Heroes Not Zombies

When medicine is practised in a fully human way, employing all parts of the doctor’s brain, not just the thinking/analytical knowledge-based functions, then something deeper and more powerful than mere symptom-relief can occur.

As far as I know there are no “artificial healing agents” in the world. Drug companies may claim their products can cure, but it’s only the individual human organism which can cure. As a complex adaptive system, like all other life forms, we have the ability to defend ourselves, to repair damage, to recover from illness and even to adapt and grow. All of those abilities are natural and innate. If a drug, an operation, or any other medical procedure helps it does so by supporting, or better, stimulating these natural mechanisms of self-healing.

But how does that happen?

One element is what Lewis and colleagues, in “A General Theory of Love”, describe as the limbic connections between two human beings. In their book they explore three aspects of this – limbic resonance, limbic regulation and limbic revision.

Every person broadcasts information about his inner world…..If a listener quiets his neocortical chatter and allows limbic sensing to range free, melodies begin to penetrate the static of anonymity. Individual tales of reactions, hopes, expectations, and dreams resolve into themes. Stories about lovers, teachers, friends, and pets echo back and forth and coalesce into a handful of motifs. As the listener’s resonance grows, he will catch sight of what the other sees inside that personal world, start to sense what it feels like to live there.

That’s a beautiful description of what I think is necessary in any good doctor-patient consultation. It’s not so much a matter of the doctor “getting out of the way”, but of “tuning in”. Quite literally. “Getting on the same wavelength”. Why? Not just to communicate effectively but to understand more fully. In an older fashioned way of expressing it, it’s about “putting yourself in the patient’s shoes”. And from a perspective of “heart rate variability” it’s about achieving not just limbic resonance, but heart and brain resonance too.

The first part of emotional healing is being limbically known – having someone with a keen ear catch your melodic essence.

I don’t know if there has to be emotional healing for their to be bodily healing too, but I suspect that to be true. Sure, suturing a laceration may be all that is required for the skin to be restored, but why do some apparently simple lesions heal quickly, and others fester and scar? Might that have something to do with the depth or breadth of the healing?

After resonance, comes regulation.

Our neural architecture places relationships at the crux of our lives, where, blazing and warm, they have the power to stabilise…..But people do not learn emotional modulation as they do geometry or the names of state capitals. They absorb the skill from living in the presence of an external modulator, and they learn it implicitly.

There’s something about a really good consultation which involves safety, confidence and hope. However, I do think all of those qualities are more likely to emerge from a place of love, care and compassion. Maybe those are the key “regulators” which calm, soothe and stabilise the patient’s limbic system.

People who need regulation often leave therapy sessions feeling calmer, stronger, safer, more able to handle the world.

How often have I had that feedback? Very often. Perhaps because that was a conscious aim of holistic, “integrative” practice.

The third element Lewis describes is “limbic revision” –

Knowing someone is the first goal of therapy. Modulating emotionality is the second. Therapy’s last and most ambitious aim is revising the neural code that directs an emotional life.

I think what he is referring to making lasting structural changes – in his, psychotherapeutic, context that’s about changing the patterns of neural connections in the brain to change the person’s emotional life. I didn’t work as a psychotherapist, but as a general practitioner with homeopathic and integrative skills. As such I didn’t separate problems into “mental” or “physical” categories, so while I see exactly what this “limbic revision” is and agree that it is important, I think a holistic doctor, whose patients are often seeking help with problems in different parts of their bodies, it was a broader “neurobiological revision” which was required.

Understanding the “limbic” aspect of medicine, is, however, an excellent place to start.