Part 3: Healing The Mind-Body-Spirit Split — 44 Revelations About Healing They DID NOT Teach Me In Medical School
In this series, I’m reviewing the Cliff Notes of everything I should have learned in medical school, but didn’t- and everything I’ve learned since I finished my medical training about healing from my own research and self-study. If you haven’t yet read the first 10 revelations about healing that I didn’t learn in medical school, please read Part 1 and Part 2 .
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Western culture is celebrated for its focus on breaking whole systems down into their constituent parts and then developing expertise in smaller and smaller reductionistic splits. For example, you have a medical problem, you go see the doctor. If you have a psychological problem, you go see a psychotherapist. If you have a spiritual problem, you go see a minister, rabbi, priest, iman, or other spiritual leader. But if nobody stands back to look at the larger picture, you’ll miss many opportunities for healing. Healing requires stepping back and looking at all those aspects of yourself into a new relationship with each other. Therefore, breaking up the healing process into silos robs you of your opportunity to heal- by definition.
The truth is that you can’t heal psychologically without having it impact the health of your body, but medical schools and psychology PhD programs don’t tend to teach that psychological healing could reverse medical diseases. You can’t heal medically without having it impact your psychological and spiritual well-being, but almost nobody in academia talks about how a cancer journey or recovery from an autoimmune disease can be a spiritual experience. You can’t heal spiritually without having it affect you psychologically and medically, but divinity schools, medical schools, and psychology graduate schools aren’t teaching this.
Medicine, psychology, spirituality, and science are all tangled together and cannot (and should not) be peeled apart, even by those who try to separate them. As much as we’d like to believe we can divide these categories into different academic silos that belong in different departments of universities, healing fails to play by such rules. Healing does not behave according to the principles of the Cartesian mind/body/spirit split. The etymology of the word “healing” comes from the Proto-Germanic word “khailaz,” which translates as “to make whole.” Healing is, almost by definition, a unifying phenomena that restores the academic splits into a reunion of integration.
If your nervous system is in Type A hyperdrive 24/7, or if it’s in dorsal vagal hypodrive beyond when you’re resting and sleeping, your body is practically guaranteed to pay the price. This is why it’s ridiculous to even think about practicing medicine without considering the state of a patient’s nervous system. We shouldn’t even be talking about mind-body- because the nervous system IS the body. Every single part of your body is connected to the nervous system, because the nervous system is far bigger and more diffusely distributed than your mind/brain. Most diseases are the result of the long term consequences of chronic nervous system dysregulation- the immune system breakdown, the chronic inflammation, the microbiome disruption, the epigenetic influences, and such. Therefore, most disease treatments will be mere Band-Aids that are ultimately inadequate and ineffective they include nervous system hygiene. Nervous system hygiene requires caring about your own safety, emotional health, relationships, and protection from abuse or exploitation.
To practice nervous system hygiene and bring your nervous system into an optimally healthy state capable of somatic self-repair, you have to heal trauma. It’s not just war veterans that have trauma that can make them sick. Everyone has some trauma that likely needs healing. Some people have experienced the Big T traumas, the ones researchers call the Adverse Childhood Experiences ). But 100% of us have experienced what might seem like smaller traumas, such as the developmental traumas that interfere with our healthy individuation, capacity for intimacy, ability to assert agency and autonomy over our lives, and other natural full expression of our authentic selves. (Learn more about whether you might have experienced developmental trauma and ) Developmental trauma and other “little t” traumas, which Buddhist psychiatrist Mark Epstein, MD calls “the trauma of everyday life,” affects every one of us and impacts our health. Therefore healing and adequately treating psychological, emotional, and spiritual trauma is essential for whole health healing.
You can be physically cured without being healed, and you can be psychologically, emotionally, and spiritually healed without being cured. Conventional medical interventions might cure disease temporarily, but unless the necessary healing also happens, patients are likely to get sick again, sometimes from an entirely different disease. Healing, on the other hand, creates the physiological conditions that optimize the body’s chance of reversing disease and preventing the onset of new diseases or recurrences of diseases in remission..
As much as we might wish we could, bypassing the psychological, emotional, and spiritual healing process, even if conventional medicine knows how to cure us physically, does not optimize health outcomes. Medications, surgeries, and other conventional medical interventions might alleviate symptoms and lead to remission of disease processes, resulting in cure. But if you’re cured without addressing the necessary healing, you’re at risk of getting sick all over again.
Likewise, you might temporarily feel better if you engage in spiritual practices or interventions, like meditation, yoga, contemplative prayer, plant medicine journeys, making a pilgrimage to a sacred site, or visiting an energy healer. But you can’t bypass the necessary psychological and emotional healing with spiritual healing alone. Medications, surgeries, and even spiritual interventions might make you feel better temporarily, and it might even look like you’re cured. But you might wind up falsely reassured by that temporary relief, thereby bypassing going back into the past pain of traumatic memories, which is what true healing requires.
Trauma survivors tend to be drawn to spiritual seeking, and this can be a blessing for some. Many trauma-supportive practices- meditation, creative practices, being in nature, engaging in rituals, prayer, movement meditation like hiking, yoga, or dancing- can help regulate the nervous system in the short run. And they feel good, so it can be tempting to just focus on doing more and more nervous system regulating practices. But nothing replaces the true trauma treatment that happens when you go back into the past, figure out how you adapted to survive, internally “redo” the past, and complete the neurological rewiring of the “memory reconsolidation” process, which lays down new neural pathways and removes the emotional charge from the past memory, thereby halting the automatic stress responses generated by those past memories that are stuck in the body.
Trauma healing and nervous system hygiene requires:
1) basic safety and survival needs get met 2) psycho-education about things like boundaries, narcissistic abuse, the various trauma healing models (like IFS, Somatic Experiencing, NARM, AIT, etc) and how trauma healing works 3) nurturing resilience, resourcing, and meaning making 4) understanding adaptive strategies so we can have compassion for why we do what we do 5) embodiment practices and somatic mindfulness 6) nervous system regulation 7) metabolizing implicit sensations, emotions, and memories 8) treating negative core beliefs, installing a new identity, and rewriting your story 9) safe, brave communities of healing. For more detail on each of these elements of trauma healing, [Hat tip to Chris Rutgers at The Trauma Foundation for helping me figure this out.]
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PCEs include positive family experiences in childhood- closeness, support, loyalty, protection, love, importance, and responsiveness to health needs, all of which can increase resilience and function in a dose-dependent way towards protecting against the negative mental and physical health consequences of ACEs. For example, a child might get sexually abused by a neighbor, but if they have loving parents at home this will help offset the ACE. They might have divorced parents or a parent in jail, but if they have loving grandparents who remind them they are lovable, this might also offset some of the trauma. ( Learn more about Christina Bethell, PhD’s research on PCEs in JAMA. )