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Tapping the Soul's Healing Potential
An Interview With Carlos Warter, M.D., Ph.D.
Anne H. Coulter, Ph.D.EDITOR'S Note: The integration of various spiritual practices and beliefs into alternative medicine has spurred a number of physicians to investigate these phenomena. Carlos Warter, M.D., Ph.D., a psychiatrist by training, has migrated through many spiritual and healing traditions, including Sufism, Buddhism, and Native American (North and South) practices, and has determined that healing, in any tradition, can be accomplished by reestablishing individual can connection with the soul, the self or animus, that is the center of wellness. His attempt to increase awareness of this approach to medicine has added a unique and important dimension to the integration of spiritually based medicine into mainstream medical practice. To understand how Dr. Warter situates himself as part of the movement toward spiritually based alternative medical therapies, Anne H. Coulter, Ph.D., Alternative & Complementary Therapies" managing editor, interviewed him this summer.
ARC: There are a number of alternative practitioners who have emphasized the importance of spirituality in healing, including Larry Dossey, M.D., Deepak Chopra, M.D., and others. These physicians have published widely and are beginning to be heard within mainstream medicine. Your work has focused on many of the same issues as these practitioners but with a different twist. Could you describe what you perceive to be unique about the work you are doing?CW: I am but one in a group of many that is making connections between prayer, spirituality, and the sacred with healing. Larry Dossey, for example, is an internist, who over the last several decades has observed the power of prayer. He has noticed and documented that people who believe and practice something of a religious or spiritual nature have experienced accelerated healing or recovery results that are more positive. In his books and his work, he has introduced the notion of nonlocal and local realities-healing that actually does happen, at a distance, from causes that may not be standard or even apparent in a traditional empirical model. Deepak Chopra looks at this phenomenon from the Indian perspective-through transcendental meditation. Using Ayurvedic philosophy, he emphasizes the need for a body/mind integration. Andrew Weil, M.D., on the other hand, has brought the rigor of allopathic research to herbs and substances that are natural in origin.
I see myself as introducing the next level in this shift toward spiritual dimensions to healing, that of body/mind/soul. I think that we have a more constricted- a more contracted-awareness of the reality of soul. A traditional model presents us as physical material entities who, with prayer, or through the experience of higher phenomena, achieve a third dimension, our soul. In my work, alternatively, I am suggesting that we do not have a soul; we are the soul. We are a non-local entity. We are really a consciousness that is taking form in this dimension, but our identity needs to shift from a head identification that is based on the object-referred culture to a subjectivity that goes beyond the mind and goes beyond the body and that is permeating and present throughout all phenomena.
ARC: This is all quite abstract to those of us who have not studied these phenomena. Could you elaborate?
CW: Sickness, at a certain level, is a reflection of a lack of awareness of who we really are. In psychological terms, we call this "object referred." Most of the time, we identify ourselves with our objects, our things or possessions-for example, money in the bank, relationships, positions in jobs, professions, or organizations. We have become dependent on objects outside ourselves, and circumstances can make us feel very vulnerable when these objects change. This period of vulnerability can be one when illness will occur. Alternatively, to be self-referred is to be aware first of our reactions to circumstances that can threaten us and later to the mechanisms that cause these reactions until, ultimately, we move to the discovery of our essential self, which is beyond space and time. Here we are not susceptible to the loss and gain that rule everything outside us. We do not feel the connection to the objects of the present that cause suffering but become more connected to the subject, the self, that is outside of suffering.
"I require that individuals shift their focus
from the head to the heart,
where one can achieve amazing instances of emotional and physical healing."
"When attachments are withdrawn, we create suffering in our minds that translates itself into biologic, physiopathologic changes in the body."
Specialized Terms
Nonlocal: Larry Dossey, M.D., defines the era of "nonlocal or transpersonal medicine" as follows: Mind is a factor in healing both within and between persons. It is not localized to brains or bodies or to the present moment. Mind is unbounded and infinite in space and time--thus, omnipresent, eternal, and ultimately unitary or oneAyurvedic medicine: Ayurveda is a traditional, natural system of medicine from India, which has been practiced for many centuries. Ayurveda provides an integrated approach to the prevention and treatment of illness through lifestyle interventions and a wide range of natural therapies. The term Ayurveda has its origins in the Sanskrit roots ayus, which means "life," and veda, which means "knowledge." Ayurvedic theory states that all imbalance and disease in the body begin with imbalance or stress in the awareness, or consciousness, of the individual. This mental stress leads to unhealthy lifestyles, which further promote ill health. Therefore, mental techniques, such as meditation, are considered essential to the promotion of healing and to prevention.
