In medical qigong, we learn cancer healing protocols as well as cancer prescription exercises. I think this is a great article by Pamela Ferguson, who had to deal with her own cancer diagnosis and healing. I believe much work needs to be done with all the issues that surround cancer, physically, of course and also the enormous fear that surrounds cancer. Part one was published in the January 2004 edition of Acupuncture Today and part 4 was published in the March 2004. I think the information, exercises and protocols are highly relevant and similar to our medical qigong protocols.

Busting Taboos About Breast Cancer, Part One

As a vigorous 16-year survivor of metastatic breast cancer, I have transformed my experiences into activism and a teaching protocol for my international students of zen shiatsu. I have taken great joy in beating the odds and busting many of the taboos surrounding cancer.

As students over 20 years ago, we were advised by instructors and textbooks to avoid treating cancer patients, but we’ve all moved beyond that into a whole new realm of understanding and specialized procedures.

My workshops cover a number of practical topics. Along with my own personal insights and postmastectomy exercises, I share my professional experiences on the following:

1. Working with other cancer patients and their families, treating each cancer patient as an individual, and avoiding sweeping generalizations about cancer.
2. Special qi and zen shiatsu treatment protocols pre -and-postsurgery.
3. Working creatively with survivors.
4. Helping patients make informed choices about a combination of mainstream and alternative treatments and adjuvant therapies.
5. Working creatively with the terminally ill.

In short, students are trained to think - and treat - multidimensionally, and to involve patients and families in teamwork. Sometimes I use shock tactics, like lifting my shirt to show my mastectomy scar, to help some students overcome their own personal fears. “There can be life, and great qi motivation after cancer,” I reassure them. “Cancer doesn’t have to be a death sentence!”

I also share the activism of those of us who feel free to use saunas and changing rooms in gyms as a way of helping others break the taboo of being unibreasted (or no-breasted) and committed to physical fitness. Too many patients have felt pressured into media-hyped reconstructive surgery and implants before giving themselves time to heal or network. Similarly, heads turn in mammography centers when I crack jokes about being entitled to “half-price” mammography - something I have been able to achieve in Zurich, Montreal, and Cape Town, South Africa - but not in the U.S., where I’ve been told that “it’s not in the system.” I remind my students that men also experience breast cancer; in some countries, up to 3% of all breast cancer cases occur in males.

My students and I also discuss new ways of changing the cancer lingo many of us find aggressive and offensive, like “cancer wars,” “bringing out the big guns,” or “battling cancer.” Instead, we opt for terms like “transforming” cancer. My own relationship with cancer changed when I realized that a cancer cell is in fact a confused cell. In my mind I needed to use imagery, such as light, to coax those cells back on track, not smash them! I wouldn’t battle a confused patient, so why battle a confused cell?

Postmastectomy Exercises/”Drawing Circles”

To ease the apprehension some students feel at the beginning of my workshops, I teach a series of “drawing circles” - postmastectomy qi exercises I developed quite spontaneously after my surgery. The circles have helped dozens of postmastectomy patients of all ages. Through one of my students in Germany, the circles have become an integral part of physical therapy training at a teaching hospital in Berlin. The exercises also help prevent the sort of qi stagnation in the breasts and painful breasts many women experience during PMT.

The drawing circles series evolved out of my qi training, and were helpful and joyful, especially when practiced to the gloriously healing sounds of Mozart concerti. The American Cancer Society kindly sent me a booklet of exercises which, while technically sound, I found uninspiring. This prompted me to create the sort of gracefully slow qi movements my body wanted in the weeks post-surgery. The circle evolved as a useful form, a holistic grid for measuring progress each day. I had lost many circles (my right breast, along with some 20 lymph nodes and left breast cysts), so performing qi movements in circle formations felt very restoring.

Performing the Drawing Circle

1. Initially, a day after surgery, heavily stitched and trussed up, I rolled my hands wrist-over-wrist to enhance deep breathing. “Wrist rolling” in Chinese medicine also helps stimulate the movement of lymph.
2. My hands then formed a rolling qi ball in front of me, which grew in proportion day-by-day.
3. These prompted fun “polishing the mirror” circles, similar to those “wax on/wax off” movements practiced in the movie “The Karate Kid.”
4. Then came the horizontal circles, with the hands moving from waist level to full lateral extension in slow, full circular movements (great for the San Jiao and Pericardium meridians).
5. Creating vertical circles proved to be the most ambitious, prompted first by swinging the arms, modestly of course, while I still had stitches. After the stitches were removed, I increased the swing each day until I could point my fingers to the ceiling and complete the circle, like a swimmer’s backstroke, in slow motion! (This was great for the Stomach and Spleen meridians.)
6. I then concentrated on “scar circles” – small, circular movements along my scars to help reduce scar tissue, increase local flexibility, and move stagnant qi out of the meridians cut by the scalpel. Other useful exercises involved pressing two fingertips into ren 17 (the front shu point for the Pericardium), then slowly extending my arms laterally and perpendicular to my body (equally good for opening the entire Pericardium meridian and enhancing qi flow through the breasts).

These exercises are simple, but quite healing, on many levels. As a result I had full arm extension and range of motion within three weeks of my surgery, and a strong sense of restored symmetry. A few months later, I began teaching these exercises to my students, and resumed my twice-weekly swimming regimen. I swear my exercises also prevented the form of lymphedema that confounds a number of postmastectomy patients who endure a thickened arm and reduced mobility. Indeed, these exercises have also been useful for reducing long-term lymphodema experienced by many patients. I’m saddened to encounter patients who were never taught how to move creatively after breast surgery, or who were given “don’t do this, don’t do that” lists that caused inhibited movements, fear, frozen shoulders, a tight neck, and a tendency to hold an arm over the area as though protecting a frightened bird.

By contrast, how wonderful it was to discover that a group of breast cancer survivors in Vancouver, Canada, created a special dragon boat canoeing team to celebrate their survival and build upper body strength through competitive rowing movements! I wrote about the team in my book Take Five, and happened to meet them recently (and quite by accident) in a Philadelphia hotel lobby.

Here’s some additional advice for shiatsu therapists who plan to work with breast cancer patients.

• Minimize your techniques. Practice the art of less is more. Maximize your own personal qi prepping. Avoid deep pressure. Practice off-the-body qi work around any area of recent surgery.
• Treating the Stomach meridian can be vital, not just because of location and function. The Stomach meridian plays a strong role in the “qi scaffolding” of the breast. I helped Peggy J., a double mastectomy patient, overcome so-called “phantom pain” by talking to her about the role of the Stomach meridian, and asking her to cup her hands around the twin spaces above her scars where she felt pain and where she had lost her physical breasts. I worked down the Stomach meridian and performed a slow-motion “ski-jump” over her hands, following the meridian line. Not only did Peggy feel the qi line, but a day later she told me the pain had gone. She was able to drive her car again and couldn’t wait to get back to the golf course!
• Similarly, the Spleen and Pericardium meridians run through the upper outer quadrant of the breasts where most tumors occur. Your diagnostic techniques will help you select the most appropriate meridians and acupoints to treat, of course, but some simple off-the-body work following the line of the affected meridians through the area of surgery will help repair meridian qi unsettled by tumors and scalpels.
• It’s always useful to ask your patients to demonstrate their range of motion so you can avoid any inappropriate movement or treatment position during simple stretching. Whether you work on a table or a floor mat, always ask your patients to arrange themselves in their most comfortable position. One of my patients, Lisa N., could hardly extend her arm in the supine position without a cushion for support.
• Placing a light, colorful cloth over the area of surgery can help remind you of its exact location.
• I often ask patients to draw their scars on body outlines, so I know the exact location. As an alternative, I suggest they line colorful Five Element stick-on dots over their clothing to track scars. I can then pinpoint the exact meridians and points affected locally and distally by the surgery. This is good for kids of all ages, especially when you show them in a mirror how stretching helps the scar “smile.”
• If a patient is undergoing chemotherapy, the Pericardium is great for minimizing nausea, especially P6 and P8. Minimize movement to avoid vertigo, especially when working neck and shoulder points.
• Remember that chemotherapy hits jing (affecting bone marrow, causing hair loss, and in some cases, premature onset of menopause). There’s a subtle art in using shiatsu to minimize pain and nausea during the actual chemotherapy process, as has been discovered by a sensitive shiatsu therapist and AOBTA board member, Wayne Mylin, in the sessions he gives in a Philadelphia cancer clinic.
• Rebuilding jing and the immune system after chemotherapy is one part of survival. Humor, life goals, a strong support system, a selection of mainstream and alternative therapies, and economic security, can all make the difference between life and death. I’ll expand on that in part two in my next column.

