Northern Mental Health Services Paper Draft for Comments

I've just started writing this paper, and I'd sure like to get some comments.

Lewis

Northern mental health services are perpetually problematic in Canada. Criticism exists at all levels – from funding, to training, to cultural competency of practitioners, to provision of specialists. This paper represents an intuitive inquiry into Northern, rural and remote, service delivery using the author as the main tool of inquiry.

Conventional models for mental health service delivery lean heavily on diagnosis and treatment. Public health models recognize that health promotion and disease prevention are, in many ways, as important as diagnosis and treatment (Gale & Deprez, 2003). Rural mental health systems, related to limited infrastructures, tend to focus on diagnosis and treatment at the expense of health promotion and disease prevention.

Mental health “is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and adversity (USDHHS, 1999: 4). This conceptualization is culturally based and therefore grounded in the values of an individual’s culture; it varies among individuals and communities. Mental illness, at the other extreme, is defined as a clinically significant behavior or psychological syndrome or pattern that is associated with present distress, disability (impairment in one or more areas of functioning), or a significantly increased risk of suffering, death, disability, pain, or an important loss of freedom (APA, 1994). Mental illness refers collectively to a broad range of diagnosable mental disorders that are characterized by alterations in thinking, mood, and/or behavior, in association with distress, impaired functioning, or both. Somewhere between these two poles are the many problems that afflict ordinary people that are commonly classified as “mental health problems,” which are signs and symptoms of insufficient severity or duration to qualify as mental illness (USDHHS, 1999: 5). These are the bulk of problems that affect people in both rural and urban environments and are those that are also under-addressed by diagnostic and treatment oriented systems. They include grief caused by bereavement, feelings of powerlessness caused by the loss of a job, and sadness related to a divorce. At a community level they can include the results of loss of a major employer or farm crises (Beeson, 1999; Hoyt et al, 1995; Ortega et al, 1994; Williams, 1996).

Rural communities tend to conceptualize their problems as lack of specialists, which is chronic, and not easily solved. Less commonly, rural communities work together to solve problems at a local level, often creatively, and usually without specialty resources. The absolute numbers of people suffering mental illnesses is smaller in rural areas and spread out over wider geographical areas. Weaker economic bases of these communities suggest that the development of specialty mental health services will not be financially viable (Geller et al, 2000). The constraints of rural practice also make recruitment difficult even if the economic base exists for specialty practice (Roberts et al, 1999; Beeson, 1991; Stamm, 1999). Personal stigma for mental illness or use of mental health services is greater in rural areas (Calloway et al, 1999). Mental health care ideally occurs during primary care or emergency department visits (Cunningham, 1997).

Mental health systems in rural communities are largely fragmented (Regier, et al, 1978, 1993). The unstated and often unrecognized core component of rural mental health systems is often the people who neighbors call when in crisis. These unpaid and largely unrecognized mental health workers fill the gaps existing in formal care systems, both rurally and among urban poor. Mental health must be addressed by primary health care providers, as well as social welfare, criminal justice, education, and religious and charitable organizations. Members of the clergy hold positions of trust and respect in rural communities and tend to be underappreciated as resource people by professional mental health staff (Heffernan, 1999).

In discussions of the weaknesses of rural mental health systems, the focus is too often on problems external to the community, such as the shortage of qualified providers, the lack of parity between mental and physical health, and inadequate funding levels (Gale & Deprez, 2003). Amundson (1993: 177) referred to this as the “ain’t it awful what they are doing to us” theme. This focus diverts attention away from the issues that are within community control (Gale & Deprez, 2003).

Gale & Deprez (2003) recommend a focus upon internal problems amenable to local solution, building upon the greater capacity of rural communities to develop collaborative relationships across service delivery sectors and with community members. Common languages are necessary.

Data

My involvement in Northern, rural and remote mental health service delivery began in August 2005 when I began flying on a monthly basis to the Athabascan Basin in the North of Saskatchewan, just south of the 60th parallel and the border with the Northwest Territories. I began with the usual specialist model of seeing patients on consultation and writing reports to practitioners. I quickly realized the inadequacy of this model


Fond du Lac

Our informant, Rose P., told us about the existence of an elder’s network composed of 6 people who had been to Medjugore and who were strong in the Roman Catholic faith. Apparently this group of elders ranged in age from 40 to 60. Entrance into this network required at least one pilgrimage to Medjugore, and preferably more. Rose P. had been to Medjugore twice, and planned to go again. Rose worked in tribal government, but has a second non-paying job of being a resource person for community members, who will call her at all hours of the day and night when they are in crisis. Rose (and the other elders) primarily help the person in crisis through prayer from a Roman Catholic orientation, combining teaching from the Bible with teaching of traditional Dene values and role expectations as they have come to be modified by Roman Catholicism. It was our impression from further discussions with multiple informants that the Virgin Mary is much more discussed and important in Fond du Lac than Jesus and may relate to prior conceptualizations of Mother Earth. Rose P. wanted recognition for her role in the community, and seemed to want employment and compensation for this role. She mentioned being underappreciated by the Band Councilors and Chief. She felt they dismissed what she had to contribute. She wanted to be able to do her helping work without burning out.

