spirituality and energy medicine

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Spirituality and Energy MedicineRoberta B. Trieschmann

The spiritual teachings of the great teachers andsages across the millennia are based upon somecore principles which can be extremely helpful toindividualswith major medical illness and physicaldisability to promote health, happiness, andimproved physical function. These principles pro-vide guidance for accessing expanded aware-ness and higher levels of consciousness.However, at the physical level these principalscan serve as a means to understand the resultsachieved within the burgeoning field of energymedicine, representative techniques including butnot limited to acupuncture, therapeutic touch,reiki, qi gong, tai chi. Rehabilitation professionals,as well as all health care professionals, haveavoided introducing the topic of spirituality withpatients and clients for fear of intruding into a per-son's religious beliefs. However, the distinctionbetween religion and spirituality is provided here-in in order to provide a rationale for the topic ofspirituality to be introduced and utilized toenhance health and healing. Some specific appli-cations of spiritual principals during the counsel-ing process are provided.

My Personal Odyssey

As a clinical psychologist with 34 years of experience in thefield of medical rehabilitation, I have always looked forpractical solutions to problems and have had little fasci-

nation with psychological theory. In my professional life, I havesought methods to assist people who were experiencing physicaland emotional pain to transcend the physical circumstances oftheir lives and to achieve some measure of happiness and con-tentment despite their losses, some of which were catastrophic inproportion. When working within a hospital system and withindividuals acutely disabled, I was usually able to avoid noticingthe limited utility of many of our traditional psychological meth-ods to produce effective change because the hospitalization wasfor a relatively short period of time and/or the person had limitedinsurance coverage for long term psychological support.

But having a private practice gave me a profound sense offrustration as I received referrals of individuals disabled for

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extended periods, often on workers' compensation, and the insur-ance companies were desperate to find a solution to the patient'sproblem, quickly. The insurance carriers had spent massiveamounts of money on medical treatments, yet the patient contin-ued to complain of pain. Most of the people who came to mewere dispirited and an interview revealed that most of them weredispirited even before onset of their physical difficulties. By thisI mean that they were out of contact with what their true Self wasreally saying to them about how they were living their lives. Well,this predicament is certainly not limited to people with majormedical or disability problems but also applies to most of the peo-ple on this planet. We have been culturally and socially shaped tobe "good" participants in our family, school, workplace, profes-

sion, community, and peer group. This shaping process involvesthe inculcation of an extraordinary number of habits, beliefs aboutproper and improper behavior, and judgments about other peo-ple's behavior and beliefs. Unfortunately, during this shaping, welearn to ignore our inner truth if it disagrees with the demands ofthe authority figures in our lives. While a certain amount of thisshaping is necessary to allow a group of people to relate effec-tively with each other (manners and morals), a feature inherent inall such shaping is a lack of behavioral spontaneity so that manyof our responses are nothing more than an automatic reaction to asituation based upon past conditioning. By the time we are youngadults, most of us seldom notice any discrepancy between whatour true Self would prompt us to do and what we have learned to

do. It is that discrepancy, the automatic and mindless doing ofwhat we are supposed to do rather than what we want to do, whichgradually can lead to a state of being dispirited, to being truly outof contact with our true Self and the spiritual heart beat of the uni-verse. During the childhood years, we learn to suppress, repress,and deny our feelings so that we do not express ourselves authen-tically. Consequently, it is the accumulation of our unexpressedemotion and the continued denial of our own truth which causesso many of our health woes in the decades of our adulthood.

My Personal Spiritual Crisis

This cultural shaping process is so pervasive that we do noteven realize that it is happening. To use a personal example, Itried to be the "good" professional, the solid scientist, the excel-lent psychologist, the super woman of the latter decades of the20th century. I had worked for years to present a model of med-ical rehabilitation which stressed the importance of the psycho-logical, social, cultural, and environmental aspects of the disabil-ity experience as essential to complete rehabilitation, rejecting thenotion that rehabilitation consisted primarily of units of treat-ments to bodies with mobility and sensory impairments.(Trieschmann, 1987, 1988). I wrote books, presented lectures atconferences and universities, served on federal and private grantreview committees, and served on committees which designed

