Finding a Healthy Approach to Terminal Illness

images If you are so fortunate as to live so long, some day you may be given a terminal diagnosis. You may be told that you have so many days or months to live. What will you do? You will require a multi-faceted approach that involves at least three different broad elements: allopathy, maximizing the power of belief, and integral. I want to discuss the strengths and weaknesses of each of these here.

None of us know for sure what we will do until we come to such a critical life juncture, but what we can do is prepare. In what follows I want to share with you what I have learned about such preparations, based on many different sorts of experiences: years of immersion in the Edgar Cayce holistic model of healing in which “mind is the builder” is the mantra; participation, managing, or creating four different multi-disciplinary pain treatment programs that included allopathic medicine, psychotherapy, acupressure, stress management, yoga, acupuncture, massage, nutrition, chiropractic, meditation, dreamwork, prayer, laying on of hands, energy medicine, visualization, and various other modalities; training in Carl Simonton’s use of visualization techniques in cancer therapy; advanced training in uses of imagery for both physical and mental dysfunction; three years’ work at the Edgar Cayce-based A.R.E. Clinic with the founders of the American Holistic Medical Association, Bill and Gladys McGarey, M.D., and the development and use of my own integral set of tools with seriously ill people for almost forty years.

I am not claiming to be right about any of what I say here, only that I have put a lot of time and experience into thinking these things through, and I want to share my prejudices, biases, and assumptions with you, so that you can factor them into decisions that you may have to someday make for your loved ones and for yourself. If you aren’t insulted or irritated by something or other say here you aren’t paying attention. I invite your challenges and disagreements. My opinions do not come from ignorance – I have been saturated in these world views and the assumptions that underpin them for years. It comes from having watched a number of very good people die slowly, painfully, and rather horribly because they didn’t make wise use of the broad variety of tools available to them. For example, one young woman was a talented musician, song writer, and singer. Steeped in New Age energy medicine, and a belief that you create your reality by how you think, when she developed breast cancer she elected to go the “alternative” route, out of awareness of the nasty effects of surgery, chemo, and radiation. Her cancer got worse. In desperation, she relented and did the surgery, chemo, and radiation, but by then it was too late. Her death was slow and painful, and she left a thirteen year old daughter. If she had gotten the surgery, chemo, and radiation at the beginning her chances for remission and survival would have been much higher.

It is not that this lady was not smart or loving; she consulted a lot of different specialists and experts; everybody who knew her loved her. The problem was that her biases and prejudices got in the way of taking advantage of available and necessary tools. In what follows, I want to make a case for multi-perspectivalism in treatment without thereby embracing everything and anything, in a pluralistic embrace of the healing power of the universe. Some things are better than others; some things will make your condition worse. Some things will distract you from putting your precious energy where it will be the most good. When people are catastrophically ill, all is not “in divine order,” and I advise you not to waste your time with people who tell you this. What they are doing is trying to reassure themselves in the face of the overwhelming prospect of mortality that you represent to them.

Allopathic Intervention:  What medicine has to offer patients with cancer and other conditions with a high rate of mortality is often terrible: chemotherapy, with nasty side-effects, surgery, radiation, and various medications with more side effects that degrade the quality of life. It is entirely understandable that good and wise people choose “natural,” “self healing,” and “energy medicine” because of the various risks, disabilities, and disfigurements allopathy offers. However, when confronted with a diagnosis of Stage III cancer or something similar, it is time to park your prejudices and listen to experts of all kinds. I have watched champion meditators, lucid dreamers, mystics, channelers, psychics, and all around wonderful people who thought they knew better or had some special knowledge or trick succumb. Some of these people died slow and painful deaths, leaving young children parentless while throwing away their life savings on treatments that had no scientific credibility. In retrospect, some wished they had made more use of the current state of the science of healing, as imperfect as it is. But horror stories combined with stories of miracle cures from treatments with little or no scientific collaboration tempt many to ignore scientific credibility and gamble on faith and belief in anecdotal accounts of miracle cures that may indeed be true, but lack any substantiation that they are indeed repeatable.