Rose reminded us that people never used to spend time in large groups before being forced to do so by the Canadian government. Some feuds (such as those that now exist among families in the community) were ongoing for years (as long as anyone can remember). In the past, people could more readily avoid each other by going off on their trap lines, knowing that they wouldn’t see each other for at least another year. Family feuds were more manageable in the past than when people were forced into constant close proximity.

Informant Rebecca M. had nothing positive to say about elders or the community. She was 19 years old and believed they were all hypocrites. She didn’t want to talk to old people about “stupid Catholic ideas” or hear their preaching to her to say more “Hail Mary’s” or “Our Father’s”. She didn’t think problems get resolved by prayer or focus on Roman Catholic values.

Informant Brenda F. believed that health lay in following community values and role expectations. She was in her mid-twenties and had no children. She had had some contact with Mental Health Services in the past, but no longer. She didn’t really see the need for any additional services for herself or anyone else.

Informant Kevin F., brother of Brenda F., believed similar to Brenda. He thought Mental Health could be helpful for filling out disability forms, but otherwise, had little to offer. He didn’t want any services but was glad services were available if he wished to avail himself to them. Kevin had a diagnosis of Psychotic Disorder probably induced by heavy marijuana use. He was on disability from his job in the mine.

Informant (and client) Carol P. wanted to be sure we knew that we “didn’t know shit” and “had no power to do anything helpful.” What Carol needed (in her mind) was housing and what we had offered her was counseling, which was minimally (to be kind) relevant to her situation and possibly even patronizing and insulting. She thought Mental Health services should help people find housing and solve their real life problems instead of imaginary head trips.

Black Lake

Elder Pierre R. (age 65) came forward to request a meeting. He had been a former chief and a Band Councilor for 25 years. He distrusted the younger generation who were now Chief and Band Councilor. He felt they were focused upon the mines and creating more mining, though he thought that 40 mines were enough and that more would be harmful for the environment. He thought other forms of economic development needed to be explored. He was particularly concerned about AA leaders and NNADAP workers selling alcohol and drugs to community members.

He proposed a meeting of 4 to 6 elders with me during my next trip north. His elder group spends their time on the trap line and promotes time on the trap line as healing. They are more or less Roman Catholic, but different from the Fond du Lac group in that Medjugore is not important to them. What matters to them are their own visions on the trap line and the restorative power of nature as interpreted through a somewhat R.C. lens. He felt more encouraged by the young people than he was by the generation after him. He believes that young people were coming back to an awareness of nature and natural processes, which the “in-between” generation didn’t have. He didn’t believe that current leadership had any interest in improving mental health and addictions. He said they should listen to the people rather than tell the people what to think.

Eileen X. thoughts on “Mental Health” was a person for support, someone to whom you can speak when no one else is there. There didn’t appear to be a concept of health or of mental health. She said “Mental Health/Addiction Services” is new to people so they don’t have awareness of it. It comes when people are in crisis. In the past 13 years, violence has increased in the family and among each other. She mentioned that the people don’t know about the help available to them. She used to work for the RCMP. People would phone her when she was not at work and would tell her that kids as young as 10 were being locked up for “drunk and disorderly.” They looked to her for help. People don’t know about help. It’s not advertised in the Athabasca Region. There’s no posters. There’s no awareness. There’s no public information in the way that community members can access it. She thought that there should be a committee to create awareness and public information, especially with the helpline. She said there’s no crisis unit. There should be a committee for each community. She stressed that professional support is required. The committee should have a number of people – at least four people supporting the NNADAP worker. There’s no 12-step programs and addictions treatment is not successful. She thought that all three communities should work together for public advertising and information. Regarding suicide, she mentioned that it’s not usual for their community. She talked about the suicide of last year that was so shocking, but people knew that this young person was going to commit suicide, but they thought, he tried before, he won’t do it this time, but he did. (He actually tried three times before being successful on his fourth try). She also talked about his family life. His parents were alcoholic. He was a sad child and a loner. He grew up with that. She was so clear in that. She thinks that when rumors of suicide occur, there needs to be mechanisms in place to communicate with these people and not just shrug it off. Six to 8 people should sit on the committee and meet once monthly regarding the issues in the community, especially rumors of suicide. The people who are functional and effective are too busy with their own jobs and too involved in their own life. She thinks that initially a meeting should be set with the Band Council, the Town Council, Addictions, Mental Health, the RCMP, and the elders. Another meeting should be set with the youth from 10 to 18 years old, which would include an Addictions Worker and a Mental Health worker to assist and help out.

