Sunday, June 8, 2014

Illness, agency, and responsibility

There is a huge amount of chatter out there about the relationship between physical illness and stress. This conversation has emerged in our culture only in the last couple of decades (and there are still many in science and medicine who don't put much stock in it). But consensus is growing that our bodies are influenced by our environments and our perceptions (and not solely by genes and pathogens). Thousands of studies using sophisticated technology like FMRIs have "documented" the impact of the mind on the body. It is kind of ridiculous that we even have to talk about the "mind-body connection." Last time I looked in the mirror, it was my neck that connected my head to my body. I can't really imagine where my mind might be hanging out, other than in my head. Do we really believe that our minds exist outside of our bodies? That's what the "mind-body connection" suggests -- that there are two separate entities that need to be connected. To paraphrase Harvard sociologist Ellen Langer, we might as well talk about the elbow-body connection. (Check out her interview with Krista Tippett at www.onbeing.org - it's fabulous).

And yet here we are, in a world constructed on the paradigm that mind and body are split. The concept is especially prominent -- and dangerous -- in health and medicine. The body, in this model, is a machine, much like a car. We don't know how it works or why it breaks down. When it does, we take it to the mechanic/doctor, and he tells us what's wrong and gives us something to fix it. Then we go on, taking for granted that it will run as needed. We don't see ourselves as active participants in diagnosing or healing illness. That requires a trained professional.

But the truth is, we have a huge amount of control. And, if we pay attention, we're pretty keen diagnosticians. Control works both ways -- we can act and think in ways that promote health or that undermine it. We may not get to choose what happens to us all the time - but we CAN always control how we respond in our own minds. From the horror of a Nazi concentration camp, Victor Frankl drew this lesson: “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” 

 Every thought and every emotion that passes through our minds - tens of thousands per day - generates a chemical reaction in our system. A good thought or feeling has a building, strengthening and enlivening effect. A bad thought or feeling does the opposite. Stress - whether it is an event or a thought or a feeling - damages our cells. Constantly.

As healers, then, there is a huge amount of unlearning that we need to facilitate. We need to help people to see how their minds affect their health. But knowing this can take us to a scary place. If my mind impacts my health, then is it my "fault" that I am sick? People with chronic illnesses are told that they need to reduce their stress. Yes, that would help. But what they hear is that their behavior, their lifestyle, their choices CAUSED them to get sick. This is devastating to hear when you are suffering. 

So how do we accept and acknowledge the impact of stress or strain on health without, in effect, blaming the victim and further disempowering someone who already feels powerless? We frame it always in the affirmative. We are NOT responsible FOR our illnesses. But we ARE responsible TO them. 

How does that work? Stay tuned. I'll get to that.

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