'Dossey, L. Healing Words: The Power of Prayer and the Practice of Medicine. San Francisco: Harper San Francisco, 1993, p.41.
b. Alternative Medicine: Expanding Medical Horizon's. A Report to the National Institutes of Health on Alternative Medical Systems and Practices in the United States. Prepared under the auspices of the Workshop on Alternative Medicine, Chantilly. VA, September l~l6, 992, p.79.
In Buddhism, it is said that all suffering results from attachments and false identifications with objects or things that are finite and that will have an end. When these attachments are withdrawn, we create suffering in our minds that translates itself in biologic, physiopathologic changes in the body: we become susceptible to illness, disease, malfunction, or dysfunctions. If, alternatively, we can focus on the essence, or the self, the changes become less disruptive, and we begin to regain a context that allows us to deal with the situation. This "context of being" allows us to re-identify with any self-identity we may have referred to others or to objects. Even at the moment of dying, this reclaiming of self can reduce the level of sickness and pain by transferring our focus to the quality of the life force, becoming present with the essence of life--the "Word of God" in the Christian and Jewish tradition, the "sound current" in Indian terms, the "inner silence" in other traditions. Even at this final moment of life, a major transformation can take place, one that reconnects the subject with the soul, that will reprogram the quality of the experience.
AHC: This sounds like an incredibly optimistic approach to healing. Which medical specialties and illnesses will benefit most from it?
CW: Although my formal training was in psychiatry, I observed early on that most illness was psychospiritual as well as physiologic in nature. To expand the spiritual treatment of more individuals, I have been board certified in family practice, a specialty that gives me access to both mental and physical illness, for ~4 years. During this time, I have treated patients for depression, anxiety, and neurosis. After treatment, I have seen a change in patient perspective. By this I mean an inward focus on meditation or prayer-a major shift, if you will, in a patient's attitude toward an illness. At some level, this internal shift toward the spiritual self has alleviated discomfort from gastric ulcers, major surgeries, and diverse cancers.
AHC: The recapture of the soul, the integration of mind/body/soul is difficult to document scientifically. Are there studies in spirituality that are elementary, more comprehensible at this stage in spiritual healing investigation?
CW: The prayer studies are a first step in scientific investigation of spirituality and medicine. They initiate a level of warmth and support that is nonlocal and that can be transferred into the patient. Several studies have been initiated; some have been successful (see box entitled Prayer Studies). Other approaches may begin to connect physiologic change with nonlocal mental interference. For example, early in my career I saw the effect of intercession, interconnection, in a study I did that measured immunology characteristics in three generations of schizophrenic and mentally ill patients. In this study, I analyzed the IgG, IgA, and IgM levels (immunoglobulins that indicate the effectiveness of the immune system) of the grandfather, parents, and seven children in one family when any of these persons was or had been hospitalized for mental illness. Immunoglobulin levels were taken for all members of the family when any one of them was hospitalized. Likewise, when a family member was released, measurements would be taken of the whole family. In this study, we were able to connect some variations in immunology with the level of warmth and togetherness, the integration of the family group. If, for example, one member were hospitalized, the rest of the family would go into stress, and the measured parameters would decline, reducing the collective resistance to disease. This early study was a starting point for my study of the effect of others on individual healing and, ultimately, the power of individual self-awareness on healing.
AHC: The next step, the mind/body/ soul integration effected not by others but by the patient, is one that your work tends toward. How does the clinician begin the process of healing that turns a patient toward the soul?
CW: We create a relaxed setting so that individuals can go through a detached , a nonjudgmental view, of what they are expressing, what they think they are (see box entitled Integrating Soul Awareness into Your Clinical Practice).We create a setting in which we develop a strong trust with individuals so that the judgment that society places on them is released. If, for example, we are treating an alcoholic, such an atmosphere will release him or her from being an alcoholic and allow him or her to see other modalities of the personality or expression, such as nondrinking. Because who he or she is is not an alcoholic. What he or she is is a human being who, for certain periods of time, has practiced alcoholism. Using the technique I describe, the individual can begin to connect with alternatives other than alcoholism.
AHC: Some of the techniques you describe seem to resemble current modes of psychotherapy. Could you please describe how your approach is different from conventional means?
CW: I require that individuals shift their focus from the head to the heart, where one can achieve amazing instances of emotional and physical healing. Most of the time our life focus is cerebral: we are identified with what we think and feel. Once our focus goes to the heart, we can reinforce our awareness of our heart and of emotions, such as gratitude and love, that originate there.
Once this paradigm shift is complete, we fall into the "voice of silence," as it is expressed in Judaism. Every sacred tradition talks of a heart-based spirituality. In Christianity, it is called the Sacred Heart of Jesus. Shamans talk about treading a path of heart. Followers of Sufism are often referred to as "people of the heart." This spiritual path to the heart can also be a path to physical healing.
ARC: How does one get on this path?
