Part 7: Six Steps To Healing Yourself — 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 here, Part 2 here, Part 3 here,Part 4 here, Part 5 here and Part 6 here.

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42. The placebo effect still works.

Scientists have known about the powerful but mysterious “placebo effect” since evidence-based medicine was born in the 1950’s, after scientists realized that somewhere between 20–80% of people (typically about ⅓) of patients given any treatment in a scientific study would get better, whether or not they were treated with the intervention being studied or whether they were given a sham intervention- a sugar pill, a saline injection, a fake surgery, or some other staged intervention that wasn’t real.

A multi-disciplinary conference at Harvard in the 1990s, the transcripts of which were published in Anne Harrington’s sentinel book The Placebo Effect, concluded that the placebo effect was still a mystery. Since then, placebo effect researchers like Ted Kaptchuk, Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School and Director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Massachusetts, have some theories.

Kaptchuk is quoted in this Harvard article: “The placebo effect is more than positive thinking — believing a treatment or procedure will work. It’s about creating a stronger connection between the brain and body and how they work together.” Scientists used to think the placebo effect was all about the power of positive thinking. But now we know it’s far more than that. You also need the rituals of treatment. “When you look at these studies that compare drugs with placebos, there is the entire environmental and ritual factor at work,” says Kaptchuk. “You have to go to a clinic at certain times and be examined by medical professionals in white coats. You receive all kinds of exotic pills and undergo strange procedures. All this can have a profound impact on how the body perceives symptoms because you feel you are getting attention and care.”

Even the simple ritual of taking a pill may have a powerful impact on how the nervous system interprets symptoms. “People associate the ritual of taking medicine as a positive healing effect,” says Kaptchuk. And you don’t even have to trick the nervous system! There’s still a placebo effect if patients know all they’re taking is a sugar pill. Kaptchuk said, “Even if they know it’s not medicine, the action itself can stimulate the brain into thinking the body is being healed.”

Is it possible to give yourself a placebo effect without having to eat a Tic Tac? Kaptchuk thinks that practicing self-help methods might help. “Engaging in the ritual of healthy living — eating right, exercising, yoga, quality social time, meditating — probably provides some of the key ingredients of a placebo effect,” says Kaptchuk.

But I think the ritual of the therapeutic relationship is key to the placebo effect. You giving yourself a sugar pill or you engaging in self-help won’t replace the nurturing care and ritual of someone in a position of authority giving that pill to and telling you they believe it will help you.

Katchuk claims that placebos won’t lower your cholesterol or shrink a tumor. Rather, they work on symptoms modulated by the brain, like the perception of pain. “Placebos may make you feel better, but they will not cure you. They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea.”

43. The placebo effect may be linked to ritual and group bonding.

Maverick scientists like William Bengston, PhD think the placebo effect may be more than just belief or changing the nervous system’s perception of symptoms. He believes groups may bond in fields of what he calls “resonant bonding.” Bengston theorizes that “resonant bonding” may offer part of the explanation for the mystery of the placebo effect. In other words, if participants in a research study are in some way bonded, those who are cured by the treatment may lead to cures experienced by the control (placebo) group who do not get the treatment. The mechanism of action of how this works is still unknown, but it could explain why patients bonded through a scientific study may have an impact from those who receive treatments, even if they didn’t receive the treatment themselves.

If groups are strongly bonded, he wonders, maybe one person’s cure may increase the likelihood that another bonded group member is also cured. If groups are equally bonded, size seems to matter. The larger the group, the more powerful the healing effect seems to be. If a larger group means less bonding, however, this does not seem to be the case. The strength of the bonding appears to matter more than the size of the group. But if both groups are equally bonded, a larger group seems to result in more healing impact.