Finally, here are some …

Useful Tips Surrounding the Treatment of Cancer Patients

1. Encourage patients to spend time empowering themselves by networking and seeking solid information before they rush into decisions about surgery and adjuvant therapies (either mainstream or alternative). Patients often go into a tailspin when they are told they have cancer. Be reassuring and supportive. It’s not helpful to throw “New Age” theories at them about why they got cancer.
2. Encourage patients’ families and friends to create a support network so practical needs can be spread around the group, such as setting up phone trees, group rides, picking up kids from school, shopping, etc. This helps free time and precious qi for the patient to deal with immediate concerns.
3. Treat your patients with ABT and meridian stretching, or ABT and needling, as often as you can before surgery. You can help enhance qi by encouraging them to do some relevant form of exercises the day before surgery. I went rowing on the lake in New York’s Central Park with my loved ones before my mastectomy, to enhance my upper body qi.
4. Encourage your patients to keep repeating positive imagery of those exercises, and your treatments, in their minds when they are wheeled into the operating room and when they awake from anesthesia. Not only does this reduce pain, but it encourages a good qi flow to help recovery.
5. Discourage female patients from scheduling surgery during ovulation, when the immune system is low. An epidemiologist at New York’s Memorial Sloan-Kettering Hospital discovered a strong connection between cycles and recovery rates.
6. Try to arrange to work on your patient a day or so after surgery. Even modest pressure-point work on the hands and feet, or simple, gentle palming down either side of the UB meridian, will help stimulate qi and peristalsis!
7. Remember that cancer is caused by a variety of factors, including environmental and industrial pollution, pesticides, stress, family genes, smoking, etc,. Survival is equally dependent on a variety of factors, along with great teamwork. Famous cyclist Lance Armstrong had youth and a driving ambition on his side to help him survive and soar through his multiple, record-breaking Tour de France victories.

Busting Taboos About Breast Cancer, Part Two

While planning part two of this series, I heard a clip on ABC-TV about a new study claiming that people who exercise are 35 percent less likely to develop cancer. Those who exercised a lot as teenagers are at an even lower risk of developing breast cancer.

Well, I’m an exception to this “comforting” news! I have always been athletic. As a teenager, I played field hockey for my school and university. I was a fitness “nut” when my cancer was diagnosed. Being fit and a vegetarian may not have prevented my cancer, but they certainly helped my survival!

Somehow, the universe had unusual ways of prepping me for this experience. As a zen shiatsu practitioner, I treated several cancer patients before my own cancer diagnosis. I learned about the valuable role played by the Stomach and Pericardium meridians in the “scaffolding” of the breast, and in helping ease pain postmastectomy. I learned the value of treating and stretching the lower extremities to help ease the discomfort of patients who couldn’t be touched around the torso or arms in the days immediately following surgery. I learned the value of teaching slow qi movements to patients to help stimulate circulation and qi flow postanaesthesia, and to prevent lymphedema. I learned the value of treating the hara and back shu points to stimulate peristalsis. Moreover, I gained great respect for the effectiveness of simple qigong techniques to help harmonize qi fragmented by surgery or organ removal.

I also learned the value of working subtle points on the hands and feet of a terminally ill breast cancer patient hooked up to assorted machines in the hospice at Cabrini Hospital in New York City. I learned the value of talking her through her interpretation of death to help ease her passage according to her belief system. During those last few days, we were able to connect on levels she had been unable to achieve with close family members. I was the outsider, the one without baggage. In the hours when she drifted in and out of consciousness, I placed a single red rose in a vase opposite her bed in direct view, to give beauty to those brief moments when she opened her eyes. I also connected with an amazing hospice nun, Sister Loretta, who used to dress up as a clown at night and drift between the beds to chat to patients with insomnia.

Some five years later, I’d had my mastectomy in that same hospital. During that same week, a close friend of mine died of metastatic breast cancer in another part of the city. During the previous year, I learned the value of giving her subtle shiatsu and qi focus to ease pain in her legs by minimizing touch after the cancer metastasized to her bones.

Roll the clock back even further to my years as an investigative journalist on Fleet Street in London, England, when I campaigned against the tobacco companies during the days when they denied any link between smoking and lung cancer. My research prompted me to write Dominion, a fictional but realistic view of the cynical ways the industry developed marketing and advertising strategies to beat or flaunt smoking-related diseases or death. My research helped prepare me for the dramatic lung cancer deathbed scene of my uncle, which I described in Dominion. The book also described a court case in which a widow sues the tobacco conglomerate following the smoking-related death of her husband. Before the work was published in the U.S. and Canada several publishers rejected it on the grounds that it was “unbelievable.” Such court cases have become commonplace in the last five years, prompting me to republish the book through iUniverse.

My resulting knowledge of smoking-related diseases helped me develop special shiatsu techniques for a dear friend, “Geo,” who died recently from lung cancer in England. To ease her coughing spasms, I encouraged Geo to sit up while I focused qi on front mu points for the Lung (L 1) when she couldn’t be touched. When Geo welcomed touch, it was helpful to support back shu points UB 13 (Lung) and UB 14 (Pericardium) and front mu for Pericardium (Ren 17) simultaneously. P6 and P 8 helped treat nausea, and helped calm her during coughing fits or anxiety spells. Geo required a minimum of movement, techniques and points. Another patient with a similar prognosis may react very differently. As always, adaptability is the key. Laughter helped her move congestion, except for a moment when she spluttered into her oxygen mask: “Ferguson, forget about cancer. Your jokes are going to kill me!” When side-effects from morphine included constipation, it was helpful to apply subtle shiatsu to Geo’s back, feet and hands (especially LI 4).

Just before I left England, I talked to her palliative physician about acupuncture, to ensure the continuity of my treatments. His minimal needling helped her a great deal. Many palliative physicians in England are trained to integrate specific acupuncture techniques (among other procedures, like compassionate counseling and working within family structures) for the specific purpose of easing pain, discomfort and distress in terminally ill patients, especially those who cannot handle morphine.

I share these assorted experiences with my students as a way of encouraging a holistic, compassionate and practical approach, tuning into the needs of each patient as an individual. I tell them to avoid preconceptions, and certainly to avoid any “recipe” approach. What worked for patient X may be inappropriate for patient Y, even though the prognosis is similar. I (and a number of fellow cancer survivors) find it offensive when we are “lumped” together in sweeping generalities about “treatment procedures for such-and-such cancer patients.” I certainly know that after my experience, I was extremely fussy about who worked on me (whether the care delivered was shiatsu, needling or chiropractic). I avoided any practitioner who spouted assumptions and preconceived ideas about cancer causes or treatments.