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research plans for federal agencies to explore aspects of the wholeperson who had acquired a disability. But over the years I saw thesame faces, all of us experiencing a subtle sense of self congratu-lation as we met, year after year, at meetings and conferences,each of us, with the best of intentions, convinced that we wereadvancing the state of the art of medical and vocational rehabili-tation. Yet, for me, the whole exercise began to seem like emptyrhetoric, merely words, divorced from actions, communal powertrips and ego stroking. This is not to say that we did not do somegood. But the whole medical system, our phony health care sys-tem, was more and more obviously becoming merely a sicknesstreatment business establishment in which money became the pri-mary focus of attention, getting more of it for some professionals,clinics, and hospitals, and keeping it for the third party payers. Inthe meanwhile, the actual socioeconomic and psychosocial statusof people with physical disabilities was deteriorating nationallyand I could no longer ignore the discrepancy between what wewere proposing to do and what was actually happening. In theearly 1990's, a friend of mine who was equally prominent at thenational levels of rehabilitation was crooning that the golden ageof rehabilitation had arrived. As I listened, I felt that I had enteredthe "Twilight Zone," that state when your sense of reality just doesnot fit with what other people seem to think is happening. At adeep level, however, I knew that I was not the crazy one.

Soon after that I resigned from almost all of my national reha-bilitation activities because I could no longer maintain the cha-rade; I no longer believed that what we were doing made muchdifference to the lives of people with disabilities or chronic ill-nesses. In essence, my heart was no longer in my work. I wastruly dispirited because my work has always been a direct expres-sion of my true Self. It was never a j ob, nor was it a career; it wasan expression of me, someone who wanted to help and to serve thegreater good. Did my ego take satisfaction at the nice words

which were directed to me? Of course. But that was not the pur-pose of my work. I wanted to make a positive difference in thelives of people who were experiencing major difficulties after theonset of medical illness or physical trauma. But the operationalpolicies of the health care system were working against all of us.

At the core of my despair was the growing realization thatwhat I believe to be the greater good, providing kind and compas-sionate health care across the spectrum of life, with or without adisability or major illness, has not been specifically articulatedanywhere within our culture. Rather it seems as if we have beenliving, increasingly, within a "value-free" vacuum in which expe-diency and eventually making money has become the greater

good, by default. This vacuum has been fueled by the decline ofthe importance of spirituality and religious values in our lives andreplaced by the new "religion of science," a religion whichpreached the dogma of objectivity, quantitative measurement, andreductionism, and which promised salvation through technologyand rationalism. Kindness, compassion, caring, altruism, love,sharing, and bealing were words not to be found in the literature,the legislation, or the lecture rooms of academia and Americanmedicine.

As I sat and contemplated my life, I realized that the cosmol-ogy of our ancestors (that God, the Universe, the Earth, and all onthe Earth were part of a divine plan, interdependent and ultimate-

ly responsible to a higher purpose than the comfort of our indi-vidual lives) was no longer evident in the values, policies and cul-ture of American life in the latter decades of the 20th century.This cosmology had been replaced by the view that the Universewas a machine with no meaning or purpose, thus almost givingpermission to people to idealize the values of expediency andgreed for power, for money, and for material possessions. (Nowwe see bumper stickers that say, "He who dies with the most toyswins" and "shop til you drop.")

Gradually I realized that I had been living a sort of "schizo-phrenic" existence: trained as a professional who adopted thedogma of science , yet personally and philosophically committedto the cosmology of our ancestors. For decades I had been"preaching" that the person, the organism (body), and the envi-ronment (P, 0, E) were a dynamic unified system that could notbe isolated into its component parts for study and treatment. Yetwith each decade the health care system was focusing more andmore exclusively on physical reparations of bodies. Thus, by theearly 1990's, I had fallen into a crisis of meaning, a spiritual cri-sis, in which I realized that the core values by which I lived mylife were at odds with the trends of society at large. To savemyself, I could no longer participate in what appeared to be amorally bankrupt health care system. I was depressed and I wasangry. My energy had plummeted and I had a clear sense that Iwas at risk for some significant medical problems unless I madesome major changes in my life and my outlook.

After resigning from major national involvement, I turned tomy private practice as a means to express my true Self, my soul,wounded though it was. It was then that I was faced with the lim-ited utility of the usual counseling techniques in eliciting the fair-ly immediate change which the insurance companies requested.Consequently, in an attempt to heal myself and find ways to heal

others, I explored and studied a large variety of alternative medi-cine fields and spiritual practices from the East. In the decade ofthe 90's, I read, studied, practiced, and trained with spiritual mas-ters within the Taoist, Zen Buddhist, Tibetan Buddhist, and Hindutraditions, with a healthy dose of Christianity as well. In the

process I realized that I had never really lost contact with my trueSelf, but rather it was my true Self that had been speaking to me,more and more loudly, so that I could see the discrepancy betweenthe philosophical foundation of my professional life and the oper-ational policies of the health care system. During this decade ofstudy and training, not only were my own health, energy, enthusi-asm and sense of purpose transformed, but I had found a strategyto assist people with major physical illness and disability to live

happier and healthier lives. Thus I have been able to guide mypatients along a path which would help them to listen to theirsouls, their true Selves, more effectively with the subsequent ben-efits of improvement in physical function, overall health, andemotional well being. (Trieschmann, 1995, 1996, 1999).