The primary objective is to initiate peer support. There’s no info about a kids’ allanon committee and there needs to be some type of program in place to set up such a committee [she’s talking about allateen]. What needs to be created are partnerships between the service providers and the community. The community can help the youth by more things spinning off from the primary crisis stage and moving on to create recreational activities.

She noted that elders don’t know about mental health workers and addictions workers. She’s really into pushing for awareness and making sure that these services are in your face and anyone can access them instead of waiting for the last minute. In conclusion, she said the voice has to be heard. Kids don’t know about mental health or addictions workers. She didn’t have a concept of mental health.

Carla’s notion is that it’s just something being put on them. Meetings will help integrate the services into their existing culture.

She also mentioned that she would be willing to sit in these initial meetings when they start up. She’s lived out of the community for a few years and she doesn’t like being back. She lived in P.A. for several years. When she was there, she’d see people come into treatment and be in the bar the night they were released.

Carla thinks there’s no concept of mental health, but everyone has a concept of social roles. (That’s historical).

Informant Rose M told us that having emotional problems is very stigmatized in the community. It means you are a defective person, there is something wrong with you. She is 42 years old and would not go to elders. When she did, they told her to pray harder and say the rosary more and say more “Our Fathers” and weren’t really able to address the causes of her distress (sexual abuse, physical abuse, feeling hopeless, having no escape, having an alcoholic partner, coming from an alcoholic, abusive past and home). She didn’t trust elders because they didn’t know how modern life was lived.

Informant Ray M, a Band Councilor, didn’t really trust the elders either. He trusted his children more. He seemed to emphasize a general distrust across adjacent generations. People seemed more able to trust one generation removed from their own. Ray attributed many of the community problems to alcohol and drug use and thought people drank because they felt hopeless and helpless. He believed that the marijuana problem was being minimized and was much larger than people were willing to admit. He believed that Mental Health and Addictions Services could help, but he saw the primary problem as stigma-free access. If the services were offered in the clinic, everyone saw who came and labeled these people as defective. If the services were offered elsewhere, they were harder to access. For himself personally, he never sought services in his home community for fear of being labeled and stigmatized. He went outside the community, sometimes as far as Saskatoon. He thought people needed to live a good life to set an example for their children, though he had only been sober for the past three years.

Stony Rapids

Informant Al P. said that Mental Health needed to teach people in the community how to have a work ethic. He said that he had told the Band for 10 years that they needed a day care center so that people could work, but they still hadn’t created one. When they tried, their main worker had a criminal record and the building they picked was under code, so they in essence sabotaged themselves.

Conclusions

The Canadian mainstream concept of mental health does not exist among the Northern Dene. Apparently one is having problems or one isn’t. When one is having problems, services are needed.
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Regier D, Goldberg I, Taube C. (1978). The de facto U.S. mental health services system. Archives of General Psychiatry, 35: 685-693.

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Stamm BH. (1999). Creating virtual community: Telehealth and self-care updated. In B.H. Stamm (ed.). Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. (2nd ed., pp. 179-210). Lutherville, MD: Sidran Press.

U,S, Department of Health and Human Services (1999). Mental Health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, Retrieved 11 August 2000, from http://www.surgeongnenral.gov/library.

Williams R. (1996). The on-going farm crisis: Extension leadership in rural communities. Journal of Extension, 34(1), Retrieved 11 August 2000, from http;//www.joe.org/1996february/a3.html.

Community and Special Needs Children

Here's a presentation I made on community and special needs children:

Conventional medicine and psychology typically ignore the surrounding social> environment in their assessment and treatment of children with disabilities > or special needs. Whether the child suffers from fetal alcohol effects, > autistic spectrum disorders, attention disorders, or learning disabilities> --> indeed for all children -- the community is important. Multiple streams of > research from different disciplines have shown that the expectations of > others> for how children will develop and behave are often more important than the> biomedical or psychological diagnosis. In this workshop, we will consider > how to> involve community in our work with children. We will explore how community > members can be a source of support and therapy and how to change community> expectations for children at risk. Examples of strategies include talking > circles, community meetings, ho-oponopono in traditional Hawai'ian > structure,> sweat lodge ceremonies and other rituals for Plains First Nations and more.> Through these approaches, people are already doing what has been called > naturalistic behavior therapy (shaping expectations for child development > and> behavior toward the positive with rewards inherent in the environment of the> child> accruing for small steps toward the goal with progressive expansion of the > goal as it is met). We will explore how to implement naturalistic behavior > therapy (which has been more effective than the more standard discrete> trials> approach) within communities using parents, grandparents, and others as > "therapists." These approaches are especially useful in rural and remote > communities> where trained professionals are lacking. They have even been shown superior> to "therapy" by professionals when the work is done by community members. > Finally, we will explore the importance of belonging to a community and the > support that comes from community involvement as was demonstrated in the WHO> studies on schizophrenia in Third World countries (better outcomes than > developed countries) and will consider how to support communities maintain > "ownership" of members who are different, thereby avoiding institutional> care.