Likewise, if two or more people are strongly bonded to the point of enmeshment, it’s possible that they might absorb each other’s illnesses. It sounds unlikely that healing could be, in a way, “contagious,” just as many people bonded to a coercively controlling leader may all wind up sick or mentally ill together. But some scientists posit that this could be true. The mystery of the placebo effect seems to resist being scientifically demystified. But we can be proactive about coming together in groups to engage in rituals of healing with intention to heal- and who knows?

44. Reclaim the feminine principle and your animist roots.

We were all Indigenous once. We all had ancestors who were connected to the earth, more in touch with the aliveness of nature, and guided by more sensitivity to intuition. Every single one of our ancestors, in every single place in the world were animistic at some point, honoring all of life as living. Every single one of our ancestors lived in the villages, where there were village healers who were sensitive and empathic and in touch with nature’s rhythms.. With conquest, industrialization, and modern medical training, many of us have lost access to the lineage of people who lived close to the land and could listen to the song lines of the place. Modern medicine fosters the opposite, driving in intellect, logic, and rational critical thinking, but at the expense of intuition, compassion, empathic sensitivity, attunement to small cues of the patient, and connection to nature. Reclaiming these more feminine principle parts of ourselves- whether we’re patients or medical providers or both- can facilitate healing.

The Six Steps To Healing Yourself

All this brings me back to 12 years ago, when I was writing the 2013 first edition of Mind Over Medicine, naively thinking I could boil down everything I had learned so far into the “Six Steps To Healing Yourself.” I changed those six steps a bit in the second edition in 2020, but they now seem so inadequate compared to everything else I’ve learned since medical school. Nevertheless, I still stand by them, and they’ve stood the test of time. So let me review them here, with 2024 updates.

Step One: Believe healing is possible.

I used to think positive belief was much more important than I do now. I still believe we need grounded, ethical hope in order to keep us uplifted while we do the deep dive of what it takes to become an Olympian of healing. But after years of watching “Law of Attraction” devotees die because of their magical thinking, I now think too much positive belief, ungrounded in reality and science, can actually kill people.

But passive resignation and automatic acceptance of a doctor’s prognosis doesn’t maximize health outcomes either. There’s a sweet spot between acceptance of what’s real, without magical thinking, denial, or delusion, and holding onto a kernel of hope that you might surprise your doctors and become the next health outlier.

Some patients have told me that if they hadn’t believed there was a chance for cure, they never would have been able to endure what they had to do in order to get Olympic gold. Even if it was just an ounce of possibility, they could motivate themselves to go for it, even when they weren’t feeling well. But if all hope had been lost, they might have just rolled over and passively accepted their fate.

Paradoxically, the health outliers me and my partner Jeffrey Rediger have interviewed accepted their diagnosis, but they challenged their prognosis, not rebelling against it in an unrealistic way, but wondering about it, staying open to the possibility that their doctors might be wrong. That kernel of hope is what fuels people to be proactive in their approach to healing, taking charge of their health, rather than just giving up.

Step Two: Surrender to the wisdom of your wise Self (or intuition or God or spiritual guidance or whatever you want to call it.)

While Step One helps people take charge of their health, Step Two acknowledges that you can’t control your healing journey, no matter how proactive you might try to be. So it’s another “paradox of healing”- It helps to be proactive about taking charge of your health AND you’re not in control of the outcome, no matter how much positive belief you have and no matter how much you invest in getting better.

It’s like getting pregnant. Sure, you can track your ovulation status, eat right, take your prenatal vitamins, make sure you have sex at the right time, and go to an infertility specialist if it’s taking a long time. But even then, you can’t control whether or not you get pregnant.

Healing is like that- you can influence the outcome, but you can’t control it. And if you’re a control freak, that might not sit well with you. So Step Two is about helping you listen to your inner voice, pay attention to the guidance you’re receiving from within, and be courageous enough to act on that advice. But it’s also about letting go of attachment to outcomes. As Tosha Silver says, “The very act of grasping for the feather creates the wind current that pushes it away.” So you can go for Olympic gold, but if you’re clinging to the outcome, you’re actually stressing your nervous system and interfering with the healing process. Try hard, but let go.