Applications to RehabilitationThe disconnect between the deep inner urging of one's true

Self and the cultural shaping process is evident in individuals withand without physical disability or medical illness. However, liv-ing with a disability is hard enough without trying to become a

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pale image of who one might have been without the disability, i.e.,trying to fit into a world designed by and for able-bodied individ-uals, most of whom are equally dispirited. Thus, the illness ordisability experience becomes an opportunity for the individual toget in touch with the needs of his or her true Self, i.e., to use thisopportunity to manifest the true essence of oneself that existsregardless of physical function. This will be immensely easier,however, if the professional who proposes to serve as a coach dur-ing this process has already embarked on such a personally trans-formative project as well. Just studying books or reading an arti-cle like this will not do it. There is NO substitute for the actualexperience of a spiritual practice that involves centering on thequiet essence within. This can be contemplative prayer, medita-tion, Tai Chi, Qi Gong, Aikido, yoga, or other centering practices,often a combination of several.

The material to be presented represents some of the key spir-itual teachings at the heart of Buddhism, Taoism, Hinduism, andChristianity. This is not a theology nor is it a theory awaiting con-firmation of western science. Jesus Christ, the Buddha, Lao Tzu,and the great Hindu Siddhas and sages were able to experiencehigh levels of consciousness which allowed them to understandthe fundamental operations of the Universe. These are levels ofconsciousness that ordinary humans can only wonder about.However, in order to enhance communication of this material to awestern professional audience, these teachings will be presentedin the form of a set of methodological guidelines for personaltransformation which have the mental, emotional, and physicalbenefits of improved mood and sense of well being, resulting inan improvement in physical function and health. It is importantto note, however that basically we are dealing with two faces ofthe same coin. One face is the personal, experiential, subjectiveaspect and the other is the objective, behavioral, and physiologi-cal correlates of the practice. The subjective and objective occur

simultaneously and are equally important. Although they cannotreally be separated, the last 70 years within psychology has beencharacterized by the decline of concern about consciousness,awareness, and introspection and an increasing emphasis on thequantitative, behavioral, and objective aspects of human behavioras if that were the only truly valid dimension of human life. Thus,the custom is to mention the objective and behavioral componentsin order to establish some validity within the professional com-munity (to have a remote chance of being taken seriously), butthe personal experiential component is the key to accessing thetrue Self and higher levels of consciousness. Please note that it isthe exclusive reliance on the objective, physical, quantitativeaspects of life which has been the dispiriting feature of our culture

in the last century and the major failure of our health care system.Consequently, it is time to bring the subjective experience of con-sciousness and the focus on the true Self back into all aspects oflife, personally, professionally, culturally, and politically.

Spir itu ality and Re lig ionEven though there is more awareness that spiritual approach-

es may bring immense health benefits (Dossey, 1993; Benson,1996; Omish, 1998), many professionals do not touch on the topicof spirituality in their interactions with clients because of a fear ofintruding into a person's religious beliefs. We have a strong ethic

of religious freedom in this country and a social and political ret-icence to discuss such topics with other than family or goodfriends. Therefore, I must distinguish here between religion andspirituality. A religion has several components: a set of beliefswhich serve as a cosmology of the person's place in the universe(which usually becomes part of the dogma over time) which agroup of people share which give meaning and value to life; a rit-ual or procedure for experiencing Spirit; the dogma, a set ofbehavioral guidelines or rules which members are urged orrequired to follow in order to live a "good" life; and an organiza-tional structure which rules on matters of dogma and ritual andwhich identifies a hierarchy of practitioners who are deemedqualified to perform the ritual and create or alter dogma.Although most religions were inspired by a great teacher who wasdirectly manifesting the Spirit of the Universe, the less enlight-ened followers, over the centuries, created a structure to carry outthe leader's teachings. This structure was intended to provideguidelines on the path to high spiritual states. Unfortunately, overtime, the structure itself can become the focus of attention forindividuals or groups rather than the spir itual experience that thegreat teacher attempted to communicate. In this manner the struc-ture MAY interfere with the spontaneity of the spiritual experi-ence as do's and don'ts, musts and shoulds, dominate and eventu-ally inhibit the spiritual experience of practitioners. As a result,participation in the world's religions has declined as many havefelt uninspired (experienced no Spir it) by the ritual and dogma. Itshould be noted, however, that many practitioners of the world'sreligions are deeply spiritual people, but it is also true that manypractitioners haven't the foggiest notion of what true spir itualityis all about and are just following the rules.

