by Derrick Jensen, for The Sun Click here for Part 2 of the interview

One of the things I like about Marc Barasch is his refusal to abide simplistic answers. He eloquently explores the role of the spirit in disease and healing, yet also demystifies the hocus-pocus of the "If your spirit is pure, no disease can touch you" line promoted by many in the new-age movement. The relationship, he says, is far more subtle, complex, and mysterious.

The complexity of Barasch's thought is mirrored in his accomplishments. At New Age Journal, his emphasis on leading-edge coverage of environmental, political, and cultural issues garnered a National Magazine Award and a Washington Monthly award for investigative reporting. He has been a contributing editor at Psychology Today, editor-at-large for Natural Health, and has been short-listed twice for the PEN Literary Award.

Barasch was educated at Yale University, where he studied literature, psychology, anthropology, and film. A thirty-year practitioner of Tibetan Buddhism, he helped found the psychology department at Naropa University. He has several television projects in development, and is currently producing a Hollywood feature film titled "Disturbance." He is also an accomplished musician, and plays and records occasionally with a San Francisco-based "lit-rock" band that includes Stephen King, Amy Tan, and Roy Blount.

The trip to interview Marc Barasch last June was a return home for me. He lives just a few miles from where I grew up, in Boulder, Colorado; my first job, when I was about ten, was cleaning up the yard at a house not three blocks from his. Barasch's own yard was overgrown with bushes - or, as he put it, "allowed to flourish unhampered." When he asked me in, I wasn't surprised to find the inside of his house comfortably cluttered. He was a little distracted - I'd caught him in the middle of a book deadline -- yet nonetheless warm. His hair, brown with a premature shock of white, was mussed and looked habitually so. As we talked, I was impressed by his sharp intelligence. Whenever we hit upon an important point, I would see his mind leap; then he'd throw back a ladder of words so that I could follow him.

Jensen: You've written two extraordinary books about a multidimensional approach to healing, have just finished a third, and have been through the cancer mill yourself. What do you think helps people heal?

Barasch: I've expressed this in different ways in the different books. In The Healing Path, I talked about people who had gotten well against the odds. They'd done everything from chemo to carrot juice. What they had in common was that they'd all decided to look upon their disease as unique, just as they were unique, and then find a path to healing that drew upon their own enthusiasms, beliefs, and coping mechanisms. Many of them found that they went back to earlier versions of themselves, from a time before they'd gone off on a life path that had stopped making sense. In a way, it's only logical: if you treat illness as a personal journey, you're more likely to marshal your own maximum resources, both inner and outer, in addition to finding an appropriate treatment regimen. But there was also another factor: a willingness to let the illness act as a catalyst for transformation, rather than following the usual model for cure, which is an attempt to get back to the old self and the status quo.

In Remarkable Recovery, we were researching "spontaneous remission" cases - and we did confirm that these were real cases with real medical records, many published in refereed journals. Once again, we didn't find any common method or substance that people used to heal. But we did notice what we called "congruence": a coming together of inner and outer. Independently, another researcher in Rotterdam also looking at remission cases came up with a similar description - he wrote of "a stronger congruence among emotions, cognitions, and behavior" - so that says to me that there must be something to it. If cancer can be understood as a form of entropy, or a growing disorder in a system, then you could say these people somehow came back into alignment with their core selves, body and soul.

Now, does this state contribute to remission, or is it just a byproduct of going through a life-changing healing journey? I don't know. These were what are called "retrospective studies." We weren't observing the ongoing process but relying on people's subjective testimony after the fact. Still, I think the patterns are striking. If they seem inconsistent, maybe that's because the healing process took different forms according to people's personalities. It definitely wasn't a case of people becoming more serene and "spiritual." Some people got nastier, more outrageous, very emotional. Others approached things very rationally.

Our main finding was that the people who healed tended to work at getting well on all fronts. They found social support, faith, and purpose, encountered deep emotion, did things they loved, and usually chose a more healthy lifestyle, including dietary changes - though not always; one just ate greasy cheeseburgers.

