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Archive for the ‘from the consulting room’ Category

I’ve noticed there is a phase of consciousness between sleep and waking up, a kind of half-asleep/not-quite-awake phase. It’s different from being asleep and it’s different from being awake. Maybe it’s a time of surfacing which sways between those two distinct states. Whatever it is the other morning, in that phase, I became aware of a number of different things “coming to my mind”….an image, a memory, an idea, a bit of a conversation, some things on a list to remember to do….it was really quite a mixture. At about the same moment I became aware of the feeling that I wasn’t in control of any of this. Whatever images, words, thoughts, ideas, memories there were, it was if they just appeared, or as if they were flowing by and I was just noticing them.

It got me to wondering where the contents of the mind come from, how many there are, and how, probably, the ones we notice are just the tips of an iceberg.

I remembered a number of occasions when I’ve stood on a bridge (like the one in the photo above) and looked down at the water as it flows towards, beneath or away from me.

This experience of noticing the contents of the mind flowing past reminded me of those times.

Sometimes what would catch my attention from the bridge would be movement. Like the flow of the water over the rocks, or leaves on the trees in the banks of the river blowing in the wind, or birds darting down to catch an insect or even a fish, or even a fish swimming in the water. Movement catches our attention. Change catches our attention. Something appears….like a branch or some leaves tumbling over the rocks to be carried away by the river. We notice that.

Sometimes my attention would be broad rather than narrow. I wouldn’t zoom in on any particular element but just gaze upstream and take in the whole scene. Seeing the general colours, the shapes of the rocks and the falling water, the patches of turbulent white and the still, dark pools…all at once.

Meditation is a bit like that. You sit and watch to see what turns up, then, after just noticing it, you choose not to interact with it, or hold on to it, but just notice it floating on by. Images pop up and then disappear, a thought half forms and then unravels, a memory emerges and then fades……

And it’s not always rushing and tumbling either. Sometimes what comes to the fore does so quite slowly and gently….

I thought of a number of bridges I’d stood on. The ones over the waterfalls, the ones of the gently flowing rivers, the ones over the big city rivers, the ones over little ponds in Japanese gardens. Each one was a vantage point. Each one allowed me to take a few minutes to stand and gaze and notice and to turn my attention towards something, then let my focus drift over to something else. Never getting stuck, never staying the same, always bringing something different, something new…….

It’s a nice metaphor for the interaction between the conscious and unconscious regions of our minds.

But, wait. I’ve got more big questions now.

Where is the bridge?

Who is the me, the observer, who is standing there watching the flow of mental content?

Where is the mental content coming from and where is it going to?

Strange how hard it is to pin down this idea of the “self”. Two things pop into my mind right now…….Mary Midgley, the philosopher, who tackles the idea that the self doesn’t exist at all…it’s an illusion….in her book, “Are you an illusion?”, where she asks the question – if the self is an illusion, who is it who is having this illusion? And Dan Seigel, who in “Mindsight” and other books, defines the mind as “an embodied, inter-relational, process of regulation of energy and information flow”.

And something else pops up now…my training in TM. Sitting, repeating the mantra, noticing words, thoughts, ideas, images and memories bubbling up and just gently returning to the mantra, letting them all flow on by.

Well, one thing at least is pretty clear to me. The origins of all this mental content are multiple. Sometimes they are a response to an external stimulus, a sound, a light, noticing something. Sometimes they emerge from memory, from imagination, or from whatever area of the mind we use for gnawing away at things….problems, worries, things to do, things we want to say. But wherever they come from, I really don’t think we have much control over that flow. What we can do is to notice, to become aware. Then we can begin to choose where to direct our attention and decide how which ones we want to follow and which we want to let go off.

 

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Richard Louv once coined the expressing “Nature Deficit Disorder”, arising from not spending enough time in Nature and proposed a treatment – “Vitamin N” – a dose of Nature. In Japanese research there have been discoveries showing positive chemical changes in the human body in relation to the immune system and a settling of inflammation when practising “forest bathing”, which consists of spending some time in a forest.

I like those ideas and so, last week, on a sunny day, we took a trip into the Limousin, found a nice forest, and had a walk.

Do you do that from time to time? I thoroughly recommend it. I mean, who really cares about the biochemical markers of immunity and inflammation when spending a bit of a day amongst the trees is just such a treat anyway? But it’s good to know the benefits are so deep.

Le Monde group has just launched a new publication entitled “Sens et Santé” – I like how French words often have several meanings all at once – “Sens” can mean “sense” or “meaning” but also “direction” (“santé” is health). One of the larger, beautifully illustrated articles in the inaugural issue focuses on “forest bathing”, describing how you can take time to become aware of the sounds, the sights, the smells, the feel of the trunks of the trees, and even, if you are so disposed, to spend a little time meditating.

Of course, I wouldn’t go without my camera, but that’s just my personally favourite way of raising my level of awareness. I notice more when I have a camera in my hand and an intention to take photos.