Transformation

Transformation has been defined as a profound change in the core ways in which we function, view ourselves, and relate to others. Transformation can occur in any or all aspects of a life and is an ongoing process of development. It can involve paradoxical movements between dialectics -- such as surrender and will and even the uncovering and reconciliation of opposites and conflicts. It usually involves increasing awareness of the spiritual dimension (less identification with an individual self and a greater sense of overall connectedness). It may move us toward a greater sense of presence, openness, and inner freedom.

Recovery from Illness

What if recovery from illness could be unrelated to how illness arises?

A basic hypothesis of a narrative approach to illness is that the conditions of a person's life are more or less conducive to illness or to recovery. This differs from previous mind-body approaches or psychosomatic medicine that locate the source for illness within an individual and his or her intrapersonal dynamics. In a narrative approach, it is the entire story that must be considered. The story includes all aspects of the context as well as all involved individuals. Through a narrative approach, we enter a larger model than our science has previously been able to grasp. The model is confusing. It defies simple statistics. It resists linear cause and effect. It proposes that illness arises as an emergent, dynamic condition supported and maintained by all aspects of the situation. This new model both reduces human agency and increases human freedom. It is distinctly similar to aboriginal models of health and disease. Mathematically it requires complex systems methods rather than simple statistical formulae.

Illness has the potential to serve as a stimulus for personal transformation. It can also transform a social network. One of the most profound changing experiences of my life came from being part of a network ofpeople connected to a young woman who died of adrenal cancer. Though she died, those of us who were ostensibly helping her, were irrevocably transformed.

A narrative approach also has the power to move us beyond the defective people model toward an optimizing systems model.

Illness can awaken us to previously undeveloped qualities, perceptions, sensibilities, and abilities. It may be the catalyst toward emotional healing. It can allow us to emerge into greater sense of meaning and purpose. Illness can serve as a call to spiritual practice, or, in the West, become a spiritual practice in and of itself. It can become an antidote to modern Western visions of growth based on developing personal ego power. Jonathan Kabat-Zinn (1993) and Deena Metzger (2004) compare the illness experience to excruciating physical endeavors which ancient spiritual seekers willingly undertook for the sake of their own spiritual development.

Narratives exist of people who have been able to "wake up" through their illness, who tranform through the real life experience of illness.

What is healing and how does one do it?

Today I am at the New York Open Center. It's so busy on the streets of Soho. Christmas has come to New York City! Everyone is bustling. And there are so many workshops and practitioner trainings to attend. Everyone has a technique or a theory. I feel a bit daunted, since I have a non-theory, more or less. My theory is that healing emerges through dialogue and that anyone can do it. That's a hard sell for a workshop. It's easier to pick a technique -- heal yourself through reiki, core shamanic practice, reflexology, numerology, iridology, ayurveda, etc. I'm doing some of that myself when I teach Cherokee bodywork, though I try to teach it as a non-technique, a way of following energy and not a strict set of procedures that one does. My sense is that we are upside down in North America. We need to develop our own abilities to follow energy and to sense spirit and listen to spirit more than we need to learn algorithms. We need to form communities of like-minded healers, start healing circles, dialogue with each other and let the emergent properties of systems hold forth. I think about John Charles, a Cree healer in Saskatchewan, who has never attended one of these workshops and who is a man you would definitely want praying for you. We'll see what happens tonight in my workshop on Native American healing amidst the cacophany and excitement that is New York, so different from Sturgeon Lake First Nation.

High dose Vitamins

Just a note about some of my non-aboriginal related research, though, in some ways, it is, because aboriginal people have some of the worst nutrition in the world, thanks to being starved and then fed government commodity food.

I'm talking about high dose micronutrient therapy for psychiatric conditions. I thought to make this post today, because a local psychiatrist called me who wanted to get started in this area because I had seen one of her patients on call and had suggested Empower Plus and it had worked so well when medications hadn't, that she wanted to know more. So word is spreading thanks to patients who are doing well.

I'm starting a study on the use of Empower-Plus for mood disorders in January, and will appreciate referrals.