Spirituality, however, consists of a path a person takes inorder to experience the oneness with all creation, the pure con-sciousness devoid of any form which is at the core of the universe.

This experience may occur within a formal religious tradition oroutside of any. It is a strictly personal matter in which the indi-vidual engages in a series of steps to quiet the mind and the bodyin order to experience the heart beat of the Universe which pul-sates within each of us. This experience has often been describedas being in the presence of God, the Holy Spirit, the GreatFather, the Self, or the Tao, the term varying according to culture.This is the process of withdrawing attention away from the sens-es and experience at the body level, withdrawing attention fromthe emotions, withdrawing attention from the thoughts which drift

endlessly across the mind, and resting in the dynamic space whichis empty yet so full, that space which no words can describe butthe feeling is one of bliss and love. Thus, no intermediary of

priest or minister is required. What is required, however, is a discipline, a discipline of consistently turning the attention to thequiet inner space, true Self, which resides all of the time withineach of us. We have been trained from childhood to ignore ourcontact with our true Self and pay more attention to the environ-ment. Such a spiritual practice does not require nor entail thewithdrawal from the everyday activities of life but rather becomesthe occasion for a gradual personal transformation in which onerides the sometimes turbulent waves of daily life with a greaterequanimity. In fact, contentment and often happiness with justwhat is starts to creep into daily life and what previously seemedlike intolerable circumstances become tolerable as attention turnsto more pleasurable aspects of life. Thus, the practice of spiritu-

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ality will not challenge nor interfere with any of the major reli-gious traditions of the world. Rather it may enhance one's expe-rience of one's religious practice.

In the last 50 years, many individuals have turned away fromthe formal religious traditions of their ancestors for a variety ofreasons: because they did not experience a spirit of upliftmentfrom participation in the group but rather a fear of judgment andcriticism by the "spiritual police" (congregation members whoappoint themselves to be guardians of dogma and procedure);because there was little inspiration in the manner in which the rit-ual or dogma was presented by members of the ministry; becausethe magic had gone out of the mythical stories of the religion inthe face of established scientific fact. Although many have fadedfrom their religious communities in an attempt to experience truefreedom and expression of spirit, the decline of participation with-in religious traditions has inadvertently precipitated a slide into acosmological vacuum in which one's conception of the universe,the source power of the universe, and one's place in the universehave been defined by science. This has happened by default. Andscience, over the last 350 years, has taken a mechanical, reduc-tionistic view of the person, of the natural environment, and of theuniverse as a whole. Because pursuit of new knowledge wasinhibited by the dogma of the Church, Rene Descartes in the 17thcentury proposed that the Church would have supremacy in con-ceptual matters relating to the mind and soul of man and woman,and science would have conceptual supremacy in matters ofbody, physical matter, nature, and the physical universe. This isthe origin of the mind-body split which has freed science to

explore the physical nature of the universe and the people in it,unimpeded by accusations of heresy. If one reads the originalworks of Descartes and Newton, however, one realizes that theywere deeply spiritual people who viewed humans in nature as aunity which could not be separated. But for research purposes,

the mind-body split was a practical solution to foster the evolutionof knowledge. Unfortunately, this practical solution to a concep-tual power struggle 350 years ago, in combination with thedecline in our adherence to the cosmological and religious viewsof our ancestors, has allowed the views of science to dominate our

conceptualization of life and our role in it. This conceptualizationis mechanical, practical, and devoid of mystery and awe. Thus,science has taken the place of religion in defining our position inthe universe and in some ways has, by default, become the reli-gion of the 20th and 21st centuries. Within this "religion of sci-ence;' those with Ph.D.'s and M.D.'s have become the priests.