Similarly, Wayne Mylin, Dipl. ABT (NCCAOM), CP (AOBTA), a gifted, sensitive shiatsu colleague and fellow AOBTA board member, shared his amazing experiences of working on patients undergoing chemotherapy at Pennsylvania Hospital’s Joan Karnell Outpatient Cancer Center in Philadelphia. The center’s administrators welcomed Wayne into an evolving CAM program, as they knew that the majority of cancer patients sought CAM therapies nationwide. They also knew Wayne based on his 17 years of experience as a psychiatric technician in the psychiatric unit. “I was hired for a three-hour block of time every Wednesday,” Wayne told me. This involved great adaptability, during which time he had to give 35-minute chair shiatsu sessions to five different patients before, during and after chemotherapy. “The challenge was that after completing an assessment (pulse, tongue, clinical intake, etc.), I had to figure out how to give the session within the limitations of the chair.” The most common symptoms he treated included fatigue, body aches, nausea, insomnia, depression, anxiety, flu-like symptoms, anger, frustration and fear. Ever modest about his shiatsu talents, Wayne said, “I have worked with patients where all I could do was lay my hands on their backs with minimal pressure, or work only on their hands, only to find that what I did made a notable - sometimes a dramatic - difference.” His background in psychology has proved invaluable. “During treatments, many patients will start talking, sharing, unloading and expressing,” he said, adding that he is often the only member of the treatment team able to give the patients 35 minutes of undivided attention.

With his group of patients, Wayne found the following techniques and points to be very helpful:

• back shu points (generally useful for a variety of problems)
• nausea and vomiting: P 6, H 7, St 36, and general footwork
• anxiety: P 6, H 7, shen ear point, Du 20 & 24 and sacrum, basically any supportive touch, and footwork
• depression: support (verbally and physically), back shu point balancing and tonifying
• vertigo: LI 4 & footwork
• yin deficiency: St 36
• rising heat: Liv 2

Wayne added, “It’s necessary for any shiatsu therapists working in this (hospital) setting to be supportive of the Western medical treatment that the patients are receiving. If you are not supportive of chemo or radiation, don’t even think of working in this setting. It is not fair to the patient.”

Wayne’s involvement in a pilot study on the effects of shiatsu on sleep disturbance in chemotherapy patients was discussed at a palliative care conference in Phoenix, Arizona earlier this year. He found the following points effective: all back shu points, St 36, GB 12 & 20, Du 20 & 24, H 7, P 6, and LI 4.

Gabrielle Mathieu, one of my graduates from the Academy of Oriental Medicine in Austin, came to some similar conclusions while writing her mammoth research thesis on shiatsu treatments on cancer patients undergoing chemotherapy (The Benefits of Zen Shiatsu for Cancer Patients, May 2000). Gabrielle wrote: “Shiatsu seems to be effective in reducing fatigue, helping insomnia and achieving relaxation. In selected cases shiatsu helped neuropathy, and abdominal distress.” In her thesis, Gabrielle concluded, “As a generalization-I noted the Liver and Kidney meridians were often involved. Five of my six clients were postmenopausal women. The Kidney energy declines during menopause. I can only speculate that cancer and conventional treatments further weakened it. The Liver is associated with the smooth flow of emotions: Certainly the experience of having cancer would distress even the most calm individual. In Western medicine, of course, the liver and kidney have the burden of clearing the drug metabolites from the body.” Gabrielle’s thesis included her invaluable experiences of working as a cancer information specialist for the American Cancer Society, and her prior background working in hospitals and clinics as a medical technologist.

I include the aforementioned examples from the fresh experiences of Wayne (an accomplished, board-certified shiatsu practitioner) and Gabrielle (now a licensed acupuncturist and certified zen shiatsu practitioner), as both of them had the additional benefit of years of hospital experience. Both believe in integrative medicine. Certainly, I owe my own survival to a skillful blend of Western and Asian medicine, two remarkable Swiss physicians, shiatsu, yoga, cycling, swimming, qigong, acupuncture, a vegetarian diet, humor, five years of mistletoe injections (Iscador), six months of the mildest form of chemotherapy possible (Alkaran), a marvelous partner and support group, and my global teaching practice. All of this was achieved without health insurance! Even when my cancer metastasized, I told God to help me survive, in order to teach my students through this experience to help hundreds of other cancer patients - and to write articles like this.

In Chinese Medicine, life style choices, which include dietary choices, is one of the causes of imbalance. With microwaves, chemicals and processed foods, whatever we can eliminate that is problematic will add to our health and longevity. There has been a lot of political controversy lately about trans fat. Although this is an older article, I think it is excellent.  It is from the USA weekend magazine edition May 3, 2001. Read labels carefully and try to avoid most fast food and processed food that more than likely contains trans fat.  As you will see below trans fat is dangerous.

Your government wants you to cut down on trans fatty acids. So do the American Heart Association and virtually every other health authority. Trans fats are created when liquid oils are solidified by partial hydrogenation, a process that stretches foods’ shelf life and changes “safe” unsaturated fats into dangerous ones. Trans fats are concentrated in stick margarine, solid vegetable shortening, doughnuts, crackers, cookies, chips, cakes, pies, some breads and foods fried in hydrogenated fat (chicken, fish, potatoes). Harvard nutritionist Walter Willett blames trans fats for at least 30,000 premature deaths a year, calling their introduction in the 1940s the “biggest food-processing disaster in U.S. history.” And pioneering trans-fats researcher Mary G. Enig, Ph.D., formerly at the University of Maryland, says: “Several decades of research show consumption of trans fatty acids promotes heart disease, cancer, diabetes, immune dysfunction, obesity and reproductive problems.” If Americans could detect the danger on food labels, they would cut back on trans fats, reasons the U.S. Food and Drug Administration. The FDA wants new food labels to reveal trans fats, contending such labels would save lives by forcing food manufacturers to eliminate trans fats. Just removing trans fatty acids from all margarines (70% now are high in trans fats) would prevent 6,300 heart attacks a year. Also eliminating trans fats in just 3% of breads and cakes and 15% of cookies and crackers would save up to $59 billion in health care costs in the next 20 years, the FDA predicts.

What’s bad about trans fats?

When it comes to the heart, just about everything is bad about trans fats, Willett says. Mainly, trans fats increase bad LDL cholesterol, triglycerides and insulin levels, and reduce beneficial HDL cholesterol, promoting heart attacks. In research at Harvard, women who ate the most trans fats, primarily in margarine and baked goods, had 1.5 times the heart attack risk of women who ate the least. In men, the risk was more than double. Special villain: margarine. It accounts for about 20% to 25% of all trans fats consumed, Enig says.

Eating an extra teaspoon of trans fat-rich margarine a day boosted men’s chances of heart attack 10%, according to the famed Framingham Heart Study. Generally, the harder the margarine, the more trans fat. Recent Tufts research shows that eating hard stick margarine sent triglycerides 18% higher than did eating semi-liquid squeeze-bottle margarine. In fact, trans fat-rich margarines are twice as bad as butter, Willett says. Butter’s saturated fat raises bad LDL, but margarine’s trans fats both boost LDL and depress good HDL cholesterol, doubling the damage. Thus, eating trans fats is extra harmful if you already have low HDLs, experts warn. Further, trans fats raise Lp(a), another artery-destroying blood fat. Butter isn’t always better, either: A tablespoon still has 7 grams of saturated fat. And new research at the University of Texas Southwestern Medical Center found that substituting very low trans fat margarine for butter reduced bad LDL cholesterol 11%. But it wasn’t as effective for obese people.

Other possible dangers

Cancer. A Dutch study found a higher concentration of trans fats in the breast tissue of women with breast cancer. A recent University of North Carolina study reported high consumption of oils, condiments and sweetened baked goods high in trans fats doubled the odds of colon polyps that may lead to cancer.
Reproductive problems. Pregnant and lactating women really should cut down on trans fats. Recent research shows pregnant women with the highest levels of a common trans fat had seven times the risk of preeclampsia, the complication of pregnancy characterized by edema and high blood pressure. High trans fats also may harm fetal and infant development. Mothers who eat trans fats pass them on to infants during breast-feeding. Infants feasting on trans fats may have diminished visual acuity and brain development.
Diabetes. Trans fats appear to reduce the body’s ability to handle blood sugar by lowering responses to the hormone insulin, which is particularly dangerous to diabetics.