The logic behind this approach comes from a paper written by Bruce Ames, Ilan Elson-Schwab, and Eli Silver, called High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): relevance to genetic disease and polymorphisms , from the American Journal of Clinical Nutrition, 2002; 75: 616-58.

Also see the research section of True Hope's web site at www.truehope.com.

Mental Health for Northern Peoples

Today I attended a gathering to discuss mental health for Northern peoples in Saskatchewan. I continue to be amazed by how much money can be thrown at a problem instead of doing actual community development which is so much cheapter. I am drawn to the World Health Organization studies of how much better outcomes India has for serious mental illness than the United States. What India has are intact communities and social networks, sorely lacking in North America. India lacks the money to invest in chronic medication for serious mental illness, so medications are only used for acute episodes. Indian patients must be cared for by their families, even in hospital, since money doesn't exist for nurses. Of course it's not magic, but social relationhip is important and it is so much more compatible with aboriginal ideas about mental health in which self is social and not individual. Identity is seen as the story we tell ourselves to make sense of all the stories that have ever been told about us. People's behavior is determined more by context, environment, and expectation than internal psychodynamics or psychic structures, or psychic apparatuses. When we focus on that, we realize people can change without ever coming to treatment if the community changes around them.

Psychology and Miracles

I've been revising an article on CAM for prevention for a book's second edition and I've been reading a dissertation by one of my students.

I was struck with the biomedical idea that psychological factors had to predict recovery from cancer if mind-body medicine's ideas were to be true. Now that seems so implausible to me. It strikes me that how illness comes about is completely separate (if anything is complete in this crazy, postmodern world) from how it is transformed, healed, or cured. I think illness always makes since within the totality of all the stories told about the person, but that doesn't need that reductionist science can predict who will get sick and who won't. I suspect ordinary people, reading narratives, could do a better job in predicting survivorship than all the experts in the world.

So, what I think now is that illness gives us the opportunity to transform. What we do with that opportunity is up to us and our communities. My graduate student, Patrick Baltazar, says that, "as painful and as difficult as illness may be, it can sometimes help us awaken previously undeveloped qualities, perceptions, sensibilities, and abilities....It has been called the Western path to enlightenment, comparing the illness experience to the excruciating physical endeavors which ancient spiritual seekers untertook for the sake of their own spiritual development." Could we add sun dance to that list? He says further that "illness can be an indication of imbalance and a teacher for aligning ourselves with our own sold, which perhaps mysteriously chooses this path toward wholeness.

Andre Heuer and storytelling in Liberia

I received the following email from an acquaintance, Andre Heuer, who has been working in Liberia. It was so amazing, because I have just come from an 8 day practitioner training in Hawai'i, in which each person's telling his or her story became much more important than any curriculum that I wished to impose. Check this out. Andre writes:

"One of my major tasks in being in Liberia was to explore and experiment with the CVT counselors to find ways to integrate their tradition of storytelling with their clinical training. In Liberia this was important because storytelling is a natural way to teach and communicate. The need was to find a format that would be culturally appropriate and sound clinically. The desired outcome was that the counselors would deepen their clinical understanding by seeing their work through the perspective of storytelling and grow their skills in using story in their counseling practice. In addition the process had to be co-created in conjunction with the counselors to insure ownership. Surprising and what should not have been unexpected was the deep desire on the part of the counselors to tell their stories and to be heard."

This was what was so amazing in Hawai'i with my practitioners: so many people needed to tell their story and to be heard. When people tried to hide in the group, other members came after them to cajole them to talk story.

Andre writes, "They expressed this as a need and as a means of gaining support. Therefore the challenge was to create a culturally appropriate process that enabled the counselors to receive support in a non-therapy group; to cultivate an awareness of and the skills to use cultural, literary, and personal story; and to provide an opportunity to learn new stories.

"The natural format was a group process and was both clinically and culturally appropriate."

Just as happened for Andre in Liberia, a group process emerged in Hawai'i, in which members supported and encouraged each other to tell their stories. Some members even dramatically acted out their stories for everyone else as an audience.

I think what is now being called "Heller Work," and what used to be called "family reconstruction", is just an opportunity to dramatically tell the stories that run through our families' collective consciousnesses.

Andre writes, "Liberians in general feel strong ties to their clan and community. Also the counselors work in teams and usually work clinically with groups. Finally, storytelling and receiving support from others were a natural fit. As we shared and worked out the format the term Story Circles was adopted as the name of the process.

