remote chance of being taken seriously), but the personal experiential component is the key to accessing the true Self and higher levels of consciousness. Please note that it is the exclusive reliance on the objective, physical, quantitative aspects of life which has been the dispiriting feature of our culture in the last century and the major failure of our health care system. Consequently, it is time to bring the subjective experience of consciousness and the focus on the true Self back into all aspects of life, personally, professionally, culturally, and politically.

Spirituality and Religion

Even though there is more awareness that spiritual approaches may bring immense health benefits (Dossey, 1993; Benson, 1996; Ornish, 1998), many professionals do not touch on the topic of spirituality in their interactions with clients because of a fear of intruding into a person's religious beliefs. We have a strong ethic of religious freedom in this country and a social and political reticence to discuss such topics with other than family or good friends. Therefore, I must distinguish here between religion and spirituality. A religion has several components: a set of beliefs which serve as a cosmology of the person's place in the universe (which usually becomes part of the dogma over time) which a group of people share which give meaning and value to life; a ritual or procedure for experiencing Spirit; the dogma, a set of behavioral guidelines or rules which members are urged or required to follow in order to live a "good" life; and an organizational structure which rules on matters of dogma and ritual and which identifies a hierarchy of practitioners who are deemed qualified to perform the ritual and create or alter dogma. Although most religions were inspired by a great teacher who was directly manifesting the Spirit of the Universe, the less enlightened followers, over the centuries, created a structure to carry out the leader's teachings. This structure was intended to provide guidelines on the path to high spiritual states. Unfortunately, over time, the structure itself can become the focus of attention for individuals or groups rather than the spiritual experience that the great teacher attempted to communicate. In this manner the structure MAY interfere with the spontaneity of the spiritual experience as do's and don'ts, musts and shoulds, dominate and eventually inhibit the spiritual experience of practitioners. As a result, participation in the world's religions has declined as many have felt uninspired (experienced no Spirit) by the ritual and dogma. It should be noted, however, that many practitioners of the world's religions are deeply spiritual people, but it is also true that many practitioners haven't the foggiest notion of what true spirituality is all about and are just following the rules.

Spirituality, however, consists of a path a person takes in order to experience the oneness with all creation, the pure consciousness devoid of any form which is at the core of the universe. This experience may occur within a formal religious tradition or outside of any. It is a strictly personal matter in which the individual engages in a series of steps to quiet the mind and the body in order to experience the heart beat of the Universe which pulsates within each of us. This experience has often been described as being in the presence of God, the Holy Spirit, the Great Father, the Self, or the Tao, the term varying according to culture. This is the process of withdrawing attention away from the senses and experience at the body level, withdrawing attention from the emotions, withdrawing attention from the thoughts which drift endlessly across the mind, and resting in the dynamic space which is empty yet so full, that space which no words can describe but the feeling is one of bliss and love. Thus, no intermediary of priest or minister is required. What is required, however, is a discipline, a discipline of consistently turning the attention to the quiet inner space, true Self, which resides all of the time within each of us. We have been trained from childhood to ignore our contact with our true Self and pay more attention to the environment. Such a spiritual practice does not require nor entail the withdrawal from the everyday activities of life but rather becomes the occasion for a gradual personal transformation in which one rides the sometimes turbulent waves of daily life with a greater equanimity. In fact, contentment and often happiness with just what is starts to creep into daily life and what previously seemed like intolerable circumstances become tolerable as attention turns to more pleasurable aspects of life. Thus, the practice of spirituality will not challenge nor interfere with any of the major religious traditions of the world. Rather it may enhance one's experience of one's religious practice.