Jensen: I spent last evening talking to a friend's step-father who has just been treated for cancer. Our conversation was centered around the mechanics of radiation therapy and the biochemistry of cancer. Similarly, with my own illness, Crohn's disease, I've focused most of my attention on physical causes and cures. We seem always to leave out the psyche, or the soul, in these discussions, even though doctors now concede that it plays at least some role in disease and healing. But how big a role, and of what sort?

Barasch: Well, first we have to define what we mean by "soul," which is not something that flits from your body like a winged heart when you die, but rather an integrative process, an authentic way of living that embraces all our polarities - intellect and emotion, body and mind, social and private. It involves intimacy with what Taoists call "the low, the dark, and the small," and also openness to the big picture - what Zen practitioners call "big mind" - in which the ego and its needs aren't running the show. In most cultures, the soul is understood to be multiple and variegated, not some eternal, fixed, singular thing. There's a bush soul, an ancestral soul, a social soul, a soul that visits with the spirits.

And the soul and the imagination are intimately linked. The fact that images of the disease we are suffering - usually highly personal and fanciful images - show up so often in our dreams suggests that illness has some business with the soul. The places where an illness deeply affects us are where we need to go to heal. Being sick batters at our emotions and has a huge existential impact. The first response - Why me? - leads straight to philosophy and religion. It affects us as social beings, in our relationships, vocation, and communities. This paradigm is as old as the biblical story of Job.

But all of these dimensions have been shunted aside in so-called scientific medicine. So many things that are considered by medicine to be "epiphenomena" or "side effects" are really central, because healing has to address the questions disease raises. It has to be a full encounter.

This is why the new approaches to illness and healing have compound names - like so-called "biopsychosocial" medicine. And this is itself an echo of earlier medical models that still exist in tribal societies, where physical illness is viewed as part of a larger constellation of imbalance - a loss of harmony with the spiritual, social, ancestral, and natural realms. Still, there's a lot of debate, especially between conventional and holistic practitioners, about just how much respective influence these different factors have.

Jensen: The spiritual factor seems to be the biggest bone of contention.

Barasch: And it should be, because it's so easily misunderstood. On the one hand, the effects of the mind on the body can't be refuted. I mean, we know this instinctively: When we get embarrassed, which is a purely psychosocial phenomenon, we blush, which is a purely physical function of blood flow. When we're anxious, we feel it in our stomach, and when we're in grief, we feel it in our throat; everything tightens and clenches up, and the flows of blood and neurohistamines are affected. Clearly, we're orchestrating the pharmacology of the brain through the way we perceive and react to things, through the emotional resonances of everyday events. The hormones we're marinating in cannot help but have an effect on the immune system, and thus possibly on specific disease processes, and logically on the healing process itself. It's what's generally called a "cofactor" - contributive rather than causative.

In general, the mind-body connection is not a direct causal relationship: emotion A creates disease B. The Freudians had a field day when ulcers were thought to be caused solely by stress, but now we're finding that ulcers are more directly caused by a bacterium called campylobacter, and can be cured by a pill. On the other hand, maybe persistent anxiety creates the kind of physiological conditions in the gut that allow campylobacter to thrive. It certainly doesn't hurt ulcer patients to look at the sources of stress in their everyday lives and try to reduce them, or to go deeper into the psyche and the social environment and see what's causing all their stress. If the causes of a disease are many, then it stands to reason the disease should be treated with a multitude of approaches. We need an antidote to the old med-school dictum "One cause, one disease," which has led to the magic-bullet approach. I mean, a magic bullet can be great, but not if it means just "fixing the machine" and returning it to the way of life that made it break down in the first place.

Jensen: The real trouble in this debate starts with the idea held by some that disease is a matter of "choice" - something we do to ourselves.

Barasch: Yes, as if nothing just befalls us. I call it "new-age Calvinism." Calvinists, you remember, believed that if a person was prosperous, it was evidence that God loved him; and if someone was in penury, that person must be a sinner, because God, who was just and good, would never afflict a righteous person. I still see this attitude all over the place; I've even been on the receiving end of it. People have asked me, "Why do you want to have this disease?" and, "Why don't you want to get well?" and, "What spiritual ignorance is causing your illness?"