How much trans fat is OK for the heart?

Virtually none, according to a recent analysis of 59 heart-diet studies by Dutch researcher Peter L. Zock at the Wageningen Center for Food Sciences. He finds the best diet strategy is not to lower total fat, but to severely restrict saturated fats (animal fats from meat and dairy) and to get near zero intake of trans fats. Enig finds that some Americans, including teenagers, eat 30-40 grams of trans fat daily.

The following article is from the Febuary 2008 newsletter of Acupuncture today. I thought it was interesting because in QiGong we talk about the 3 levels from which ones does Qigong exercises. The first level is ming jing which is obvious power with no particular attention to subtle movement. The second level is ang jing which is subtle power. Inherent in this power is the rippling of an X pattern, where, for example, pushing off with the right foot causes a ripple to move from the right foot up the right leg/hip through the torso and then to the left shoulder. This is an interesting article of how the same principles apply to pattern diagnosis and treatment. Like acupuncture, Medical Qigong has many healing protocols using external qi emission as well as treatments for scar tissue.

Acupuncture Treatment of Polar Opposites and Scar Tissue

By John Amaro, LAc, Dipl. Ac. (NCCAOM), FIAMA, DC

A 42-year-old weekend athlete consulted my office, complaining of disabling right-wrist pain from which he’d been suffering for more than a year. He stated the pain was so intense that his three-times-a-week tennis match had been put on hold, and he had been forced to resign from his company’s softball league.

Not only was this patient suffering from the effects of pain and dysfunction, but he also was suffering from the effects of anxiety, fear and uncertainty of the future. He was obviously despondent.

Two previous orthopedic surgeons had been unable to diagnose the cause of the problem, ruling out the usual: carpal tunnel syndrome, sprain, arthritis or any other plausible explanation. He had suffered no known injury to the right wrist. The pain was a complete mystery. Physical therapy had been to no avail; chiropractic care and treatment by a professional acupuncturist also had failed to provide any relief.

The patient was leery, frustrated and unenthusiastic, but still hoping for an answer. General examination of the right wrist was unremarkable, as were the X-rays from the orthopedist. Since the patient already had received eight acupuncture treatments from a licensed acupuncturist and a fellow of the International Academy of Clinical Acupuncture, I advised the patient that anything I could do would probably not be any more productive than his earlier acupuncture experience.

It was then I noticed a rather large irregular scar on the outside of his left ankle. On inquiry, I learned the scar was from an earlier skiing accident. He had fractured his ankle, requiring surgical intervention and pinning. On further questioning, I learned the skiing accident was exactly two months prior to the onset of the right wrist pain, which occurred suddenly and without incident. The pain and dysfunction he experienced in his wrist defied a logical explanation.

One of the most significant cause-and-effect relationships in healing is “what affects the top affects the bottom and what affects the right side affects the left side and vice versa.” It also is understood that “the right shoulder affects the left hip, the right elbow affects the left knee, the right wrist affects the left ankle, and vice versa.”

With this in mind, I stimulated the entirety of the scar tissue of the left ankle with a teishein (nonpenetrating acupressure device). On the second visit, the scar tissue of the left ankle was stimulated with an electronic acupoint stimulator. I was wondering if the patient thought I was crazy, incompetent, or both, as I had yet to touch his right wrist. On the third visit, the patient advised me the pain was remarkably improved. Following two more visits of the same treatment to the left ankle, the patient said he had played a little tennis with his wife. Three weeks following the initial treatment, the patient reported 100 percent improvement in pain and range of motion. He received a total of eight treatments, and not one time was his right wrist directly treated.

The patient’s family and virtually every friend and business associate he has had have been referred to me. It has been almost nine months since I first saw him, and the pain has never returned. My file cabinets are filled with similar case histories, as are those of so many other practitioners who have learned to simply stimulate the scar tissue wherever you find it and never discount the significance of the direct opposite side of the body.

Recently, I received a letter from a prominent practitioner who attended a lecture in which I elaborated on the effects of stimulating scar tissue for various ailments. His letter reads:

“Remember our conversation about treating scar tissue? I told you of a patient who had severe, residual left-posterior scapular pain of five years duration who was resistant to any medical or chiropractic care. Having mentioned the patient had had breast reduction surgery 15 years prior, you advised me to find and treat the scar tissue around the breast. I thought to myself, “This sounds crazy … I told him it was the left posterior shoulder, and he sends me to the front of the body!” Being a perpetual student, I decided to give your suggestion a try. The scar tissue under and around the breast was stimulated with one of my assistants in attendance. Within two hours the patient reported a complete elimination of pain that has not returned. This was six months ago.”

The second case involves a patient with chronically elevated liver enzymes. He was on aggressive medical care, along with abstinence from alcohol and a fat-free diet for three months, only to have an increase in the level of his enzymes. In addition to an obvious chemical imbalance, his history revealed a procedure 14 years earlier (lymphangiogram) that required an incision on top of each foot directly over Liv 3 and 4. The scar tissue from the procedure was large and keloid. I treated the scar twice and repeated the lab work. All liver enzyme values came back within normal limits. His doctor called it “spontaneous remission”; he called it “miraculous.”

The person in the third case had left lower-quadrant pain for two weeks and was told by her gynecologist that she had adhesions in her scar from a hysterectomy 10 years ago. He told her surgery to remove the adhesions was her only hope for relief, which would be doubtful at best. Stimulation of the surgical incision along with the ah-shi points in and around her right lower back brought about a complete reduction in pain. The pain is managed as long as she comes in for periodic treatment.

Want to turn some lives around? Then look for complete opposites in locating the possible cause of pain and always remember to stimulate scar tissue wherever you find it, regardless if the scar is from a brilliant life-saving surgery or from a broken glass. Scar tissue may disrupt the flow of qi in the meridian channel. A teishein is a very good modality for stimulation. Electronic stimulation is likewise effective and laser or red-light photodynamic therapy achieves results similar to the needle. Of course, needles with moderate stimulation over the scar with random stimulation achieve phenomenal response.

It is imperative in acupuncture that we remember the polar opposites of yang ming, shao yang, tai yang, shao yin, tai yin and jue yin. This goes for both musculoskeletal and somatovisceral disorders.

For those of us who love coffee, read the following which comes from the Institute of Taoist Education and Acupuncture in Louisville, Colorado

Why we say “No Coffee Please’

In our work with clients we often recommend certain lifestyle changes that will enhance the effects of treatment. One thing we ask of ALL clients is to refrain from drink coffee for the following reasons:

Chinese Medicine classifies coffee as a bitter, pungent, cold medicine which has the power to transform kidney essence into qi energy which moves upward and outward through the body, giving an experience of heightened energy (this is unrelated to the caffeine content)

The Kidney is the home of ancestral energy. When we are born we come into the work with a finite amount of this energy, and while we can’t obtain more, we can, through careful lifestyle habits, enhance and guard this storehouse of energy. Using coffee as an energy boost is like continually dipping into one’s saving account with the expectation that someone, somehow will cover the shortfall later. The oils present in coffee are one of the foremost ways in which we can deplete this ancestral kidney energy.

When coffee was first introduced in Europe it was recognized as the powerful drug that it is. There were movements to prohibit its use and laws passed to that effect. Additionally, in some native cultures, coffee was used in animal rituals equivalent in strength to those once celebrated with peyote. It is ironic that we think of coffee in this culture as a daily ritual.