In the last 50 years, many individuals have turned away from the formal religious traditions of their ancestors for a variety of reasons: because they did not experience a spirit of upliftment from participation in the group but rather a fear of judgment and criticism by the "spiritual police" (congregation members who appoint themselves to be guardians of dogma and procedure); because there was little inspiration in the manner in which the ritual or dogma was presented by members of the ministry; because the magic had gone out of the mythical stories of the religion in the face of established scientific fact. Although many have faded from their religious communities in an attempt to experience true freedom and expression of spirit, the decline of participation within religious traditions has inadvertently precipitated a slide into a cosmological vacuum in which one's conception of the universe, the source power of the universe, and one's place in the universe have been defined by science. This has happened by default. And science, over the last 350 years, has taken a mechanical, reductionistic view of the person, of the natural environment, and of the universe as a whole. Because pursuit of new knowledge was inhibited by the dogma of the Church, Rene Descartes in the 17th century proposed that the Church would have supremacy in conceptual matters relating to the mind and soul of man and woman, and science would have conceptual supremacy in matters of body, physical matter, nature, and the physical universe. This is the origin of the mind-body split which has freed science to explore the physical nature of the universe and the people in it, unimpeded by accusations of heresy. If one reads the original works of Descartes and Newton, however, one realizes that they were deeply spiritual people who viewed humans in nature as a unity which could not be separated. But for research purposes, the mind-body split was a practical solution to foster the evolution of knowledge. Unfortunately, this practical solution to a conceptual power struggle 350 years ago, in combination with the decline in our adherence to the cosmological and religious views of our ancestors, has allowed the views of science to dominate our conceptualization of life and our role in it. This conceptualization is mechanical, practical, and devoid of mystery and awe. Thus, science has taken the place of religion in defining our position in the universe and in some ways has, by default, become the religion of the 20th and 21st centuries. Within this "religion of science," those with Ph.D.'s and M.D.'s have become the priests.

It is time for each of us personally and professionally to examine our own view of cosmology. Are we just a widget in the machine of the universe that can be described by a series of quantitative and objective physical measurements of parts? Or are we a dynamic, creative, loving manifestation of the Universal Source, or God, the whole which is greater than the sum of its parts? Thus spirituality, regardless of one's religious membership, is the attempt to experience this Universal Source, no longer constrained by the limited view of our minds, no longer dominated by the sensations of our human senses, and no longer obsessed by the experiences of the body, an attempt to rest in the state of pure consciousness which is at the core of every atom in the universe.

Energy Medicine and Spiritual Practice: Two Sides of the Same Coin

For the purposes of the discussion here, we will be linking spirituality and science by focusing on methods that have been at the core of many spiritual practices across cultures on this planet. These methods are also found within a burgeoning field known as energy medicine. What is becoming increasingly apparent is that these methods provide very effective means to improve the quality of life of people with major medical illness and physical disability despite the fact of the disability or illness itself. For example, if we fill an 8 ounce glass with 4 ounces of water, we can bemoan the fact that the glass is half empty or we can be grateful that the glass is half full. Same amount of water in the glass; different reaction to what is. This approach is not intended to suggest that psychologically processing the sense of loss and pain associated with illness and disability is not necessary. But after a while, a person needs to expand the focus beyond the experience of loss and find channels for the expression of the true Self. Nor is it intended to suggest that advocacy for improved services to individuals with disability is not necessary. But by practicing the following guidelines, an individual can channel anger against injustice into participation in advocacy activities from a position of health and well being and avoid being destroyed by anger, despair, and worry.

An extraordinary benefit of this approach is that consistent spiritual practice can lead to states of higher consciousness. Now we are talking of going beyond the benefits of greater equanimity and well being and opening the door to the psychic, subtle, causal, and nondual levels of consciousness (the higher spiritual states) as described by Ken Wilber (1995). Currently many humans have achieved the level of consciousness development called vision-logic, the ability to engage in high level conceptual activities. This has been the basis of our technological and scientific advances. Until recently, only the greatest sages and holy persons were able to access these higher spiritual states. Now, however, the evolution of human consciousness is bringing evidence that more and more people are having experiences of these higher levels of consciousness, initially through drugs such as LSD in the 1960's, but now in the last thirty years, through regular spiritual practice.

The linkage between spirituality and energy medicine can be understood by looking at some basic physics. This does not imply that the science of physics is proving the existence of higher spiritual states but rather that the principles of physics present a familiar point of view from which individuals shaped by the western scientific tradition can understand the nature of reality, the nature of the universe, as revealed in the teachings of the great spiritual leaders of all time.

Each atom is an electromagnetic unit of vibratory energy. All atoms vibrate. The largest amount of "space" within an atom is the ambient dynamic energy potential of the universe (which the sages call God or Spirit) with the electrons, protons, and neutron accounting for a minimal portion of the atom's structure. Humans (as well as all matter on this planet) are composed of atoms. Atoms collect to form molecules which agglomerate into cells which coalesce into organ systems and body parts. Every cell in our body has a characteristic vibration. When these cells vibrate at a certain rate and in a certain pattern, the body functions well and the person feels good. When they vibrate at a different rate and pattern, the body functions less well and the person feels not so good. It is highly probable that assessment of the differential vibratory patterns associated with health and sickness will be a core feature of the research of the 21st century.