Step Three: Surround yourself with healing support.

This is the relational aspect of healing, focusing on another paradox of healing- “You can heal yourself AND you can’t do it alone.” If you believe you have to do everything involved in healing all by yourself- and if you can’t dare to rely on anyone else’s love and support, that’s a recipe for illness. People in narcissistic abuse situations often feel this way, as if their needs are a burden and their only value comes in caregiving others, not being cared for. Some people don’t even feel safe challenging their physicians if they’re not getting nurturing care. But those who have exceptionally good health outcomes typically are embedded in a community of support- not just from doctors, nurses, therapists, and other healers, but from friends, family, neighbors, and spiritual communities. When we know we’re held and loved and that we matter, our nervous systems are more easily able to wind up in the ventral vagal parasympathetic state, where healing can happen.

Step Four: Diagnose the root cause of illness.

This is not the diagnosis your doctor writes in your medical chart. This step is about diagnosing why your nervous system is firing stress responses, why your body might have chronic inflammation, and why the self-healing mechanisms have broken down. What that means is that most people have to face the elephant in the room they’ve been trying to avoid- the abusive spouse, the toxic work environment, the excessive busyness, the lack of reciprocity in your friendships, the creative desert, the martyring caregiving pattern, the song still unsung- or maybe all of the above. The Whole Health Cairn was designed to help people structure this diagnostic process, to root around in all the aspects of your life that could be medicine or could be poison. Once you get out of denial and can spot the poison, you can start to heal it.

Step Five: Write The Prescription for yourself.

Once you’ve identified what’s activating your nervous system or putting your body at risk of disease, the next step is making an intuitively-guided action plan. This might include doing what your doctor recommends, but it might also include making changes in your relationships, setting clear, firm boundaries with people who aren’t treating you right, changing your diet, giving up bad habits that might be harming your health, or hiring a therapist to help you heal your trauma. You don’t have to know the whole journey before you take the first step. One intuitively guided action step may lead to the next, and if you trust the process, all you need to know is your next right step.

Step Six: Treat your resistance.

100% of the people I’ve worked with, myself included, have at least some bit of resistance to the Whole Health healing process. You might be afraid to follow through on what your inner guidance is telling you to do. You might have one foot on the gas and one foot on the brakes because of the secondary gain you’re getting from your illness. You may also see a whole series of steps that overwhelm you. This is fine. Most of us have resistance to change, even positive change.

That’s where the trauma healing method Internal Family Systems (IFS) can be very helpful. Part of the model acknowledges that we all have inner polarizations between parts of us that want to self-improve or get well and parts that have very different ideas about such things. Just look at New Year’s resolutions! We have parts that want us to join a gym, eat better, lose weight, quit the bad habit, become enlightened, etc. And then we have parts that hate the gym, love Ben & Jerry’s, are bored by meditating, and like wearing our stretch pants. IFS helps us love and become intimate with all of our parts, not just the well-intentioned ones, but the parts that might threaten to sabotage the healing journey.

Some of our parts will be really motivated to get better so we can be free from pain, live longer, feel well enough to do what we love doing, and stick around for our loved ones. Other parts might not want to upset the apple cart, change the status quo, learn to set boundaries, dig into past pain that needs healing, or let go of benefits we might be getting by staying sick, like a disability paycheck or an excuse to say no if you struggle to set boundaries any other way. It’s no small thing to decide to end a marriage and interrupt a family, leave a soul-sucking job and the security of that paycheck, or finally delve into your painful past, so it’s no wonder some of our parts would prefer to avoid doing so. That makes sense!

It never works to bully our parts. But if we work with all of our parts compassionately, without shaming them or pretending they’re not there, we can mediate between these polarized parts and help get all our parts negotiated to be on the same page. This can help us achieve the best health outcomes without overriding parts that have legitimate fears, hesitations and resistance.

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