Is scientific credibility important? It all depends on whether you want to go with luck and divine grace or with the law of averages. “Scientific credibility” means that results are duplicatable and meaningful at a rate above chance, randomness, or “luck.” Medicine has calculated survival rates for people who have taken some treatment.

Most of us think that we have special knowledge and special protection and that therefore we will beat the odds. You are an exception to scientific norms, because you and your circumstances are individual and unique; therefore, you need to consult sources in addition to science that take into account your particular consciousness, perceptions, behaviors, and relationships. However, to not use allopathic medicine is to flippantly discard years of accumulated knowledge by wise, well-meaning people who have dedicated their entire lives to the healing arts. To dismiss them as money-hungry pill-pushers, or as ignorant because they are not familiar with things that are outside their areas of specialization, does not hurt them; it only demonstrates the narrowness of your world view while cutting you off from sources of support you need.

You may be an exception to those averages, because you are unique, but you probably are not the exception, because all the people who were in those studies that created those averages were unique and exceptional in their own ways, just like you. While it is a mistake to entrust your care only to those who know science and have been allopathically trained, it is a worse mistake to think that you know better. Why? Because scientific knowledge is accumulated knowledge built up by smart, good, hard-working people through painstaking effort over decades. In general, cumulative knowledge is broader and wiser than you are, which is not to say that it knows anything about you individually and your unique needs.

Go to doctors. Trust them. Get second opinions. Seek verification. Do your research. Begin today to identify and cultivate a strong medical advocate that can be a representative to the medical profession for you when the time comes that you need one. This person does not have to be a doctor, but they need to be someone who knows medicine and can talk the language that doctors understand to bridge your needs and their professional aptitudes.

Maximizing the Power of Belief: Understanding placebo and creating the expectation of health are both vitally important to your recovery. We now know that if you go to a witch doctor or take a sugar pill you have a 30% chance of improvement. Sometimes this is astounding. At least one study has shown that approximately 30% of people complaining of chronic knee pain from x-ray verified degenerative arthritis or torn meniscus report the same degree of pain relief after an incision but no surgery as those who have received reparative surgery. Bruce Lipton relates this study as well as many others in his book, The Biology of Belief. Medical hypnosis demonstrates the amazing changes that can occur in the body when disbelief is suspended. White blood cell counts have been demonstrated to increase and decrease based on belief. Consequently, I am a strong advocate of using placebos. We know that they work for that 30% for which placebos work, even if you are told you are getting a placebo. Therefore, there is no need to deceive yourself or anyone else about the “magical” nature of what you are doing. Pre-rational, irrational, voodoo and stupidity will work 30% of the time. It doesn’t work because it is scientific or because it’s a miracle; it works because of what is well known about placebos.

This means that treatments and interventions that are not science-based but are instead placebos still help about 30% of the ill via the placebo effect.  This makes placebo sound like a miracle cure, more effective than science, until you realize that another 30% will show no change while 30% get worse. Placebo is therefore another name for randomness, chance, and luck at work. You have an equal chance of getting better or worse. However, the 60% comprised of those who get better or do not get worse when you do Reiki, homeopathy, use Oberon (energy field-enhancing devices) or become a true believer in some religion or cult, like Christian Science, form a majority that is sufficient to build a professional guild that has a financial interest in promoting itself. It can and will point to anecdotal cases from that 30% that persuasively demonstrate the effectiveness euro-linguistic programming, massive doses of vitamin C, lemon water, wheat grass, or shock therapy. Because most people do not understand placebo, they think that the treatment, rather than placebo, is responsible for the improvement. The list of “treatments” that people swear by but which have not succeeded in duplication with double-blind studies is very, very long. In fact almost everything that you have heard of or that will be recommended to you will owe its success either to placebo or to performance only a few percentage points above it. It is also important to remember that 30% of people who go to allopaths are getting better due to placebo; it is only the percentage beyond placebo that substantiate credibility. In some cases that may be only one or two percent! It is very rare for any treatment to show effectiveness as high as 60%. What that means is that the difference between voodoo and science is probably somewhere less than 30%. That is not insignificant, but it is hardly everything. That is why you need a multi-pronged, well-thought out approach to illness that is based on realism, not fairy dust. This is a basic reason why I favor multi-disciplinary, multi-perspectival approaches. No one knows what is going to work in your unique case; the more approaches that are offered in a coordinated, thought-out way, as occurs in a well-run holistic clinic, the more likely it becomes that an approach or some combination of approaches will work for you.