CW: To achieve this end, I developed a model of healing that I call the Pyramid of Healing,(c) one that, as the patient ascends, leads him or her to spiritual health and well-being. At the lowest level of the pyramid, patients are involved in actively doing things to improve their health. They consult practitioners in a wide variety of traditions ranging from allopathic medicine to traditional Chinese medicine including diet, exercise, botanical medicine, Ayurvedic medicine, and a myriad of others. At this fundamental level of the pyramid, the choice of the healing modality and the responsibility for healing reside with someone else-the family physician or another practitioner. Patients follow the advice of friends or family and practitioners: they de liver their bodies to someone to be fixed.
At the next level of the pyramid, patients are empowered. Instead of heading directly to their usual doctors or healers, they survey all the healing traditions and choose the modalities that are most appropriate for their conditions. Patients are wise enough to recognize that a chiropractor will not heal a skin rash, nor will an herbalist aid in aligning bones and joints. Patients, at this level, use their own intuition, their own knowledge of themselves to choose a practitioner to help them. At this level, patients recognize that healing has to happen in and come from within. The chosen practitioner can only facilitate that process. Even the most skilled healer cannot help someone who does not want to get well.
On the next, the highest, level, patients approach their unhealthy conditions with understanding, compassion, forgiveness, and love. They recognize that, in some way, they are responsible for their current conditions, although they may not have had control over the cause. They may suffer from congenital anemia that will be part of them merely by birth, or they may suffer from an emphysema caused by cigarette smoking. Whatever the cause, patients must learn to let go of any guilt or shame that they feel because they have conditions. Patients, at this level, learn to develop a tolerance for the disease cause that transforms from shame into self-compassion and self-love. Self-love is how we attain mastery in healing-the top of the pyramid. Here the self merges into the divine, where love of self becomes love of soul, all soul.
Selected Prayer Studies
Byrd Study
In 1988, Randolph Byrd, M.D., a cardiologist, tested intercessory prayer over a 10-month period for 393 patients admitted to a coronary care unit (CCU) in San Francisco. In the randomized, double-blind study, some differences were noted in the group that had received prayer by intercession. Among them, patients were (I) five times less likely to require antibiotics and (2) three times less likely to develop pulmonary edema; in addition, (3) none required intubation.
Walker Study
Scott Walker, M.D., a research and treatment psychiatrist at the Center on Alcohol Substance Abuse and Addictions, University of New Mexico, Albuquerque, modeled a study of alcoholics in treatment on the Byrd study. This two-group, double-blinded study was set up to evaluate whether patients receiving prayer by intercession would be more likely to succeed in their treatment programs. The results, which were made available in June 1996, showed no statistical difference between groups. Researchers are still analyzing details of the study to determine whether they overlooked something in design or analysis. Some suggest that in a study such as this, where the illness may be regarded in an unfavorable or negative light by those interceding, the effects of prayer may be minimal or nonexistent.
Thurman Study
Ken Thurman, Ph.D., professor of special education and adjunct professor of pediatrics, at Temple University in Philadelphia, Pennsylvania, is beginning a study that will examine the role of prayer on the recovery of premature babies. This study should add some new information to the growing body of scientific literature on prayer. In considering the work of previous researchers, Dr. Thurman, who is a special educator by training who has worked for the last 20 years on early intervention with children and families, has created a double-blinded study that will consider the amount of prayer received by and its effect on individual babies.
In this study, there will be three groups of babies born at 30 weeks gestation or less who have no genetic anomalies. Group I will be the "nonprayer" group; group II will have two groups praying for it; group III will have five groups praying for it All parent participants will be asked to fill out a questionnaire designed to determine what kind of social support the family has, their degree of dispositional optimism, and their level of religiosity. These factors will be considered when the final results are tabulated. In addition, parents will be asked to estimate how much prayer was done by them or other friends and family during their baby's hospitalization.
*
"Self-love is how we attain mastery in healing."
Integrating Soul Awareness into Your Clinical Practice
1. Find out who you truly are: this means as professionals we need to do the inner work of finding out who we are as human beings. We cannot just be identified with our role, skill, or specialization. In ancient times, healers were initiates in inner work of self-discovery. In what we call primitive cultures, it still happens today.
2. Engage in a spiritual practice that will allow you to be aware of your soul. In modern times, this will also prevent stress.
3. Recognize the sacredness of our profession, a health care-related activity. It is a privilege and an honor to be able to be of service. At the level we work, we enter into an intimacy with the feelings, body, and even mind of unknown individuals who come to us for help.
4. Recognize that the companionship of peers is a spiritual fellowship. This will require a shift from an economic-based reality to an essentially inner focus that we are all servants together.
5. When interacting with patients, believe that they are spiritual beings having human experiences, which, at the time of consultation, is usually pain.