Every thought is a pattern of energy characterized by a certain vibratory rate and pattern. Positive thoughts have a higher vibratory rate and a smoother, more harmonious, pattern. Negative thoughts have a slower vibratory rate and a more irregular, dissonant pattern. Positive thoughts lead to emotions such as, pleasure, happiness, calmness, well being, whereas negative thoughts lead to anger, fear, and sadness, the whole gamut of negative emotions. The vibratory pattern of the thought and its consequent emotion are experienced throughout the entire body, by each cell, and this vibratory influence triggers the release of certain kinds of neuropeptides which flood through the body (Pert, 1997). The job of neuropeptides is to turn on and off the function of certain cells on which there are receptors for that neuropeptide. The cumulative effect of this cascade of neuropeptides is a sense of well being, lightness, happiness or a sense of heaviness, lethargy, and discontent, depending upon the positive or negative nature of the thought and the consequent cascade of neuropeptides. Thus thoughts are patterns of energy which influence the function of the whole body. Therefore we can ask, is the glass half full or is it half empty? The answer, which implies an attitudinal approach to life, has major consequences for the long term health and well being of the individual, disabled and nondisabled alike.

Which brings us to the question, what is consciousness and where is it located? Pure consciousness is the awareness of life, the awareness of seeing out of one's own eyes, the awareness of being. Pure consciousness is the experience of the dynamic energy at the core of each atom in one's body and therefore, consciousness is located throughout the body, not merely in the brain. And it should be noted, consciousness is not the PRODUCT of brain processes as certain of our reductionistic scientists are currently proposing; it is NOT the end product of certain biochemical operations occurring within that jelly-like tissue within our skull. Consciousness is the precursor of matter and the biochemical processes within the brain are only the physical manifestation of the operations of consciousness (Goswami, 1993). Thus consciousness, spirit, energy versus matter are just different forms of manifestation of the same vibratory principle, as stated in Einstein's famous equation(E = [mc.sup.2]). When matter accelerates to (vibrates at) the square of the speed of light, it becomes pure energy without form. Not all experiences of consciousness are pure, however; in fact few of them in the daily life of the average human being are. Rather consciousness, the awareness of being, is filtered through our habitual beliefs and attitudes, which usually tend to distort or color our experience of what is. Rather than the pure radiance of being (the pure consciousness at the core of each atom) which is expressed as love, compassion, and peace, we experience the turbulence, a vibrational state, which is the consequence of our most recent thoughts. Thus in spiritual practice we turn inward to contact that dynamic inner space, that pure consciousness, which is Spirit, our personal experience of which represents our true Self. Spiritual practice is the discipline of learning to rest within that inner space, to experience pure consciousness, so as to be able to "see", as an objective observer, our thoughts drift across our mind and the resulting emotional consequences of each thought. It is also the discipline of making the CHOICE, over and over, to interrupt the negative thought cycles and substitute positive thought cycles. It is the repeated shifting from negative thought patterns into positive thought patterns which allows the radiance of pure consciousness to become more and more apparent in one's experience of daily life.

The result of this discipline is a gradual uplifting of one's mood, a greater lightness and brightness in one's outlook and experience. Over time, a sense of calmness accounts for more of one's day and one's reaction to difficulties is less pronounced and less prolonged. One bounces back from trouble more readily and surprisingly, less trouble enters one's life. Over time, one's overall health status improves and the ability to function in a variety of settings improves. Energy level increases, mood improves, the immune system function improves so that one is less susceptible to infections and illnesses; in other words, the body is functioning in a more harmonious, balanced, and normal manner. The need for medication declines and in fact one begins to notice how badly some of that stuff makes one feel.