No matter how fancy the wrapping on this doctrine, it too often turns into blaming the victim. I think it's a way to distance ourselves from our common fragility and impermanence, which illness shoves right in our face. In the Bible, Job's buddy Eliphaz complains that Job's misfortunes are giving him nightmares; he's afraid maybe this mess could happen to him, too. But then Eliphaz reassures himself that Job must have done something to deserve it and says to him, rather coyly, that no one is "blameless against his Maker."

We have to be careful to try to chart a course, as psychiatrist and author David Spiegel so beautifully put it, between the "Scylla . . . [of] mindless materialism - viewing people as nothing more than the product of physical processes" and the "Charybdis . . . [of] disembodied spiritualism - the idea that if one fixes a problem in one's mind, it is fixed in the body." This whole idea of "taking personal responsibility for your disease" can get pernicious.

Jensen: For a long time after I was diagnosed with Crohn's disease, all sorts of people told me, "You've got to learn to take responsibility for this." I'd like to go back and point out to them that there's a difference between being responsible for my disease, in terms of causing it, and being responsible to it, meaning being capable of responding to my body's distress.

Barasch: Yes, that's it exactly. Because we do have choices in how to respond to our condition. And not just treatment choices like chemotherapy or surgery - though these can be critical - but emotional, spiritual, and social choices. With regard to the latter, for instance: Do we go it alone, or join a support group? Do we reach out to friends and community, or just family? Or, looking at the psychological dimension, we might explore what Alfred Adler, Freud's breakaway disciple (he had a lot of those), called "organ dialect": What is your symptom saying - that is, what does it mean to you? How do you imagine it, dream it? How does it function in your life?

Simply examining and living with a disease can open some space for change, even if it's only a change in how we relate to it, experience it, frame it, reframe it. And this is healing, in the root meaning of that word - becoming whole; joining body, mind, and spirit. But it doesn't necessarily mean we've gotten rid of the symptom that ails us. We can be both ill and healed - whole within our affliction.

Jensen: I haven't heard you use the word hope yet. Is hope not a part of the healing path? I have a friend who is HIV-positive, and soon after he was diagnosed he sent me a stack of AIDS literature. A sentence in one pamphlet grabbed me: "Eliminate false hope." What that means to me is that one shouldn't use hope as a shield against reality.

Barasch: Often, hope is an extrapolation of our usual strategies projected forward into some idealized future. And maybe if we weren't so intent on this cherished fantasy, we'd find a fresh approach to illness - indeed, to life - right under our nose. Illness often means that we have to revise our expectations, let go of preconceptions.

The Buddhist ideal is to live "beyond hope and beyond fear." Many people have trouble with that. They say, "Fear's bad, sure, but hope's good; I want to hang on to that." But I've had teachers who are very ruthless on the subject. They say, "Hope and fear chase each other's tails": either you're hoping because you're afraid of what's actually happening, or you're afraid because you worry you won't see your hopes realized. Meanwhile, that which demands your attention here and now, though it looks forbidding, may have something deeper to offer you. It's worth exploring. If hope and fear are really two sides of the same coin, then maybe you need to balance that coin on its edge.

None of this is to say that you shouldn't have a positive attitude. And there are certainly times when provisional hope - or whatever you want to call it - has been absolutely key to people's healing journeys, allowing them to take that next step and behave "as if," despite all evi-dence to the contrary.

Jensen: When I had my worst attack of Crohn's, I was vomiting maybe twenty times a day from the pain. Had I believed I would get no better - had I not hoped the pain would subside - I might have just killed myself.

Barasch: I would say that chronic disease especially requires us to exhibit a deep kindness toward ourselves. It can be important to find a way to accept our pain - accept ourselves in pain - if we can't eliminate it. I'm still haunted by a vivid dream I had when I was ill, one that seemed irritatingly irrelevant at the time, and that I just brushed aside. In it, a voice said, "The way out is the way in." That's a koan worth contemplating.

But if going in is too much for us, there's nothing wrong with stepping away. So often we're too harsh on ourselves. We expect ourselves to endure, achieve, overcome, and conquer. Being kind to ourselves in our weakness - which is really the only basis for healing - is not always the first thing we try in a crisis. Usually, we reach for the nearest blunt object and try to cudgel the problem into submission: the heroic ego to the rescue. And we usually wind up hitting ourselves in the head.

Go to Part II of the Interview.



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