"The counselors developed a ritual of calling each other to attention to begin the group. Each group of counselors chose their own way of doing this. Some chose song, others a call and response, others very simply chose to start with a "Hello" in their own language, and one group chose to begin with "Once Upon a Time." As a fairly religious community with strong ties to Islam and Christianity for the next step each group chose prayer. This prayer could be said or song and they agreed either Christian or Moslem. The telling of personal story would be next and each person would be given three to five minutes to tell their story. Once the story is told the group would acknowledge with a "Thank you" the person sharing the story. The group ends the Story Circle by sharing for fifteen minutes what they personally gained from hearing each other's story. "

What a great format!

The second part of the session is focused on learning a story. The story is told or read and several steps are taken to encourage the learning of the story. The second phase is a discussion about the story and then the circumstances and with whom to use the story. This discussion encourages critical analysis of story both clinically and personally. (I have not fully described this part of the session because of the complexity of the approach.) The session ends with an opportunity for each participant to briefly tell the group one thing they are taking with them from their time together.

As the clinical supervisors experienced how well the process was working for the counselors a decision was made to adopt the Story Circles for use throughout Liberia. In the next two weeks I will be intensely training selected clinicians in the details of the process and conducting story circles in all of the counties served by CVT.

Sick of Doctors

Here is a wonderful post about Olivier Clerc's new book. Olivier is the translator of my two books (Coyote Wisdom and Narrative Medicine) into French