Clinical Implications: Some Hints on Practice

After an introductory interview, I will immediately teach the person to meditate. I quite frequently will not use that term initially but describe it as a stress reduction breathing technique. A brief explanation of the function of the autonomic nervous system as the mediator between thoughts and feelings and the actual experience of stress at the emotional and physical level provides a context for presenting meditation as a perfect means of turning down the level of the sympathetic activity and stimulating the action of the parasympathetic activity. This slows and deepens the breathing, lowers the blood pressure, relaxes the muscles and organs, and leads to a sense of calm. Although less so recently, some people are afraid of "meditation" and therefore I provide a biological explanation for our activities in our initial therapeutic encounters in order to defuse fear of "mind control" by someone else or strange religious practices. Basically I ask the person to spend 3 periods of at least 20 minutes each day sitting quietly and focusing on the in and out breath without controlling it in any way. It is helpful to count each successive exhalation up to 10 and then start over again at number one. The instruction is to interrupt thoughts which enter the mind and return to the counting of the breaths. It is helpful for the client to choose a spiritually meaningful phrase to coincide with the exhalation. Although terribly boring after the excitement of our mental "Sturm and Drang," quietly counting the breaths is the beginning discipline, the practice which is essential to quieting the mind and body. The practice of removing our attention from our thoughts over and over and over again and returning attention to breathing is essential and some version of this is a core feature of almost all spiritual approaches. Initially this is very difficult but, with persistence, moments of pleasant quiet and relaxation will occur. As we turn down the level of sympathetic arousal, the parasympathetic calming provides the physiological basis for the beginning of spiritual practice. It is the repeated interruption of our habitual thoughts, beliefs, and attitudes that allow us to begin to listen to our true Self because that is what we find waiting for us when we shut up and listen. It is then that we start to make friends with our true Self, the Self that has been hidden under the layers of our conditioning. Initially there may be episodes of powerful feelings that are released but only because they have been suppressed for so long. These feelings, the thoughts accompanying them, and the urges of the true Self become the focus for successive counseling sessions. However most people need assistance in the mechanics of the meditation process for several weeks and thus a therapist without personal experience in meditation will be next to useless.

There are many workshops available to teach meditation as well as numerous books on the meditation process which will be helpful to client and therapist alike (Budilovsky & Adamson, 1999; Das, 1997; Hanh, 1975; Levey, 1987; Suzuki, 1970;). However, it really helps for the therapist to connect to a meditation group or spiritual teacher for training and support. There is no substitute for experience.

The issue of powerful emotion needs to be addressed. Our religious traditions have trained us to view anger as wrong and therefore many of us have learned to suppress our anger and smile through gritted teeth. Although the ultimate goal of all spiritual practice is relative equanimity, this does not mean that anger, when it arises, should not be recognized and expressed. Anger is one form of energy, a vibrational pattern, which is best dealt with by letting it rumble on through us and fade away. By defining the very experience of anger as wrong and stopping the expression of this energy at the outward level, we have guaranteed that the vibrational pattern will be held within our system and will require new energy to hold in check. And, of course, the anger accumulates and requires even more energy to hold back. This is the precursor of future health problems. Within this approach to spirituality and energy medicine, anger is viewed as normal and this energy should be released but in a manner that does not cause verbal or physical abuse to others. Thus, part of the training is to learn to recognize clearly what one is feeling each moment and deal with it promptly and appropriately. By engaging in a meditation practice, one becomes much more sensitive to one's state at the moment and learns to see the cause and effect relationships in one's life. Usually, anger is caused by a thought we have had about a situation or a person. The correlate of the thought is both the anger at the emotional level and the neuropeptides at the physiological level which stimulate the sympathetic nervous system. Typically we mentally rehearse the thoughts about the person or event with the result that the experience of anger continues and the physiological response increases. The training is to detect the thoughts which trigger the anger, interrupt them, allow the anger to rumble through us, and use our breathing to calm the physiological cascade of neuropeptides. This is an act of will, the CHOICE of letting go of negativity and focusing instead on the positive; this is the discipline of spirituality applied to daily life. Over time, we become less and less angry because we see how most of our emotional upsets result from undisciplined and habitual thought patterns. EVERY moment we are making a choice, to take the high road or the low road, so to speak, in our habitual thought processes. Since we think between 50,000 and 60,000 thoughts a day, the opportunity for choice occurs moment by moment. The meditation and the spiritual practice make us much more aware of our experience and thoughts in each moment rather than mindlessly trudging through the days with our unrecognized habitual beliefs, habits, and attitudes triggering almost a steady state of sympathetic arousal, with its consequences of headache, sleep disturbance, tension, and pain. Eventually, across the decades, the result is immune system disorders, cancer, heart disease, and all of the other diseases of "civilization," diseases resulting from faulty control over the mind and self-destructive reactions to the stress. Spiritual practice becomes the opportunity for personal assessment and change: the ultimate stress reduction technique. Relief is not always immediate because initially one can feel a bit worse as all of the suppressed feelings begin to surface. But by adhering to the practice of interrupting the thoughts, focusing on the breath, and using a spiritually uplifting phrase, the suppressed feelings rumble through one's system and one's whole sense of being lightens. In this way it becomes a personally transformative practice. The clue to sensing the true Self is an expansive, warm, uplifting feeling which is sustained. That is, it is more than the joy of eating a piece of chocolate or juicy piece of pizza, the satisfaction from which is temporary. The clue to sensing the return to old habits, outmoded beliefs, or limiting attitudes is the sense of tightness, constriction, and lack of enthusiasm. Personal transformation occurs by choosing the direction prompted by the feeling of upliftment and interrupting the limiting and negative thoughts. Initially in this process, it may seem that feelings of upliftment are few and far between but as we give ourselves permission to feel what we truly feel and do what feels "right," the true path will become clearer. This may lead to an even greater understanding of how unhappy we are with the paths we have chosen in the past and the methods we have used to deal with the events and people in our lives. But this self-examination and increased awareness provide the opportunity to assess what can be changed and the option to make new choices.