For example, one M.D. I know gives people homeopathic remedies. She does not do so because she believes in homeopathy. She has read the studies and knows that homeopathy does not function above placebo. However, she believes in placebo, and she knows a lot of her patients believe in homeopathy. To be ethical about it, she does not charge them for the homeopathic treatments she gives, because she does not want to charge them for drinking water or eating sugar. However, I absolutely agree that by providing a placebo she is increasing the curative rates for her patients while reducing side effects. Placebos should not be taken in place of medical treatment when time is of the essence, but when you are waiting for the results of a biopsy or for surgery or radiation therapy to begin, taking a placebo is smart. Continue to take it after other treatments begin. They can’t hurt and they may help. However, know that what you are doing is something that is partially superstitious.

I don’t know of any research that shows that eating right, thinking happy thoughts, prayer, or believing in the right deities increases the placebo effect. However, such practices are not necessarily superstitious behaviors if they make you feel better and there is data to show that they reduce your health risks, like not smoking, drinking sparingly, and losing weight. Chances are you will not beat the odds: if you do, it will probably be because you happened to fall into the 30% placebo group, for reasons not yet understood. In the end, you will die, because you are human and not immortal. You will die not because you failed to think happy thoughts, were “called home,” or “fulfilling your dharma,” but because the machinery of your body broke down or wore out.

You can, however, create and enhance the expectation of health by using aggressive mental intervention. Carl Simonton, M.D., an oncologist, taught his patients to imagine that their white blood cells were “sharks” or other predators that were attacking their cancer cells. This strategy is based on the idea that “thoughts are things” and that “you become what you believe.” I also recommend pre-sleep incubation of your goals and desired outcomes so that your dream consciousness can access sources of creativity you don’t and also to counteract cognitive processes that contribute to disease. However, the power of the mind to structure reality, while indeed powerful and undeniable, generally takes months or years to bend the arc of your life course. Most of the “miracle cures” that are explained by the power of the mind are probably better explained by the placebo effect and being fortunate enough to be in that 30% group. This is the most likely, and therefore the most parsimonious, explanation. It is not that the mind cannot or does not have any effect on the body, but only that the more primal, intense, and immediate the imbalance, the less likely the mind will have an effect above and beyond placebo. Mutation is a very, very ancient and foundational adaptive mechanism that one-celled organisms evolved before the health of multi-celled organisms became important. When cells mutate it is easy and natural for your immune system to handle normal amounts of them. However, when tumors develop and they metastasize, the power of positive thinking, prayer, energy healing, hope, belief, and angels is a little like putting a chihuahua in a ring with a pit bull. Yes, chihuahuas are tenacious and courageous, but bet on the pit bull.

This is why highly intelligent people like Barbara Ehrenreich, who has her Ph.D. in immunology and is a breast cancer survivor, point to the cruelty and disservice that the “positive thinking” culture does to many seriously ill people. In Smile or Die, Dr. Ehrenreich draws attention to the existence of  “an oppressive culture of mandatory optimism” that has attained cult status as a fundamental belief system supported by both medicine and industry because it creates compliant patients and workers, who, when they should be holding others accountable, instead take full responsibility for having “created” their disease (or low wages or firing) as a “learning opportunity.” She points out how grandiose such thinking is, and how a failure to go into remission thereby marks one as a failure for not having “believed” enough. She provides a good overview in this video:

Here is another example of why my belief in the power of positive thinking has become tempered by a strong dose of healthy skepticism. The well-known medical clairvoyant Edgar Cayce, considered by many to be the founder of holistic medicine,  had a son named Hugh Lynn. I met him on a trip to the Middle East in 1963, when I was thirteen, with a group of people who had a shared interest in studying the Edgar Cayce psychic readings. The philosophy of the readings taught that “mind is the builder,” that we created in past lives what happens to us in this one, that divine grace is always available to us, and that sometimes death is the greater healing. In my late adolescence and early twenties I lectured and taught about the readings with Hugh Lynn. He was a wonderful man who was steeped in holism and a strong believer in the healing power of belief, energy medicine, divine intervention, grace, psychic phenomena, and Christ-centered love. He was a walking, breathing, enthusiastic advertisement for all these things, and largely on the strength of his personality built a strong organization to research the Cayce readings, called the “Association for Research and Enlightenment.” In about 1980, when I was thirty, Hugh Lynn was diagnosed with a cancerous brain tumor. Now if anyone was in a position to access divine healing, it was Hugh Lynn. He personally knew the best holistic physicians, had a  deeply intimate ongoing relationship with Jesus, was a world-class meditator and dreamworker, and was a truly loving and generous individual. Everybody loved Hugh Lynn. He didn’t have a mean or selfish streak in his body.

Hugh Lynn not only was killed by his brain cancer; it was a slow, agonizing and extremely painful death that was horrible for everyone. There was no miracle. There was no placebo effect. There was no divine intervention or grace. To explain his death as a lack of “positive thinking” is simply cruel. To explain his death as a karmic “payment” for something he did in a past life, or as burning off karmas so he wouldn’t have to be reincarnated, is outrageous, because it implies that his torment was somehow necessary. To explain all that suffering as being in “divine order,” but we just don’t have the wisdom to see it, is a lot like excusing war and child molestation as part of “God’s plan.” To say that Hugh Lynn has now been released from bondage and that he is now happy in heaven is reminiscent of the famous scene in Star Wars where the deceased Darth Vader, embodiment of evil, is happily celebrating with those he did his best to kill. Such mythologies are attempts by human minds to generate a sense of justice and meaning from circumstances that are unjust and lack meaning, rather than learning to live and accept that the world neither requires justice or meaning, and that both are projections onto it by the minds of men. Such “explanations” are desperate creations by people who cannot accept the simplest and most realistic explanation: some things are not good or right; some things do not have meaning on the scale of an individual life; some things result in the extinction of individuals, species, and collections of life forms forever. 

If you hear that as cynicism or pessimism you are wrong; I am basically an optimistic person, who believes that life evolved your frontal lobes for a purpose. There are reasons why you possess the executive mental functions that you do. This is because reasoning is a very powerful adaptive strategy. If you abandon it in favor of belief and blind faith in miracles and positive thinking you are handicapping yourself and lessening your chances of survival. Thinking, reasoning, logic, doubt, skepticism, and the demand for validation are not the enemies of faith, belief, and love. In fact, they are pre-requisites for compassion, altruism, and growth into a collective consciousness or sense of oneness with nature, love, or life itself. By all means, be positive and hopeful; visualize your body attacking your cancer cells. By all means, contact the deceased, the White Brotherhood, the space brothers from Arcturus, or the dolphin masters from the Pleiades; do whatever you can to trigger the placebo effect. However, be aware that you can damage your psychological health, in addition to increasing your chances of death, if you put your compete trust in the power of positive thinking or placebos.

Be Integral: Integral is not throwing out science in favor of belief and it is not throwing out belief in favor of science. It does not say, “all you need is love,” nor does it say, “if it is not scientific, it’s voodoo.” Denial of belief and denial of science are both forms of reductionism, and integral is not reductionistic. However, it also does not say that everything is of equal value. When you are terminally ill, your window of opportunity for healing closes over time, so if you spend that time depending on your Tarot deck or Oberon for your healing, you are probably surrendering your life to blind chance. Integral does not confuse pre-personal, belief-based interventions, like reiki, astrology, palmistry, channeling, mediumship, homeopathy, acupuncture, neuro-linguistic programming, most forms of “energy medicine” and “quantum everything” with trans-rational and transpersonal experience. This is called the “pre-trans fallacy,” identified and described by Ken Wilber; a summary is here. A rule of thumb is that if something calls itself both spiritual and scientific, it is probably neither. If something calls itself spiritual, it doesn’t have to be, and probably isn’t transpersonal. Most of what is termed “spiritual” is, on close examination, pre-rational and pre-personal, which renders the use of the term “spiritual” almost meaningless, because it tends to deny reason and logic, tools necessary to access and maintain transpersonal anything. Consequently, integral includes and transcends religion and spirituality.