It is time for each of us personally and professionally to

examine our own view of cosmology. Are we just a widget in themachine of the universe that can be described by a series of quan-titative and objective physical measurements of parts? Or are wea dynamic, creative, loving manifestation of the Universal Source,or God, the whole which is greater than the sum.of its parts?Thus spirituality, regardless of one's religious membership, is theattempt to experience this Universal Source, no longer con-strained by the limited view of our minds, no longer dominated bythe sensations of our human senses, and no longer obsessed by theexperiences of the body, an attempt to rest in the state of pure con-sciousness which is at the core of every atom in the universe.

Energy Medicine and Spiritual Practice:Two Sides of the Same Coin

For the purposes of the discussion here, we will be linkingspirituality and science by focusing on methods that have been atthe core of many spiritual practices across cultures on this planet.These methods are also found within a burgeoning field known asenergy medicine. What is becoming increasingly apparent is thatthese methods provide very effective means to improve the quali-ty of life of people with major medical illness and physical dis-ability despite the fact of the disability or illness itself. For exam-ple, if we fill an 8 ounce glass with 4 ounces of water, we canbemoan the fact that the glass is half empty or we can be gratefulthat the glass is half full. Same amount of water in the glass; dif-ferent reaction to what is. This approach is not intended to sug-gest that psychologically processing the sense of loss and painassociated with illness and disability is not necessary. But aftera while, a person needs to expand the focus beyond the experienceof loss and find channels for the expression of the true Self. Noris it intended to suggest that advocacy for improved services toindividuals with disability is not necessary. But by practicing thefollowing guidelines, an individual can channel anger against

injustice into participation in advocacy activities from a positionof health and well being and avoid being destroyed by anger,despair, and worry.

An extraordinary benefit of this approach is that consistentspiritual practice can lead to states of higher consciousness. Nowwe are talking of going beyond the benefits of greater equanimityand well being and opening the door to the psychic, subtle, causal,and nonduallevels of consciousness (the higher spiritual states) asdescribed by Ken Wilber (1995). Currently many humans haveachieved the level of consciousness development called vision-logic, the ability to engage in high level conceptual activities.This has been the basis of our technological and scientific

advances. Until recently, only the greatest sages and holy personswere able to access these higher spiritual states. Now, however,the evolution of human consciousness is bringing evidence thatmore and more people are having experiences of these higher lev-els of consciousness, initially through drugs such as LSD in the1960's, but now in the last thirty years, through regular spiritualpractice.

The linkage between spirituality and energy medicine can beunderstood by looking at some basic physics. This does not implythat the science of physics is proving the existence of higher spir-itual states but rather that the principles of physics present a famil-iar point of view from which individuals shaped by the westernscientific tradition can understand the nature of reality, the natureof the universe, as revealed in the teachings of the great spiritualleaders of all time.

Each atom is an electromagnetic unit of vibratory energy. Allatoms vibrate. The largest amount of "space" within an atom isthe ambient dynamic energy potential of the universe (which thesages call God or Spirit) with the electrons, protons, and neutronaccounting for a minimal portion of the atom's structure. Humans(as well as all matter on this planet) are composed of atoms.Atoms collect to form molecules which agglomerate into cellswhich coalesce into organ systems and body parts. Every cell in

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our body has a characteristic vibration. When these cells vibrateat a certain rate and in a certain pattern, the body functions welland the person feels good. When they vibrate at a different rateand pattern, the body functions less well and the person feels notso good. It is highly probable that assessment of the differentialvibratory patterns associated with health and sickness will be acore feature of the research of the 21st century.

Every thought is a pattern of energy characterized by a cer-tain vibratory rate and pattern. Positive thoughts have a highervibratory rate and a smoother, more harmonious, pattern.Negative thoughts have a slower vibratory rate and a more irreg-ular, dissonant pattern. Positive thoughts lead to emotions suchas, pleasure, happiness, calmness, well being, whereas negativethoughts lead to anger, fear, and sadness, the whole gamut of neg-ative emotions. The vibratory pattern of the thought and its con-sequent emotion are experienced throughout the entire body, byeach cell, and this vibratory influence tr iggers the release of cer-tain kinds of neuropeptides which flood through the body (Pert,1997). The job of neuropeptides is to turn on and off the functionof certain cells on which there are receptors for that neuropeptide.The cumulative effect of this cascade of neuropeptides is a senseof well being, lightness, happiness or a sense of heaviness, lethar-gy, and discontent, depending upon the positive or negative natureof the thought and the consequent cascade of neuropeptides. Thusthoughts are patterns of energy which influence the function ofthe whole body. Therefore we can ask, is the glass half full or isit half empty? The answer, which implies an attitudinal approachto life, has major consequences for the long term health and wellbeing of the individual, disabled and nondisabled alike.