As an example, one of my patients, a woman in her early 50's, has had multiple sclerosis for ten years, characterized by exacerbations every six months or so, usually involving her balance and motor ability in the lower extremities. She came to see me, however, after an onset of blindness in the right eye resulting in optic atrophy. She was anxious about the future, depressed about her increasing loss of function; habitually she was very tense and very sensitive to others' approval and disapproval. Unfortunately, her life had been spent allowing people's opinions of her to dominate her life. However, use of the above clinical procedure resulted in a dramatic decline in her anxiety and depression about her condition; over time her concern about approval or disapproval also declined significantly. She gave herself permission to be happy by listening to her own true Self and by interrupting negative thought cycles. After six months of weekly meetings she was convinced that she had learned what she needed and discontinued therapy. But evidently she quickly slipped back into the old habits of thinking negatively, and under the stress of her father's death, she lost sight in the other eye. Now she was significantly disabled. She returned to me immediately and we resumed the same procedure. Now after several years of one hour sessions every three weeks or so, she still has impaired vision in both eyes but sufficient function to be independent and fully functional in daily life. She states that she is happier now than at any point in her life, despite the residual balance and mobility problems (sufficient for ambulation without aids) and her visual impairment. What is, at the physical level, has not changed dramatically although she has not had an exacerbation of her MS for five years, and her physical function has improved slightly. But what has changed is her reaction to what is. Now she focuses on the glass being half full and interrupts any return to dwelling on the glass being half empty. Do I recommend therapy for life? No. But everyone needs support for this new way of living from an individual or a group since the focus on the negative is so pervasive in society at this time. This woman has chosen sessions with me as a means of support. And as a final point, it sure is helpful if the therapist is walking the talk, manifesting the principles in his or her own daily life.

Nothing recommended here interferes with the religious traditions or beliefs of the centuries. In fact, the addition of meditation and the discipline of spirituality will enhance one's experience of the religion of the ancestors if that is a meaningful part of the person's life. Thus, during my interactions with clients, their religious beliefs are not necessarily a part of our discussions unless they initiate the topic. Rather we have found a point of commonality with our focus on the core spiritual principles which underlie all of the religions. Thus the issue of spirituality can fit quite comfortably into rehabilitation practice.

References

Benson, H. (1996). Timeless Healing: The Power and Biology of Belief. New York: Scribner.

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Trieschmann, R. (1996). The energy paradigm: The new model for health care. In Krotowski, D., Nosek, M. & Turk, M., (Eds.) Women with Physical Disabilities: Achieving and Maintaining Health and Well-Being. Baltimore: Paul H. Brookes Publishing Co.

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Roberta Trieschmann, Ph.D., Consulting Psychologist, P.O. Box 5566, Scotsdale, AZ 85261.