URL http://www.sickofdoctors.addr.com/articles/modern_medicine.htm

Modern Medicine: The New World Religion

The Hidden Influence of Beliefs and Fears by Olivier Clerc, France

When the Christian missionaries of the last three or four centuries were evangelizing so-called "primitive people”, they believed that they had only to destroy or burn the various cult objects of these people in order to eradicate their religions, superstitions, and customs. Centuries after the conquistadors tried to stamp out the Inca culture, or the Inquisition tried to stamp out the protestant ‘heresies’, or the similar attempts to annihilate the Voodoo, or the many African and Asian religions, we know that such arrogant high-handedness does not work. These beliefs still continue today, sometimes under different guises, long after the objects of worship associated with them have been destroyed.This lesson from history is not only valid for primitive people and their religions. It can equally be applied – if not more so – to aspects of our own modern society. Indeed, even a superficial study of contemporary culture will reveal that the supposed secularization of present day society is just an illusion. Even though most people do not conform to the outward show of religious custom and practice – mostly Judeo-Christian in western culture – the beliefs and superstitions remain deeply embedded in their subconscious, influencing many aspects of their daily lives without them realizing it. And as several sociology studies have shown, the superstitious beliefs that used to be attached to the formal religions have in many cases simply been transferred to other objects, persons or events. The daily evening television news bulletins, watched by millions worldwide in their respective countries, the stars of show business and sport, humanitarian associations, cults and all sorts of other things in modern life, these have now become the new gods we venerate or fear, or the shrines at which we worship or curse, and where we still experience those primitive religious urges and feelings, where we can believe without necessarily having to think or rationalize.However, it is in the field of medicine that this unconscious transposition of the religious experience - and more specifically the Judeo-Christian ideology, myths, beliefs, expectations and hopes - seems to have had the greatest impact. The facts show clearly - for anyone taking the time to study them - that medicine enjoys today an astonishing degree of undeserved credit that is out of all proportion to its actual results or promises. Real health keeps regressing, while the great medical "miracles”, such as vaccines and antibiotics, are now clearly showing their limitations, which some had foreseen and warned of right from the start. This undeserved credit comes mostly from the fact that medicine and science have replaced religion as the only certain belief in an uncertain world. And the doctors and scientists are seen as the priests of the new religion, delivering through the certainties of science what the old discredited gods were not able to deliver. If we can no longer believe in the miracles, the cures, and the curses of the old religions, we can certainly believe in the miracles, the cures and the destructive powers of the new science.Almost imperceptibly, medicine has taken on a saving, or messianic role, the characteristics of which we must examine. Looking back through history, there is a sense in which medicine can be said to have displayed characteristics that have at various times characterised the Roman Catholic Church: autocracy, centralization, the control and manipulation of people, censorship, propaganda, total obedience, infallibility, the destruction of heretics, the stamping out of individuality. All this, of course, has been done in the name of public health and the general good, just as the church acted for mankind’s salvation.Let me make my position clear. I am not a conspiracy theorist. I do not believe that doctors, scientists and governments are intentionally and corruptly conspiring together, abusing their powers in pursuit of wealth, "Big Brother” and "Brave New World” just a step away. But rather, I do believe we are faced with a phenomenon that is largely of the unconscious kind.What I believe is happening is that people, whether within the medico-pharmaceutical industry or outside it, are being subconsciously influenced by their deeply rooted myths, fears and superstitions which are now being projected onto the new screens of science and medicine. This produces an amazing paradox. Although medicine sees itself as exclusively scientific and rational, with no room for spiritual or human dimensions (such as psychic healers, or shamans, who are dismissed as charlatans), it organizes itself and functions in a way that can be described as intrinsically religious. The paradox is that by rejecting any spiritual dimension medicine in fact becomes the toy of the forces and myths it tries to ignore and cannot control. Mere denial of something’s existence has never made it disappear, except perhaps in our consciousness, but instead, it is banished to our subconscious mind, where, beyond our control, it can roam free, wreak havoc, and wield even greater power.We can see, then, that even though our society considers itself to be secular, it has remained as Christian as it was a century ago, but with two major differences. Firstly, our society is not aware of it. It believes itself to be rational, scientific, and free of superstition. It fails to recognise that it is still, in effect, observing the old religious rituals, but under a new guise. Secondly, our society now lives its religious experiences through secular forms - medical ones, in particular - and has at the same time transferred its hopes and aspirations from the spiritual world to the material.Medicine, then, has become the new world religion. The specific myths, beliefs and rites of Christianity have been unconsciously projected over medicine since Pasteur. As I explain in detail in my book, we can establish a very close parallelism between the catholic religion and modern medicine, although, for lack of space, I cannot go into all the details of each comparison in this article. In brief:- physicians have taken the place of priests; - vaccination plays the same initiatory role as baptism, and is accompanied by the same threats and fears; - the search for health has replaced the quest for salvation; - the fight against disease has replaced the fight against sin;- eradication of viruses has taken the place of exorcising demons;- the hope of physical immortality (cloning, genetic engineering) has been substituted for the hope of eternal life; - pills have replaced the sacrament of bread and wine;- donations to cancer research take precedence over donations to the church;- a hypothetical universal vaccine could save humanity from all its illnesses, as the Saviour has saved the world from all its sins;- the medical power has become the government’s ally, as was the Catholic Church in the past;- "charlatans” are persecuted today as "heretics” were yesterday;- dogmatism rules out promising alternative medical theories; - the same absence of individual responsibility is now found in medicine, as previously in the Christian religion; - patients are alienated from their bodies, as sinners used to be from their souls.People are still being manipulated by their fears and childish hopes. They are still told that the source of their problems is outside them, and that the solution can only come from the outside. They are not allowed to do anything by themselves and they must have the mediation of priest-physicians, the administration of drug-hosts, and the protection of vaccine-absolutions.Just as the magnetic field of a magnet placed under a sheet of paper controls the way iron filings fall on its surface, revealing the invisible lines of force between the two poles of the magnet, a "religious field” likewise imperceptibly structures and organises the development of modern medicine. Invisible, impalpable, this "religious field” is made up of all the beliefs, myths and values of the Christian - and more specifically the Catholic - religion. In other words, the secularisation of society happened only on the surface. We took away the "iron filings”, the specific religious forms, but we did not change the "current of thoughts”, the underlying "religious