Women especially do well to avoid coffee because the upward dispersal of energy initiated in the body seems to clog the Chong Mai - the central pathway which connects the kidneys and the heart, causing accumulations in the breasts and the pelvis.

For people with any kind of heart condition, blood or skin disorder, ulcers, arthritis, bowel problems, PMS, depression, stomach problems, emotional ups and downs, or low energy, coffee should definitely be eliminated. For everyone else coffee should simply be avoided because of its effects on our basic health and strength.

Coffee is one of the very few things we unequivocally ask all our clients to avoid. Your whole being will thank you!!!

AND from “GUA SHA: A Traditional Technique for Modern Practice” by Arya Nelson

If a patient is losing blood, fluid, Qi or Jing through leakage, before attempting it’s restoration, ‘first stop the leaks’.  For example, this applies to excessive menustral bleeding, sweating, urine, exercise, sex, work, illness, stress, drugs like pot, cocaine, amphetamines, any lack of sleep and so on.

Regular coffee drinking is like having a little hole in the bottom of your boat.  There is a constant tiny leak.  As a diuretic taken daily, coffee deplete the boyd of water-soluble nutrients: B vitamins, Victam C, as well as minerals such as calcium and magnesium.  This will exacerbate any painful conditions as well as fatigue the patient, supporting their desire for more coffee.  It can slow and even prevent the healing of musculoskeletal problems.  I also believe that coffee abuse contributes to the prevalence of hot flash disorder in menopausal women in the West.  The diuretic activity severely depletes the Yin which is already in decline at this age.  Depletion of Yin unroots the Yang which flashes chaotically up and out to the surface.  Soon the unchanneled Yang also becomes depleted and the patients becomes cold between hot flashes.

Caffeine of any kind increases urination frequency. This abuses the Kidneys and weakens Yang areas associated with the Kidneys, such as the back and knees. It is strongly recommended that caffeine be removed from the diet altogether.  Chronic painful conditions often resolve with treatment because the patient has stopped the leaks.  After recovery, coffee can be resumed as an occasional pleasure rather than daily habit

This article in the November 2007 issue of Acupuncture Today on Diagnosis by Touching the Qi is consistent with the way International Institute of Medical Qigong teaches flat palm sensing and diagnosis through the energy fields. Additionally, we teach the energy field as having 3 layers: physical, emotional/mental and spiritual so from this perspective each of the 3 fields can be sensed. A reminder that all physical disease will first be perceptable in the energy fields!!!

Diagnosis by Touching the Qi

By Lawrence Howard, LAc, MSAc

Oriental medical practitioners evaluate by asking, looking, listening and even smelling the patient. The signs and symptoms derived from these methods are indicators of disharmonies of the patient’s qi dynamic.

When considering that signs and symptoms provide an indirect understanding of the patient’s qi dynamic, the question arises if we, as practitioners, can gain a more direct understanding of the patient’s qi. The answer is yes.

One simple method is to develop our “qi awareness” and use a technique called “scanning.” When scanning, the hand is held at various positions relative to the patient’s body in order to feel the patient’s qi dynamic and/or “energetic” structures. Those imbalances are correlated to traditional Oriental medical terms and confirmed by asking, listening, etc.

To become qi aware, begin by sensitizing your hands. Hold your hands apart in front of your body while you are relaxed. Hold them at about 6 to 8 inches apart, with palms facing each other. Move your hands toward and away from each other at minute distances until you feel something. At first, the sensation is barely perceptible. Pay attention, and the sensation will increase in intensity. Relaxation is vital to this process.

To scan, hold the palm of your hand about 3 to 6 inches away from the patient. Then move your hand slowly about the patient; at about the speed of stroking a cat. The direction is not particularly important, but the general tendency is along the midline from head to toe or along the meridian.

As you move your hand over the patient, you will notice that your hand is “pulled” at some areas of the patient’s body, “pushed” at others, and you will feel boundaries at still others. These sensations are indicative of the energetic structures and the qi dynamic of the patient. You will notice different sensations at different distances from the surface of the body.

The area an inch or two from the body is called the inner aura (subtle energetic field surrounding the body) or “etheric body” and is where acupuncture structures are readily felt. (Although not directly connected to TCM, it’s good to know it exists because you will eventually find it anyway.) When the hand is held with the palm facing the patient about a few inches away, a definite boundary parallel to the body is detected; this is the boundary of the aura. When the fingertip is moved over an acupuncture point, a definite boundary is felt that is about a half inch to 1 inch in diameter. The finger feels as though it was being pulled in the direction of the flow when held pointed toward the meridian.

Once the normal is known, then the abnormal becomes more apparent. Those areas where the hand is pulled toward the body are associated with deficiency. Those areas where the hand is pushed away are associated with excess. Those areas of clear boundaries are associated with stagnation – typically pain. A stagnation that is clearly defined is associated with a sharp, stabbing pain. Diffused stagnation is associated with a dull, achy pain. The more pronounced the stagnation, the more severe the pain. Where the fingers are drawn against the flow, the meridian is counter-flow.

Specific disharmonies with symptoms are readily confirmed by asking the patient. I like to ask about imbalances in the following order: region, organ, emotion and time. For example, if my hand is pulled toward the body at the low back; I would consider the region deficient and ask if they have low back pain, then, if there is localized or general weakness, or urinary difficulties; and finally, issues of fear. If the patient says no, then I ask if any of these have been recent problems. The reason is that symptoms are often not completely resolved, but just diminished to a level where it is no longer noticed. In other instances, it is indicative of an impending symptom. If doubt remains, then the typical findings take priority.

These disharmonies may even occur in a “layered” fashion. For example, a patient may have low back pain along the muscles, yielding a finding of an area of stagnation, but the overall region is deficient. In this case, the patient may have qi stagnation with an underlying qi (kidney) deficiency.

If you find unusual sensations, then investigate with an open mind. I once had a patient whose face had a very well-defined, thin area of stagnation; it seemed to have “felt” like a wire. She had trigeminal neuralgia. This technique is easy to integrate into the treatment. You can perform the regular intake, then scan to confirm or explore. You can also perform the intake and scan at the same time.

Words of caution: Do not let your hand linger at any one region for more than a few seconds. This is to avoid inadvertent “energetic interaction.” This is where the patient’s qi dynamic interacts with yours. When using this technique, remember to wash your hands with running water to wash away any qi that may have accumulated on your hands. If you notice that your hands/fingers feel heavy, “shake it off.” This is due to the patient’s qi/energy accumulating on your hands. This interferes with your perception and potentially may allow qi to gather – stagnate in the joints – eventually causing joint pain.

Diagnosing by touching the qi isn’t just a diagnostic method; it’s a learning process. It allows us to think in the same terms the ancient practitioners might have thought. An area where the patient’s qi is not moving and is defined by a boundary is where it is stagnated. It just makes sense.

Resource

1. Howard, Lawrence. “Getting to the Point … and the Meridian, Too.” Acupuncture Today, December 2005 (Volume 6, Issue 12).

This is an interesting study. The problem I have with research studies is that there are so many subjective factors that can’t be quantitively measured. Factors that I consider interesting and/or important from the study are:

1) the participants didn’t feel conventional medicine was helpful

2) fake acupuncture worked as well as real acupuncture

3) the important of either the mind or intentionality in elicting positive response (placebo effect)

4) the importance of the relationship the practitioner has with the client and the belief system they are conveying to the client.

5) the fact that energy when stimulated flows to where it is needed
CHICAGO, Illinois (AP) – Fake acupuncture works nearly as well as the real thing for low back pain, and either kind performs much better than usual care, German researchers have found.

The theory of acupuncture holds that stimulating specific points on the body can release blocked qi, or vital energy.

Almost half the patients treated with acupuncture needles felt relief that lasted months. In contrast, only about a quarter of the patients receiving medications and other Western medical treatments felt better.