Integral is a balance between taking multiple perspectives on health and disease, respecting the power and meaning of placebo, belief, myth, voodoo, and superstition, on the one hand, and yet insisting that there is a hierarchy of value and usefulness by which you can determine what is most likely to work for you. If you don’t, you will try anything and everything, because you have no way of sorting out the good from the better because like, it’s all love, you know.

This is where the work I developed, Integral Deep Listening, comes into play. As I mentioned before, science knows your odds of survival based on repeated, control research studies. It knows predicted remission rates based on what you do or don’t do. However, it doesn’t know you. Placebo may help you, since it helps about 30%, on average, but this means it is not going to help you beyond chance. Science will boost your odds, because it has data of performance beyond chance, but those treatments are largely non-discriminatory, toxic, and have built-in noxious side-effects. Integral does not look at the benefits to the 30% from placebo and then jump to the conclusion that either the treatment is the cure or that because some got better that you will get better. In contrast to science, Integral Deep Listening is an approach to integral that knows you. It is about you getting in touch with other perspectives that have “skin in the game:” your fears, your hopes, your physical body, your immune system, your cancer cells. The idea is that you can create a treatment path for yourself that is authentic, that has a heart, that has meaning, and is also reasonable.

IDL interviewing will help you move out of the fear, reactivity, magical thinking, and false hopes that normally get triggered by a terminal diagnosis. You will become less attached to a particular outcome as you amplify six core qualities of awakening: confidence, compassion, wisdom, acceptance, inner peace, and witnessing. You will connect with perspectives that will help you to be realistic about both your disease and the healing process. You will get specific recommendations for treatment that you can take to your doctors and otherwise evaluate for yourself.

I have done IDL interviews with many different cancer patients and have interviewed many different perspectives representing creative and highly individual responses to disease. You can find some of these posted on the IDL web site, blog/examples of Deep Listening/cancer. I cannot claim that IDL has added a day to the life of any of these people. However, I can claim that IDL has most definitely improved the quality of life of almost all of them. This is because the more perspectives that you identify with, the less invested and identified you are with your habitual waking point of view. This means that death becomes less of a big deal for you. Instead of passivity, fear, grief, or anger in the face of your mortality you will develop the ability to survey what is available and sort through alternatives and well-intentioned advice more objectively. You will cultivate cosmic humor, or the ability to see the poignancy of the drama of your life, abundance, or a sense of the presence of life, creativity, and growth even in death and pain, and luminosity, or a connection with the formless and timeless wellsprings of creativity that describe life itself. Consequently, you will be more likely to make decisions about your treatment or that of a loved one that are comfortable, meaningful, and worthwhile, even if they are painful or have gruesome side effects.

IDL advocates something called “triangulation,” and you can see it at work in what you have just read. It says, “consult both objective and subjective sources of objectivity.” You do this when you consult doctors, experts, faith healers, and New Agers on the one hand, and do IDL interviews, on the other. Compare the advice and recommendations that you get from each with the other and then compare that against your common sense. By using all three sources for decision-making you increase the odds that you will make decisions that you can live with, that feel good to you.

I saw a quote recently, which offers a “new thought” approach that, by contrast, helps to explain what triangulation is and how it works. The quote said, “Once you make a decision, the universe conspires to make it happen.”  The problem with this idea is that the universe has its own agenda, and it isn’t necessarily yours. Nor should you, as most people do, assume that your agenda is, of course, shared by the universe. This is exemplified by ideas like, “God wants me to be rich!” “The universe wants me to be happy and healthy!” It is far wiser to practice deep listening and learn the priorities of the universe and then make them your own. By aligning your priorities with those of the universe, instead of the other way around, you increase the odds that your decisions will be good ones and that the universe will conspire to make them happen.

Use doctors, placebos, aggressive mental interventions, and integral together to increase your odds when dealing with life-threatening situations and see what happens. If you are interested in prevention you could do much worse than to develop an Integral Life Practice, as described in the book of the same name by Ken Wilber, et. al. If, in addition, you use IDL interviewing to guide your integral life practice through access to interviewed emerging potentials and your inner compass, terminal illness and even death can even become causes for celebration.

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