field”, which continued to exert the same influence, but through medicine. That is the reason why behind the different structures of medicine and the Church of Rome we find the same fundamental concepts, the same relationships, the same characteristics, the same fears, the same hopes and expectations.This substitution of medicine for religion has had many unfortunate consequences. In medical research, it influences what should be looked for and what can be discovered. Any discovery or theory that is at odds with the over-arching orthodoxy is rejected, and its authors called heretics. Entire areas of research, as well as promising new lines of approach, are thus disqualified.Furthermore, the unconscious need to bring the medical world into "religious” obedience frequently leads to (involuntary) falsifications of results, as became clear with Pasteur's discoveries. The medical credo takes precedence over reality, something that scientists refuse to acknowledge when it does not correspond with their preconceived ideas.And lastly, the hidden religious dimension of modern medicine inhibits the free debating of already fixed beliefs, and preventing them from being properly re-examined and criticised. Indeed, dogmatism, irrationality and passions - all characteristic of the religious experience - take precedence over any calm and carefully thought out argument, even over the most tenuous facts. The same vehemence that led Galileo to be condemned by the Church for his theories, in spite of the scientifically demonstrable facts, is now being used by medicine to reject any thesis that is contrary to its own dogmas. Science has learnt its lessons from the Church.My aims in writing and lecturing on this topic have therefore been several. Firstly, I wanted to bring to the fore this phenomenon of projection and transfer of religious content, which takes place in the medical field. In recognizing this phenomenon, we should then dissociate from medical practice the spiritual aspirations that quite logically can only be satisfied in the spiritual dimension. It is dangerous to mistake eternal life with physical immortality, or to think we can achieve collective salvation through science and genetic engineering instead of individual salvation through transformation and personal achievements.I also hope that by bringing to the fore the influence of religious beliefs in medicine, which is but one example of a very widespread phenomenon today, readers will start thinking about how their beliefs filter their perceptions, biasing and distorting them. Every time an object, a person, a social group or an event becomes the target of religious projections, there is danger. Their real characteristics fade in the eyes of those who colour them with their beliefs. These targets then become the objects of religious urges, impervious to any rationalisation, whether they are expressed through fear, hatred, "devilisation” and search for scapegoats, or through deification, idealisation and unconditional devotion. From Princess Diana to Wacco, and from Mother Teresa to Saddam Hussein, there are numerous examples of the kind of consequences brought about by this transfer of religious expression to real persons or situations.Beyond this dissociation of medicine and religion, I would like to encourage an increased awareness of the fears found in the depths of our consciousness, which remain the hidden determining factors of most of our actions. As shown in my book, these fundamental fears - fear of death, mostly, but also fear of evil, fear of suffering, fear of separation, fear of solitude - have lead humanity, at all times throughout history, to make up all kinds of beliefs, in an effort to exorcise these fears. Then, with the development of science and the rise of intellectualism, mankind has tried to justify rationally these beliefs, hidden under the cloak of medicine and life sciences.In other words, there are three layers superimposed inside us:1) a core of fears, from which we have learned to protect ourselves by covering it with2) a layer of beliefs, which make us feel safe (even though those fears have not disappeared), this layer being itself dissimulated under3) an intellectual varnish, a rational facade, which give us the illusion of having transcended superstitions and beliefs, and which shelters us from our fears, keeping us barricaded behind intellectual knowledge.But in reality, as soon as any unexpected event scratches this varnish, our underlying beliefs and fears reveal their presence and their indirect influence.As long as they are not acknowledged, accepted and transformed, these fears will feed on every area of human endeavour. The intellect cannot think freely and the heart may not love fully, as long as both of them are hamstrung by the permanent task of appeasing our deepest anxieties, which keep trying to re-surface in our consciousness. No technological innovation, no scientific discovery, no external knowledge will ever enable us to avoid this confrontation with ourselves, and - more specifically - with our shadow. It is quite instructive to see to what degree the intellectual and technical knowledge of this century - often quite remarkable - remains captive to the fears that haunt society. We only have to look at the poor state of our planet, at the multiplicity of wars and at the emergence of new diseases, to see how this way of using our inner capacities is unproductive.Finally, through this increasing awareness and consciousness to which I invite my readers, I hope to encourage greater individual responsibility, be it on the medical or on the spiritual level. It seems inexplicable to me that we should give away our power to whatever external authority (priests, physicians, experts) and then blame them for abusing us with it. Very few people are capable of being totally impartial and disinterested, especially when money and power are at stake. And especially when psychological studies show that the noblest motivations often go hand in hand with more dubious unconscious intentions. Therefore, taking personal responsibility for our own health, our own inner evolution, and our own life at every level, without rejecting any available help or advice, remains the safest and most rewarding attitude. The obscurantism that endures under new forms will not so much be fought by the lights of science than by the sparks of our own self-awareness, that each one may awaken in himself. At least, such is my conviction.
This text first appeared in CONTINUUM Magazine and is the introduction to the book "Médecine, Religion et Peur; l’influence cachée des croyances” by Olivier Clerc The book has been published with Editions Jouvence, 1999. France. Olivier Clerc has been working for 20 years in the field of alternative medicine, spirituality and personal development, as author, translator, journalist and publisher. Beside his book on medicine and religion, he has written a book on lucid dreaming ("Vivre ses rêves", Helios, 1983) and another about isolation tanks ("L’océan intérieur", Soleil, 1985), and was chief editor of a French magazine dedicated to health, ecology and social issues. He was editorial director of Editions Jouvence, Switzerland, until February 2001.The author can be contacted at olivierfclerc@yahoo.fr

My Purpose

Why did I start blogging besides wanting to be like everyone else in the cyber-universe?

I came of age in the 60's. Like everyone else, I wanted to change the world. I still do. I want to inspire us all to make something better and different from what we have.

Primarily, my focus is to change medicine and psychiatry. I wish to re-animate the world, to re-infuse our field with the spirits of shamanism, to keep what works and discard what doesn't, to overthrow our worship of theory for a love of possibility, to support what is beautiful and transformative among people, to support hope, faith, and love, and to defy the idea that people are defective, that change is impossible, and that mechanism is everything. I wish to return art and spirit to health care, to explore what is healing and what does it mean to heal and be healed.

Within larger arenas I am interested in how we can build healthy communities, use communities to support health, and replace punishment and retribution with reconciliation and forgiveness.

I hope to explore these and other topics within this blog as time progresses and to engage others who share my purpose and interests.