Which brings us to the question, what is consciousness andwhere is it located? Pure consciousness is the awareness of life,the awareness of seeing out of one's own eyes, the awareness of

being. Pure consciousness is the experience of the dynamic ener-gy at the core of each atom in one's body and therefore, con-sciousness is located throughout the body, not merely in the brain.And it should be noted, consciousness is not the PRODUCT ofbrain processes as certain of our reductionistic scientists 'are cur-rently proposing; it is Nat the end product of certain biochemi-cal operations occurring within that jelly-like tissue within ourskull. Consciousness is the precursor of matter and the biochem-ical processes within the brain are only the physical manifestationof the operations of consciousness (Goswami, 1993). Thus con-sciousness, spirit, energy versus matter are just different forms ofmanifestation of the same vibratory principle, as stated inEinstein's famous equation( E = mc2). When matter acceleratesto (vibrates at) the square of the speed of light, it becomes pureenergy without form. Not all experiences of consciousness arepure, however; in fact few of them in the daily life of the averagehuman being are. Rather consciousness, the awareness of being,is filtered through our habitual beliefs and attitudes, which usual-ly tend to distort or color our experience of what is. Rather thanthe pure radiance of being (the pure consciousness at the core ofeach atom) which is expressed as love, compassion, and peace,we experience the turbulence, a vibrational state, which is theconsequence of our most recent thoughts. Thus in spiritual prac-tice we tum inward to contact that dynamic inner space, that pureconsciousness, which is Spirit, our personal experience of which

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represents our true Self. Spiritual practice is the discipline oflearning to rest within that inner space, to experience pure con-sciousness, so as to be able to "see", as an objective observer, ourthoughts drift across our mind and the resulting emotional conse-quences of each thought. It is also the discipline of making theCHOICE, over and over, to interrupt the negative thought cyclesand substitute positive thought cycles. I t is the repeated shiftingfrom negative thought patterns into positive thought patternswhich allows the radiance of pure consciousness to become moreand more apparent in one's experience of daily life.

The result of this discipline is a gradual uplifting of one'smood, a greater lightness and brightness in one's outlook andexperience. Over time, a sense of calmness accounts for more ofone's day and one's reaction to difficulties is less pronounced andless prolonged. One bounces back from trouble more readily andsurprisingly, less trouble enters one's life. Over time, one's over-all health status improves and the ability to function in a varietyof settings improves. Energy level increases, mood improves, theimmune system function improves so that one is less susceptibleto infections and illnesses; in other words, the body is functioningin a more harmonious, balanced, and normal manner. The needfor medication declines and in fact one begins to notice how badlysome of that stuff makes one fee1.

Clinical Implications: Some Hints on PracticeAfter an introductory interview, I will immediately teach the

person to meditate. I quite frequently will not use that term ini-tially but describe it as a stress reduction breathing technique. Abrief explanation of the function of the autonomic nervous systemas the mediator between thoughts and feelings and the actualexperience of stress at the emotional and physical level provides acontext for presenting meditation as a perfect means of turning

down the level of the sympathetic activity and stimulating theaction of the parasympathetic activity. This slows and deepensthe breathing, lowers the blood pressure, relaxes the muscles andorgans, and leads to a sense of calm. Although less so recently,some people are afraid of "meditation" and therefore I provide abiological explanation for our activities in our initial therapeuticencounters in order to defuse fear of "mind control" by someoneelse or strange religious practices. Basically I ask the person tospend 3 periods of at least 20 minutes each day sitting quietly andfocusing on the in and out breath without controlling it in anyway. It is helpful to count each successive exhalation up to 10 andthen start over again at number one. The instruction is to interruptthoughts which enter the mind and return to the counting of thebreaths. It is helpful for the client to choose a spiritually mean-ingful phrase to coincide with the exhalation. Although terriblyboring after the excitement of our mental "Sturm and Orang," qui-etly counting the breaths is the beginning discipline, the practicewhich is essential to quieting the mind and body. The practice ofremoving our attention from our thoughts over and over and overagain and returning attention to breathing is essential and someversion of this is a core feature of almost all spiritual approaches.Initially this is very difficult but, with persistence, moments ofpleasant quiet and relaxation will occur. As we turn down the levelof sympathetic arousal, the parasympathetic calming provides thephysiological basis for the beginning of spiritual practice. It is the

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repeated interruption of our habitual thoughts, beliefs, and atti-tudes that allow us to begin to listen to our true Self because thatis what we find waiting for us when we shut up and listen. It isthen that we start to make friends with our true Self, the Self thathas been hidden under the layers of our conditioning. Initiallythere may be episodes of powerful feelings that are released butonly because they have been suppressed for so long. These feel-ings, the thoughts accompanying them, and the urges of the trueSelf become the focus for successive counseling sessions.However most people need assistance in the mechanics of themeditation process for several weeks and thus a therapist withoutpersonal experience in meditation will be next to useless.