6. During patient interviews:
a. Explain clearly that you understand the patient's human experience to be pain or distress
b. Relate as a soul to a soul; do not place yourself above the patient
c. Explain that your intention is toward the patient's overall well-being
d. Make clear what your area of technical expertise is and that you might need the assistance of others to help during the healing process
e. Include family and friends in your evaluation, and, above all, profess respect for the spiritual beliefs they hold
f. Create an environment that is conducive to relaxation
g. Be on time for appointments and value patient presence: make them feel respected, valued, and loved
h. Ask what their belief structure is
i. Be creative when introducing your beliefs and do not be an absolutist: allow for patients to grow and get well in their own belief system
j. Find out what they know about their conditions and suggest that problems really are conditions, not absolute illness, labels that they must wear forever
k. Emphasize that they are spiritual entities having a human experience; engage in a discussion of this experience, not just a diagnosis
Source: Adapted from Carlos Warter, M.D., Ph.D.. work in progress.
ARC: What are you doing to inform others of your techniques?
CW: I am working on several different levels to educate and inform clinicians of my work. On one level, I'm doing my own personal work with a corporation called Heartnet. The purpose of this organization is to bring the heart into healing-the heart into medicine. I'm also doing a few retreats, and a few seminars every year, here and outside the country. These seminars are designed to introduce clinicians to the possibilities of spirituality in the context of their own practices. A typical seminar will cover aspects of the following:
(1) practical techniques of spiritual healing and spirituality in daily patient care;
(2) introduction to beliefs and practices of major religious groups;
(3) techniques for spiritual history taking;
(4) overview of the individual spiritual evolution from birth to death;
(5) alternative medicine and medical practices or beliefs your patients will never tell you about;
(6) spiritual healing for the terminally ill patient; and
(7) recognizing spirituality in both clinician and patient.
I also attend different conferences of like-minded people to exchange information about the field.
"Spirituality is not "something out there" separate from reality but is a cornerstone in the notions of reality that patients have."
ARC: But much of this is preaching to the converted or those who are willing to be converted soon. What are you doing to introduce your ideas to the skeptics, the non-believers?
CW: There, my focus is on two things-patient/doctor relationship and reawakening of vocation. These aspects I am introducing in lectures to different medical schools. I will be speaking on spirituality in a spirituality and healing curriculum, a proposed curriculum, through the Healing Arts Guild, in Phoenix, Arizona, within the context of a hospital and a family practice program. In this program, residents, faculty, and interns will begin to learn that spirituality is not "something out there" separate from reality but is a cornerstone in the notions of reality that patients have.
ARC: What is the contribution that integration of mind/body/soul, awareness of soul-your nascent technique of healing-ultimately makes to medicine?
Healing Arts Guild Project
The Healing Arts Guild Project is the brainchild of Howard Silverman, M.D., M.S., the program director of the family practice residency at Good Samaritan Regional Medical Center, in Phoenix, Arizona. Although the Guild, or forum, has not yet met, it is one of a two-part approach Dr. Silverman has toward integrating spirituality into the medical profession. In his unique position as family practice residency director, he has the potential to introduce a curriculum for spiritual awareness into the physician training program at his institution. This curriculum, which he developed following a formal needs assessment study he conducted, includes several very specific goals:
1. Establish and maintain a supportive (healing) environment at the teaching institution that values and nourishes the spirituality of patients, residents, staff, and faculty. Do this by discussing spiritual issues openly and without judgment
2. Residents, staff, and faculty will learn about health-related spiritual beliefs and practices of common faith groups.
3. Develop, evaluate, and teach practical methods for spiritual assessment, treatment, and referral.
4. Identify research questions regarding clinical issues related to spirituality and pursue investigations to resolve them.
Dr. Warter may be one of the speakers for such a program. Dr. Silverman envisions having him introduce the diverse spiritual approaches in our culture to practicing physicians through the Healing Arts Guild and to resident physicians through the spirituality curriculum.
The Healing Arts Guild itself is designed to be a forum of practitioners in the Phoenix medical community, who would openly discuss their own interest in spirituality. Dr. Silverman hopes to see its members come together to discuss: (1) why it is difficult to talk about spirituality; (2) what skills are lacking to develop this dialogue; (3) how to expand individual knowledge based on spiritual issues; and (4) how to develop their own spirituality.
Source: Silverman, H.D. Creating a Spirituality Curriculum for family' Practice Residents. National Institute for Program Director Development Fellowship Project, May 1996.
CW: When patients reach the top level of my imaginary pyramid, when they have surrendered to self-love, they reach a frequency of coherence that is body, mind, and spirit-life itself. They reach the raw source of all healing. They wake up each morning grateful for life and the restoration of consciousness, and everything else in the day-they wake up well.
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