Look at this particular tree. I posted about a strange shaped tree a few months back, wondering what had happened in its life to bring about its peculiar shape. Well, here’s another one to stop me in my tracks and get me wondering….what on earth happened here?

And immediately another thought pops up – what resilience! What an incredible power to overcome what looks like it could have been a fatal event, to grow again, not just a new trunk, but six of them! Wow! There’s an inspiration!

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Last November I was invited to address the Faculty of Homeopathy at their Congress in Belfast. I prepared a talk entitled “Images of Health. Pictures and stories” based around some of my own photographs and covering the key principles of health which guided me through my career as a doctor.

Here’s the video of that talk. I hope you enjoy it, find it interesting, or even inspiring. (by the way, if Google pops up any ads along the bottom of the video, just click the “x” box to make them go away 😉 )

I wrote a book to accompany this talk. It’s called “Escape to Reality” and I’ve published it (so far) only as a Kindle e-book. You can find it on Amazon.

 

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red-veg

Peter Brabeck-Letmathe, the outgoing chairman of Nestlé’s intention is for Nestlé to develop food scientifically – synthetic food which will be better than “natural food”. He rejects the notion that food grown in the ground is best for us. He says

Nature is not good to human beings. Nature would kill human beings. The reason why homo sapiens have become what we are is because we learned to overcome nature.

What do you think when you read this?

Is “Nature not good to human beings”? Does Nature seek to “kill human beings”?

I was pretty astonished at this claim because I think human beings are part of Nature, not something outside of “it”. If we want to learn what’s good for us my own feeling is that we should look to the rest of Nature. As Idriss Aberkane says of “biomimicry”, Nature is a library, a source of knowledge, not a source of repository of fuel to burn.

So where does this idea that Nature is trying to kill us come from?

Well, as chance would have it I read an interview with the French philosopher, Michel Onfray, at the weekend, and he mentioned the definition of life given by Bichat, the physiologist

Life is the sum of the forces which resist death

That’s an interesting definition of life – life is resistance. Is death constantly attacking life? I think that’s a pretty miserable and negative understanding of life. But I think it might come from the notion of entropy. You know about entropy? Entropy is “the gradual decline into disorder”. The second law of thermodynamics states “entropy always increases over time”. You can probably see how this observation can lead you to think that we are only alive as long as we resist death, disorder, and decline. But is that enough to lead you to conclude that Nature is trying to kill us?

It seems to me that this entropic force in the universe is only one of the major forces at play. What Thomas Berry referred to as “wildness” is another way of thinking about this force. It’s the chaotic force. If this was all there was, or if this was the dominant force, what would the universe look like? Would there be stars? Would there be galaxies of stars moving together? Would stars have planets? Would there be any complex living organisms? How could there be? There is a second force. One Thomas Berry calls “discipline”. It’s the ordering principle, the structuring principle, which contains, limits and holds together. But what if that was the only force in the universe? What would the universe look like then? Would it be any more than a dense ball of energy? Would it be expanding? Would it show diversity? Or would whatever existed by “more of the same”?

I think there is a third force at work in this universe, because it seems to me, without it, there is a tendency for the first two forces to cancel each other out, or for there to be a significant tendency towards either chaos or uniformity.

That third force is creativity. The creative force is a force of integration – it integrates the two forces of wildness and discipline to produce astonishing levels of complexity. Look at the history of the universe. Is it a history of endless decline and degeneration, or one of stasis and constriction? Or is it a story of ever increasing complexity and diversity?

It’s this latter, isn’t it? The universe is on a course of increasing complexity. We humans, with our bodies, our brains and our consciousness, are the most complex phenomena the universe has produced so far. But we haven’t been about for very long.

cosmic_calendar

(the cosmic calendar)

The universe is on a course of increasing diversity. Not just the rich diversity of species and life forms on planet Earth, but in the diversity of unique human beings. Not one of us ever repeated. No single experience of a whole life ever duplicated.

So is Nature a threat to us? Or is Nature a manifestation of the creative force of the universe?

I’m opting for the latter view. And I’m going to continue to enjoy the fruits of that rich creative diversity, just like you see in my photo at the start of this post. I won’t be swapping “real food” for synthesised, chemically “enhanced” stuff any time soon!

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two

In the Spring of 1784, Armand Marie Jacques de Chastenet, marquis of Puységur, discovered that Victor Race, one of the peasants who worked on the marquis’ land, had pneumonia. The marquis had become interested in the work of Mesmer and “animal magnetism” so decided to see if he could help Victor back to health using this new method.

Victor fell into a trance and began to speak. But to the astonishment of his master, he didn’t speak in his usual patois, but in perfect learned French instead. Not only that but he talked about subjects that an illiterate peasant couldn’t have known about.

What happened next is even more astonishing. The marquis and Victor became a therapeutic couple. The marquis would ask an ill person about their symptoms….he’d “take the history of the patient”, and, in trance, Victor would pronounce the diagnosis and prescribe treatments.

