What Isn't Hurting You Today?...Medical Koan

A while back, I started asking patient-partners the question "What ISN'T bothering you today?", shortly after "How can I help you today?" (or "what's on our agenda for today? " ) Usually this question is reserved for those who I know well, are chronically ill and suffering from many different symptoms; or sometimes those with many different symptoms and NO signs of chronic illness! To my delight, a patient-partner recently came in to his follow-up encounter with a list of all the symptoms that used to plague him that were no longer active.

Bernie Siegel, MD, author of "Love, Medicine and Miracles", used to ask patients: "In what ways are you thankful for your cancer?", or something like that...a shocking question in certain contexts. Yet there are times when his question and mine are not only called for but exactly what the doctor ordered.

Maybe we can develop a whole set of "medical koans". I think of a koan as a question for which there is not really meant to be an answer, but that shakes things up, and out of the momentary chaos that ensues, provides a unique path forward.

Dick Grossman ( see coming "Dick" post), one of my teachers, was a proponent of the Erickson confusion technique. Milton Erickson, MD was a psychiatrist who developed a hypnotherapy induction technique that was remarkably effective, often used for "highly intelligent" patients who were resistant to induction, the process by which one enters a trance. The essence of the confusion technique had to do with nonsense. Nonsense shakes things up, and when the brilliant Erikson spoke , people had to pay very careful attention. Not being able to follow his nonsense, shrewdly constructed chatter with various internal contradictions, was disorienting and pushed a tiring mind to give up and relax, setting the stage for the trance which was the gateway to therapeutic intervention. So medical koans have some of this effect.

But hypnotherapy, and my disorienting question about what ISN'T hurting, while useful for creating an open space to lay the groundwork for insight and transformation is only a tool. The hypnotherapist or the healer-partner needs at least two other essential ingredients to permit an opening for transformation: compassion and wisdom. So the practitioner must be on her game... must have opened her/his own heart and mind. Not all of us need transformation, and certainly none of us need it all the time! But how many of us are stuck? If we have a stuck patient-partner, and we know how to shake things up and DON'T, then what exactly are we waiting for?

Koans, trances, direct addition of energy in various forms, informed by the skill of a wise and compassionate guide can lay a path for moving forward. This is the work of modern mind-body-spirit medicine, and it is not a medicine of supplements, or even only good, food, herbs, yoga and acupuncture, though all of these things are useful. How do we, as patient-partners and guides, create time, spaces and opportunities for this kind of work?

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