There are many workshops available to teach meditation aswell as numerous books on the meditation process which will behelpful to client and therapist alike (Budilovsky & Adamson,1999; Das, 1997; Hanh, 1975; Levey, 1987; Suzuki, 1970; ).However, it really helps for the therapist to connect to a medita-tion group or spiritual teacher for training and support. There isno substitute for experience.

The issue of powerful emotion needs to be addressed. Ourreligious traditions have trained us to view anger as wrong andtherefore many of us have learned to suppress our anger and smilethrough gritted teeth. Although the ultimate goal of all spiritualpractice is relative equanimity, this does not mean that anger,when it arises, should not be recognized and expressed. Anger isone form of energy, a vibrational pattern, which is best dealt withby letting it rumble on through us and fade away. By defining thevery experience of anger as wrong and stopping the expression ofthis energy at the outward level, we have guaranteed that thevibrational pattern will be held within our system and will requirenew energy to hold in check. And, of course, the anger accumu-lates and requires even more energy to hold back. This is the pre-

cursor of future health problems. Within this approach to spiritu-ality and energy medicine, anger is viewed as normal and thisenergy should be released but in a manner that does not cause ver-bal or physical abuse to others. Thus, part of the training is tolearn to recognize clearly what one is feeling each moment and

deal with it promptly and appropriately. By engaging in a medi-tation practice, one becomes much more sensitive to one's state atthe moment and learns to see the cause and effect relationships inone's life. Usually, anger is caused by a thought we have hadabout a situation or a person. The correlate of the thought is boththe anger at the emotional level and the neuropeptides at the phys-iological level which stimulate the sympathetic nervous system.Typically we mentally rehearse the thoughts about the person or

event with the result that the experience of anger continues andthe physiological response increases. The training is to detect thethoughts which trigger the anger, interrupt them, allow the angerto rumble through us, and use our breathing to calm the physio-logical cascade of neuropeptides. This is an act of will, theCHOICE of letting go of negativity and focusing instead on thepositive; thi s i s the d iscipl ine of spi ri tua li tyapplied to daily life.Over time, we become less and less angry because we see howmost of our emotional upsets result from undisciplined and habit-ual thought patterns. EVERY moment we are making a choice, totake the high road or the low road, so to speak, in our habitualthought processes. Since we think between 50,000 and 60,000

thoughts a day, the opportunity for choice occurs moment bymoment. The meditation and the spiritual practice make us muchmore aware of our experience and thoughts in each moment ratherthan mindlessly trudging through the days with our unrecognizedhabitual beliefs, habits, and attitudes triggering almost a steadystate of sympathetic arousal, with its consequences of headache,sleep disturbance, tension, and pain. Eventually, across thedecades, the result is immune system disorders, cancer, heart dis-ease, and all of the other diseases of "civilization," diseases result-ing from faulty control over the mind and self-destructive reac-tions to the stress. Spiritual practice becomes the opportunity forpersonal assessment and change: the ultimate stress reductiontechnique. Relief is not always immediate because initially onecan feel a bit worse as all of the suppressed feelings begin to sur-face. But by adhering to the practice of interrupting the thoughts,focusing on the breath, and using a spir itually uplif ting phrase, thesuppressed feelings rumble through one's system and one's wholesense of being lightens. In this way it becomes a personally trans-formative practice. The clue to sensing the true Self is an expan-sive, warm, uplifting feeling which is sustained. That is, it is morethan the joy of eating a piece of chocolate or juicy piece of pizza,the satisfaction from which is temporary. The clue to sensing thereturn to old habits, outmoded beliefs, or limiting attitudes is thesense of tightness, constriction, and lack of enthusiasm. Personaltransformation occurs by choosing the direction prompted by thefeeling of upliftment and interrupting the limiting and negativethoughts. Initially in this process, it may seem that feelings ofupliftment are few and far between but as we give ourselves per-mission to feel what we truly feel and do what feels "right," thetrue path will become clearer. This may lead to an even greaterunderstanding of how unhappy we are with the paths we have cho-sen in the past and the methods we have used to deal with theevents and people in our lives. But this self-examination andincreased awareness provide the opportunity to assess what can be

changed and the option to make new choices.