Even fake acupuncture worked better than conventional care, leading researchers to wonder whether pain relief came from the body’s reactions to any thin needle pricks or, possibly, the placebo effect.

Although the study was not designed to determine how acupuncture works, Endres said, its findings are in line with a theory that pain messages to the brain can be blocked by competing stimuli.

Positive expectations the patients held about acupuncture — or negative expectations about conventional medicine — also could have led to a placebo effect and explain the findings, he said.

In the largest experiment on acupuncture for back pain to date, more than 1,100 patients were randomly assigned to receive either acupuncture, sham acupuncture or conventional therapy. For the sham acupuncture, needles were inserted, but not as deeply as for the real thing. The sham acupuncture also did not insert needles in traditional acupuncture points on the body and the needles were not manually moved and rotated.

After six months, patients answered questions about pain and functional ability and their scores determined how well each of the therapies worked.

In the real acupuncture group, 47 percent of patients improved. In the sham acupuncture group, 44 percent did. In the usual care group, 27 percent got relief.

“We don’t understand the mechanisms of these so-called alternative treatments, but that doesn’t mean they don’t work,” said Dr. James Young of Chicago’s Rush University Medical Center, who wasn’t involved in the research. Young often treats low back pain with acupuncture, combined with exercises and stretches.

Chinese medicine holds that there are hundreds of points on the body that link to invisible pathways for the body’s vital energy, or qi. The theory goes that stimulating the correct points with acupuncture needles can release blocked qi.

Dr. Brian Berman, the University of Maryland’s director of complementary medicine, said the real and the sham acupuncture may have worked for reasons that can be explained in Western terms: by changing the way the brain processes pain signals or by releasing natural painkillers in the body.

In the study, the conventional treatment included many methods: painkillers, injections, physical therapy, massage, heat therapy or other treatments. Like the acupuncture patients, the patients getting usual care received about 10 sessions of 30 minutes each.

The study, appearing in Monday’s Archives of Internal Medicine, used a broad definition for low back pain, but ruled out people with back pain caused by spinal fractures, tumors, scoliosis and pregnancy.

Following are excerpts from Tuesday, May 29, 2007, The Irish Times, LifeFeatures section. It is an interview of Jeffrey Yuen, 88th generation Daoist priest and practitioners of Classical Chinese Medicine, by Arminta Wallace.

Humanity’s attitude to healing is startlingly ambivalent. We’re fond of a quick fix, but suspicious of people who describe themselves as “Healers”. We cling to our prescription drugs of choice,even when tests suggest they’re better avoided. Few of us-especially those who’ve spent any time in hospitals recently - believe in miracles. Fewer still, despite the accumulated evidence of years of research from cognitive psychology and neuroscience, imagine that we can do anything much to heal ourselves.

Jeffrey Yuen, however, has no doubts about the latter. Why I (the interviewer) ask him, is the focus on spirit (the subject of his talk in Ireland) when he’s primarily concerned with healing the body? “The Chinese medical classics say that all diseases involve the spirit, so to heal them, you must go all the way down, or up to the spirit level. The problem then is that everyone tries to define ’spirit’. Which is a somewhat elusive concept. There are alot of traditions that talk about ’spiritual growth’ and ’spiritual development’. But the question is: what exactly are you trying to develop?”

One of the most basic ideas which needs to be teased out, Yuen explains, is the relationship between illness and its polar opposite, wellness. “First of all,” he says, “we need to confront the myth of illness. We tend to construct a belief system around what a disease basically consists of; and then we buy into this belief. We expect that if we have this disease, then certain things should emerge from the disease process. So, in a way, what we’re really doing is validating the disease. In the healing process, on the other hand, what we need to do is validate how we feel when healing occurs.”

Among his many other qualifications, Yuen is an ordained Daoist priest who defines “spirit” as, quite simply freedom. “It’s about a sense of liberating ourselves. If I focus on the disease, I’m not doing that. I’m really trying to find out who I am with this disease, rather than who I can become when the disease begins to heal.”

This applies, he insists, even - perhaps especially - to life-threatening illnesses such as cancer, which often come with a large label marked “scary”. “Think of the physiological process which someone undergoes when they’re afraid”, he says. “At a very acute level that’s called anaphylactic shock - and you can die from that. So just imagine someone having this on a vew slow scale. That means you could die from the fear of cancer rather than the cancer itself. If a person is not afraid, it will help them. Some people say this is a placebo effect - but even if it is placebo, it shows the power of the mind.”

Which is of course, precisely what conventional medicine, with its emphasis on physical healing processes tends to shy away from. “It should be something we seek to nurture,” Yuen insists. “How do we change the mindset of someone who is ill? If you change the consciousness, you can change the condition.”

Yuen takes a relaxed approach to the conventional/alternative debate, treating his clients with traditional Chinese medicine alongside their own medications if that’s what they feel most comfortable with. “It’s not up to me to put down something they believe in”, he says. “That doesn’t help any patient. Healing is about having faith in what you’re doing regardless of what someone else may or may not believe.”

“The famous Daoist statement is that flowing water never decays”, Yuen says. “This is the dynamic of life. So when you work with an individual, you try to see what aspect of their life has stopped - where they’ve become stuck. The pathways that help us to understand these movements are the acupuncture pathways”.

If Yuen had one piece of wisdom to offer the public at large, what would it be? “There are no incurable diseases, only incurable people.”

This article is fascinating on several accounts. First, it signifies the real tangibility of an etheric field or “body blueprint” that tangibly affects the physical body. This concept is not new to energy healers but the fact that volunteers were taught how to do it is amazing. Additionally, it offers scientific proof that not only do we have an energy body but there is a correlation between the energy body and the physical body. In this case, the scientists threatened the virtual body of the participants but what if they had sent them loving kindness or had worked on specific energy centers. This is exactly the premise for working through the energy field in order to make changes to the physical body.

CHICAGO (AFP) - For centuries, people have claimed to have had out-of-body experiences but now scientists have recreated the sensation without using drugs in the first experiments of their kind, a study said Thursday.
As many as one in 10 people say they have experienced the sensation of being awake and seeing their own body from another location, according to the study published in the journal Science.

“Out-of-body experiences have fascinated mankind for millennia. Their existence has raised fundamental questions about the relationship between human consciousness and the body,” said Henrik Ehrsson, a neuroscientist formerly of University College London, and now at the Karolinska Institute in Sweden.

Now neuroscientists have manipulated a group of perfectly healthy volunteers into thinking they had moved outside their bodies by distorting their perception of reality.

Using virtual reality goggles to mix up the sensory signals reaching the brain, they induced the volunteers into projecting their awareness into a virtual body. Participants confirmed they had experienced sitting behind their physical body and looking at it.

The illusion was so strong that the volunteers reacted with a palpable sense of fear when their virtual selves were threatened with physical force.

The findings suggest there may be a scientific explanation for these types of out-of-body experiences, which are often thought of as delusional or paranormal, and the scientists believe their research could have important applications.

“The invention of this illusion is important because it reveals the basic mechanism that produces the feeling of being inside the physical body,” said Ehrsson.

“This represents a significant advance because the experience of one’s own body as the center of awareness is a fundamental aspect of self-consciousness.”

And inducing people to have out-of-body experiences could have wide-ranging uses, he believes.

“This is essentially a means of projecting yourself, a form of teleportation. If we can project people into a virtual character, so they feel and respond as if they were really in a virtual version of themselves, just imagine the implications.

“The experience of video games could reach a whole new level, but it could go much beyond that. For example, a surgeon could perform remote surgery, by controlling their virtual self from a different location.”

But scientists still don’t know exactly what causes such experiences which have often been associated with traumatic experiences such as car accidents and linked to compromised brain function in epileptics, drug addicts and stroke victims.