Neither of these men were able to carry out the acts of healing by themselves, but together, they could.

This was one of the first recorded episodes of “lay mediumship” in Western civilisation.

I think that’s a remarkable story and I know of other instances from within my own lifetime where such astonishing collaborations occurred.

But even setting aside the somewhat “supernatural” aspect of these tales, isn’t there something like this going on in every therapeutic act? Isn’t every therapeutic act a collaboration between the patient and the therapist. Without each other they can’t achieve healing, but together, they have the chance to become something unique and greater than either of them. Together they can gain a greater understanding, and together they can find answers they couldn’t find alone.

I think we forget that in modern medicine, thinking that the doctor can do it all by him, or her, self. Thinking that one person has all the answers, ready made, so to speak.

There can be some of the most astonishing examples of magic happening when two people form a bond and work together for a common purpose.

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alone

When I worked at what’s now called the NHS Centre for Integrative Care in Glasgow, every patient attending for the first time had a sixty minute appointment. 60 minutes doesn’t seem a lot in the context of a life time but to receive a whole hour of undivided, focused, non-judgemental attention feels like a gift.

My colleagues and I would frequently have patients tell us “You’re the first doctor to have actually listened to me.” I don’t think that feedback ever lost its power to shock. How did so many people get so far into the health care service and not have the experience of being listened to?

We all need to be heard. We all have the right to be heard. All of us.

The recent EU Referendum in the UK, and its political fall-out has made it even clearer to me that, politically, we are not being heard. There is a disenchantment with politics and politicians across the so called democratic world. Maybe one of the reasons for that is that our democracies are not enabling people to be heard.

In the UK there is a whole chamber of government, the House of Lords, which is 100% unelected. There is nothing democratic about it. Nobody voted for them and they aren’t accountable to the electorate.

The electoral processes based on simple majorities lead to government after government which does not represent the majority of the electorate. In the recent referendum 52% of those who voted, voted Leave and 48% voted to Remain. About 30% of the electorate didn’t vote. The 52% of the 70% are heard (on this question). The rest of the population are ignored. Parliamentary elections are like that too.

Is handing power to the largest minority the way to ensure that most people in the country are heard?

How can it be?

Most people don’t have the experience of being heard and, in consequence, don’t feel the elected governments represent them.

There’s an additional problem and that is that politics, as currently practised, is about power, not consensus. Those minorities who are elected believe they have the power to act according to their own beliefs and values. They act to exert power over others. If politics was about creating consensus, rather than wielding power over others, it would be an entirely different kind of politics. It would be more democratic. More people would have the experience of being heard.

Being heard isn’t enough.

We need to be cared about too.

Whilst it’s a good thing to listen to someone, to give them the time and attention to enable them to tell their unique story, it’s not enough. The response to that story, the doctors’ responses, the politicians’ responses, need to show that they give a damn. They need to show that the individual human being matters.

If we don’t have a system based on the principle that every one of us is unique and valuable then we get what we’ve got – politics, economics, education, health care, as if people don’t matter.

Isn’t it within the capacity of we human beings to create something better? What would the world look like if we did?

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really

Karol Sikora, a well-known “cancer doctor”, just said this

It doesn’t make much difference whether you are one of the people who get cured or not

He was talking about cancer care in “the NHS” (as a Scot, it bugs me every time when people refer to “the NHS”, as if there only was one). I suspect he was saying things in a controversial way to promote his new book, but this particular sentence really caught my attention.

He’s referring to how organisations and systems can be managed to work “efficiently”, and I think this probably applies to most health care systems around the world. We’ve developed a way of delivering health care as if individual patients don’t matter. Protocols are created based on the statistics from research into the experiences of groups of patients. I’ve even heard a young doctor say they were told that if a patient takes an evidence based drug and it doesn’t work, then either they haven’t taken the drug or they are lying. These are the kinds of things which happen when doctors take their eye off the ball.

When we base health care on management systems designed for industries which produce physical objects to sell, then, it seems, statistics become king.

It doesn’t make much difference whether you are one of the people who get cured or not

Really?

In what way does it not make much difference? To the individual it makes all the difference in the world. To the doctor? Shouldn’t it matter if this individual gets cured or not? Isn’t that an irreducible fundamental of all medical codes of behaviour? It’s always this patient, this very patient I am dealing with right now who has the right to the best possible care I can provide.

I struggled a bit to find a photo to go with this post then stumbled across this one of a sculpture I saw recently in a garden. It seems to capture that sense of caring for the individual. And it seems the character’s hair is standing on end. Maybe the little bird just told him what Karol Sikora had said!

We can’t accept this way of delivering health care, can we?

This story also made me think of those pretty pointless statistics you can see every day on billboards at railway stations, telling you what percentage of trains arrived on time this week. Should we deliver health care by aiming at percentages of patients properly cared for? Or should we deliver health care by always, I mean always, giving the very best care and attention to every single patient in every single interaction?

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