As an example, one of my patients, a woman in her early50's, has had multiple sclerosis for ten years, characterized byexacerbations every six months or so, usually involving her bal-

ance and motor ability in the lower extremities. She came to seeme, however, af ter an onset of blindness in the right eye resultingin optic atrophy. She was anxious about the future, depressedabout her increasing loss of function; habitually she was verytense and very sensitive to others' approval and disapproval.Unfortunately, her life had been spent allowing people's opinionsof her to dominate her life. However, use of the above clinicalprocedure resulted in a dramatic decline in her anxiety and

depression about her condition; over time her concern aboutapproval or disapproval also declined significantly. She gave her-self permission to be happy by listening to her own true Self andby interrupting negative thought cycles. After six months ofweekly meetings she was convinced that she had learned what sheneeded and discontinued therapy. But evidently she quicklyslipped back into the old habits of thinking negatively, and underthe stress of her father's death, she lost sight in the other eye.Now she was significantly disabled. She returned to me immedi-ately and we resumed the same procedure. Now after severalyears of one hour sessions every three weeks or so, she still hasimpaired vision in both eyes but sufficient function to be inde-

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pendent and fully functional in daily life. She states that she ishappier now than at any point in her life, despite the residual bal-ance and mobility problems (sufficient for ambulation withoutaids) and her visual impairment. What is, at the physical level, hasnot changed dramatically although she has not had an exacerba-tion of her MS for five years, and her physical function hasimproved slightly. But what has changed is her reaction to whatis. Now she focuses on the glass being half full and interrupts anyreturn to dwelling on the glass being half empty. Do I recommendtherapy for life? No. But everyone needs support for this newway of living from an individual or a group since the focus on thenegative is so pervasive in society at this time. This woman haschosen sessions with me as a means of support. And as a finalpoint, it sure is helpful if the therapist is walking the talk, mani-festing the principles in his or her own daily life.

Nothing recommended here interferes with the religious tra-ditions or beliefs of the centuries. In fact, the addition of medita-tion and the discipline of spirituality will enhance one's experi-ence of the religion of the ancestors if that is a meaningful part ofthe person 's life. Thus, during my interactions with clients, their

religious beliefs are not necessarily a part of our discussionsunless they initiate the topic. Rather we have found a point ofcommonality with our focus on the core spiritual principles whichunderlie all of the religions. Thus the issue of spirituality can fitquite comfortably into rehabilitation practice.

ReferencesBenson, H. (1996). Timeless Healing: The Power and Biology of

.Ikfua. New York: Scribner.Budilovsky, J. & Adamson, E. (1999). The Complete Idiot's

Guide to Meditation. New York: Alpha Books.Das, L. S. (1997). Awakening the Buddha Within: Tibetan

Wisdom for the Western World. New York: Broadway Books.Dossey, L. (1993). Healing Words: The Power of Prayer and the

Practice of Medicine. San Francisco: Harper Collins.Goswami, A., Reed, R, & Goswami, M. (1993). The Self-Aware

Universe: How Consciousness Creates the Material World.New York: G.P. Putnam's Sons.

Hanh, T. N. (1975). The Miracle of Mindfulness. Boston: BeaconPress.

Levey, J. (1987). Relaxation. Concentration. and Meditation:Ancient Skills for Modem Minds. London: WisdomPublications.

Ornish, D. (1998). Loye and Survival: The Scientific Basis for theHealing Power of Intimacy. New York: Harper Collins.

Pert, C. (1997). The Molecules of Emotions: Why You Feel theWay You Po. New York: Scribner.

Suzuki, S. (1970). Zen Mind. Beginner's Mind: Informal Talks onZen Meditation and Practice. New York: John Wetherhill,Inc.

Trieschmann, R (1995). The energy model: a new approach torehabilitation. Rehabilitation Education. 9, 217-227.

Trieschmann, R (1996). The energy paradigm: The new modelfor health care. In Krotowski, D., Nosek, M.& Turk, M.,(Eds.) Women with Physical Disabilities: Achieving andMaintaining Health and Well-Being. Baltimore: Paul H.Brookes Publishing Co.

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Trieschmann, R (1999). Energy medicine for long term disabili-ty. Disability and Rehabilitation. 21, 269-276.

Wilber, K. (1995). Sex. Ecology. and Spirituality: The Spirit ofEvolution. Boston: Shambhala Publications, Inc.

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