“Brain dysfunctions that interfere with interpreting sensory signals may be responsible for clinical cases of out-of-body experiences,” said Ehrsson.

“Though, whether all out-of-body experiences arise from the same causes is still an open question.”

Quoting from Mehmet Oz, professor of surgery at Columbia University and a health expert for the “The Oprah Winfrey Show” noted on the February 13, 2007 episode of “The Oprah Winfrey Show”,

“The reason I’m so excited and passionate about alternative medicine is [because it is] the globalization of medicine,” Alternative medicines, Dr. Oz noted, deal with the body’s energy, something that traditional Western medicine generally does not recognize. “We’re beginning now to understand things that we know in our hearts are true but we could never measure. As we get better at understanding how little we know about the body, we begin to realize that the next big frontier in medicine is energy medicine. It’s not the mechanistic part of the joints moving. It’s not the chemistry of our body. It’s understanding for the first time how energy influences how we feel”.

Sponsored by the Pine Street Foundation, this transcript gives more important information regarding the link between nutrition and disease.

ABOUT THE CHINA STUDY

The China Study demonstrates the link between nutrition and heart disease, diabetes, and cancer. Referred to as the “Grand Prix of epidemiology” by The New York Times, this study examines more than 350 variables of health and nutrition with surveys from 6,500 adults in 65 counties, representing 2,500 counties across rural China and Taiwan. While revealing that proper nutrition can have a dramatic effect on reducing and reversing heart disease, diabetes, cancer, and obesity, this study calls into question the practices of many of the current dietary programs, such as the Atkins diet, that enjoy widespread popularity in the West. The impact of the politics of nutrition and the efforts by food industry lobbyists on the creation and dissemination of public information on nutrition is also discussed.

SCIENTIFIC JUSTIFICATION

In the late 1970s and early 1980s, there were two principal observations suggesting a relationship between diet and cancer. First, rich Western diets (high in fat and meat, low in dietary fiber) were strongly associated (correlated) with incidence of colon and breast cancer. Second, migrants moving to areas of different cancer risks acquired the risk of the country to which they moved, regardless of their ethnic or genetic backgrounds.

WHY CHINA?

In 1981, the Chinese Academy of Medical Science published an Atlas of Cancer Mortality on the 1973-75 mortality rates for about a dozen different cancers for 2,400 counties in China. These maps showed that cancer was highly localized in specific geographic regions. Residents of these regions tended to live in the same regions all their lives and to consume the same diets unique to each region each and every year. Their diets (low in fat and high in dietary fiber and plant material) also were in stark contrast to the rich diets of the Western countries.

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ABOUT DR. CAMPBELL

Colin Campbell, PhD, is the project director of the China-Oxford-Cornell Diet and Health Project (the China Study), a 20-year study of nutrition and health. He is a Jacob Gould Schurman Professor Emeritus of nutritional biochemistry at Cornell University. In more than 40 years of research, he has received more than 70 grant-years of peer-reviewed research funding and authored more than 300 research papers. He lives in Ithaca, New York.

ABOUT DR. KUSHI

Lawrence H. Kushi, ScD, is Associate Director for Etiology and Prevention Research, Division of Research, Kaiser Permanente. Internationally recognized for his expertise in nutritional epidemiology, Dr. Kushi’s research interests have focused on the role of food and nutrition in the development and prevention of coronary artery disease and breast and other cancers. Dr. Kushi is also is the second son of Michio and Aveline Kushi, the foremost proponents of macrobiotics and leaders in the development and acceptance of unconventional and lifestyle approaches to cancer. Dr. Kushi is collaborating with the Pine Street Foundation on the Pine Street Survival Study, a 10-year follow-up study of people with breast, lung, and colon cancers treated with an integrative vitamin/herbal protocol in combination with standard chemotherapy.

THE INTERVIEW

Dr. Lawrence H. Kushi: You are a strong advocate of essentially vegetarian or even vegan dietary choices. One of the things that I find interesting is that you actually grew up on a dairy farm in Virginia.

Dr. T. Colin Campbell: As a youth, I was a meat and potatoes kind of guy. I was raised on a farm and milked cows until I went away to school. I was the first member in my family on either side to even go to college, let alone graduate school, so I really went into the whole scientific profession rather naïvely. My initial graduate work at Cornell University was on how to grow cows more efficiently so we could eat more of them and drink more of their milk. My doctoral dissertation was specifically focused on making sure we all got enough protein, especially so-called “high quality” animal protein. I would have preferred to have continued on that path, but as I got involved in the Philippines working with malnourished children and then in the laboratory doing a lot of basic research, I started to get some results that began to question my whole upbringing, especially what I believed about protein.

LK: Can you give an example of your work in the Philippines that triggered this?

CC: My job in the 1970s was to coordinate a nationwide program to feed malnourished children in the Philippines. In those days, and still to some extent today, the notion was that malnourishment largely resulted either from not enough calories, not enough protein, or some combination of the two. The protein issue was one of my principal interests when I first got involved.

One day, I was playing golf with a medical advisor to President Marcos who told me that he and some other doctors had recently been operating on children four years old and younger for primary liver cancer, which I thought was very interesting. I then started investigating where these children were likely to come from and they seemed to be from families who were the best fed and who were getting the most protein. All of a sudden, I began to question what I was doing there; I was trying to get more protein to the kids and, in some cases, they were ending up worse off. It was exactly the opposite of what I thought I was going there to do.

LK: How did you then take this observation into your work?

CC: I first told one of my senior colleagues back at MIT about this and he thought it was crazy. Then I saw a paper in the Indian journal Pathology that showed that when rats were exposed to a carcinogen and then fed two different levels of animal-based protein, the animals fed the regular levels of protein essentially all got tumors whereas the animals fed the lower level – the so-called “inadequate level” – did not. That was essentially what I thought I was seeing in the children, too. The interesting thing about that study was that the level of protein being fed that caused tumors to develop was not exorbitant; it was well within the range of what humans might ordinarily consume (the protein requirements of rats and humans, as a percentage of total calories, are fairly identical).

LK: The type of protein used in that study was casein, the principal protein found in milk.

CC: In the beginning, I didn’t pay a lot of attention to the kind of protein we were using in our research, but eventually had to come to terms with the fact that the type of protein I was using all along – as everyone else was doing in those days – was casein. So I then tried soy protein and wheat protein and they didn’t have the same tumor growth effect. I also found that the casein effect only existed when the level of protein in the diet was above 10% of total calories. In other words, once the animal satisfied its need for protein and then started consuming excess of that as casein, tumors started to grow. In the case of plant proteins, however, exceeding 10% and even up to 20% of total calories as protein, tumors did not grow. So, suddenly there emerged this dichotomy between the two kinds of protein, animal and plant.

LK: Would you say casein is a carcinogen?

CC: Chemicals that cause cancer are called carcinogens and here we had a situation where casein fed at levels that could be anticipated in human diets was, in a sense, having a very strong effect in promoting tumor growth; 20% protein (as casein) diets generated tumor growth whereas 5% didn’t. Although we didn’t do the test at the time, there was also all sorts of evidence to suggest that this effect was probably a property of animal protein in general, not just of casein.

LK: How did the China Study first begin?

CC: At the time, the Chinese government had just released a study showing that cancer tended to occur more in certain Chinese counties and much less in others, resulting in great differences in mortality rates. Intrigued by this, we decided to go to China and measure various factors with respect to diet and lifestyle experiences and then compare those measurements with the disease rates that the Chinese government had already obtained for the years of 1973 to 1975 to see what relationships between the two, if any, existed. We selected 130 villages in rural China, which tended to be a very stable population (people lived in the same village all their lives) and tended to produce and use locally grown foods. From an epidemiological point of view, it was very nice.

LK: What were some of the major findings from the China Study?

CC: Essentially that animal-based foods were a problem. In the China Study, we found that as soon as animal-based proteins started to appear in the diet in certain Chinese counties, blood cholesterol levels, which were very low by Western standards (about 80mg per deciliter) started going up and that various cancers and heart disease started to appear. The association between the increase in animal-based foods and the increase in those diseases was highly significant, so much so that it made me get to a point where I started to question the way I was raised and made me switch to consuming a purely plant-based diet.

LK: What is your opinion of the current promotion of low-carbohydrate diets?

CC: When the promotion of these diets first started, I reacted in a negative way because the proponents took that term and essentially confused the public – on purpose – to make their point. The whole genesis for the notion of low-carbohydrate (and therefore higher in protein and higher in fat) being better was basically a frontal attack in a very simplistic, albeit very effective, way on the recommendations that I have become accustomed to because plant-based diets are inherently “high carb” diets. In the China Study, it was the diets highest in carbohydrates that were associated with the least cancer and the least heart disease.

LK: What about studies that indicate that low-carbohydrate diets do appear to have some short-term health benefits, such as lowering cholesterol levels and assisting in weight loss?

CC: Low-carbohydrate diets have been shown to cause some weight loss, especially among those who are substantially overweight. To some extent, cholesterol levels have also been shown to decrease. But not all studies have produced those effects, however, and the weight loss and lower cholesterol benefits are minimal as compared to what is possible with a plant-based diet. Furthermore, people who go on low-carbohydrate diets usually consume fewer calories, at least initially, so we’re talking about a calorie effect there that can’t be sustained.

LK: What about the “Mediterranean Diet”?

CC: There was research that showed that people who lived in various Mediterranean countries – Crete, southern Greece, southern France, and so forth – tended to have lower rates of breast cancer, colon cancer, and heart disease as compared to people living in the United States and England, despite the fact they were consuming diets that were fairly high in fat, mostly from olive oil. It turns out that in those Mediterranean countries where the fat intake is quite high, the proportion of their total food as plant food was very similar to what we saw in rural china. However, when you compare the rural Chinese to people in Mediterranean countries, it turns out that the heart disease rates in the Mediterranean are quite a bit higher than in rural China. So, really the question you should be asking is, “Why are the disease rates so high in those Mediterranean countries as compared to rural China?” Is it because of the consumption of olive oil?

LK: What about soy protein?

CC: Soy is a legume and a good source of protein, as far as plants are concerned, so it should be part of a healthy diet. But soy has now been processed into so many products and this processing can lead to things that one might raise some questions about.

Another issue is that we have people who are quite possibly consuming too much soy. One element that has been discussed is the presence of phytoestrogens in soy; these estrogens might be just as mischievous as people’s own estrogens or estrogens they might consume from animal foods. At certain consumption levels, these phytoestrogens are probably beneficial because they are antiestrogens and tend to diminish the effect of otherwise high levels of mammalian estrogens. But I think soy protein, if it were fed at high enough levels, might end up doing some of the same things as animal proteins…it’s simply a matter of quantity.

Regarding the soy debate itself, I first saw it emerge in the 1970s when I was living in the Philippines. The Philippines wanted to ship soy to the West and, almost immediately, there erupted all these news releases about the hazards of soy that ultimately proved to be coming from the dairy industry. I know that the dairy industry has not been happy over the years with the erosion of their territory because of soy products, so when I see so-called “reports,” I don’t know how to react to them because I just have this inherent skepticism as to where it might really be coming from.

LK: Are there differences between protein from fish and protein from beef?

CC: In one study, Dr. Kenneth Carroll compared a whole variety of animal-based proteins, including fish protein, to a whole variety of different plant proteins in their ability to generate cholesterol levels. What he found when he examined them in a systematic way in experimental animals was that animal proteins tended to increased cholesterol and plant proteins tended to decrease cholesterol. Fish protein was the one animal protein that was the least effective in increasing cholesterol levels, but it was still far higher than all the plant proteins.

LK: Because you advocate a plant-based diet, one of the questions you are often asked is, “How are you supposed to get enough protein?” It seems there has been a large fixation on protein, both in the nutrition science community as well as in the general public.

CC: The Recommended Daily Allowance for protein, ever since 1943 when we were making such recommendations, is set at 10% of total calories. This amount allows for some variation among individuals and is supposed to be enough. This is also about the level of protein that a good plant-based diet provides. However, there’s such a fixation on protein in this country that, as a population, we’re consuming somewhere between 11% and 23% and the average now is around 17% or 18%. If we listen to the food pyramid recommendations, we’re being encouraged to go even higher.

LK: Is there an over-emphasis on cholesterol measurements?

CC: Yes. Generally speaking, the higher the cholesterol levels, the greater the risk for heart disease and stroke. But when reducing that to the individual level, we know there are lots of exceptions; some people with relatively low cholesterol levels have heart disease while some people with relatively high cholesterol levels don’t have heart disease.

Cholesterol measurement is a crude instrument. It was refined, to some extent, when we started measuring HDL and LDL – “good cholesterol” and “bad cholesterol” – and now has become more refined by measuring oxidized LDL, but that hasn’t really been taken into consideration clinically yet. But I think we should recognize the limitations, especially for individuals, of measuring cholesterol as an indicator of heart disease and recognize that there’s a host of other factors that, when put together – perhaps as an index – is eventually going to turn out to be a better estimate of disease risk than just measuring cholesterol alone.

LK: You have said that “the distinctions between government, industry, science, and medicine have become blurred and the distinctions between making a profit and promoting health have become blurred.”

CC: That’s a view that I think a lot of people share, too. Unfortunately, I’ve seen things that I find to be deeply, deeply troubling and I think it’s getting worse. I think our academic science is being severely corrupted by commercial interests. Right now, for example, the most recent food and nutrition board report from the National Academy of Sciences is funded, in part, by the food and drug companies.

The food pyramid committee has been similarly corrupted. For example, when someone requested information as to what conflicts of interest the panel members on the previous board may have had, the USDA refused to make that information publicly available, even though it’s required. So after about eight months, a judge forced the USDA to release that information, which showed that six of the eleven members, including the chair, had an association with the dairy industry. And now in the new food pyramid that was just released, we’re getting recommendations to increase milk consumption. I find it deeply troubling that we can’t be honest about the science without having to worry about who’s paying the bills.

As previously mentioned, life style choices are a caustive factor in diseases from the Chinese Medicine paradigm. Stress definitely falls under an unhealthy life style choice. This article from the BBC news shows research linking type 2diabetes to stress. With the potential for type 2 diabete to reach epidemic portions, I think this is one area of our life  that we need to continually evaluate. The basic questions become “are you stressed out?” and if so, “what steps are you to taking to remedy it?”. There are always options even when we may feel that there are none. The point GV 20, the highest point on the head, is a reminder of the inherent possibilities of life.

People who suffer from job burn-out may be prone to developing type 2 diabetes, research suggests.

An Israeli study of 677 mostly male, middle-aged workers found those affected by burn-out were nearly twice as likely to develop the condition.

When the possible effect of blood pressure levels was eliminated, the risk was more than four-fold higher.

The study, in Psychosomatic Medicine, suggests stress can be added to other factors known to increase risk.

The researchers, from Tel Aviv University, said they included obesity, smoking and lack of exercise.

Lead researcher Dr Samule Melamed said: “Emotional burn-out may pose a risk to health.

“Earlier studies have found it to be associated with cardiovascular disease risk, sleep disturbances, impaired fertility and musculoskeletal pain.

“Our finding suggests that the potential damage to health may be greater than suspected and it may also include a risk of diabetes.”

Cannot handle stress

The Tel Aviv team found people who experienced job burn-out were 1.84 times more likely than others to develop type 2 diabetes, even when factors like age, sex and obesity were taken into account.

The researchers looked at a smaller sample - 507 workers - and tried to statistically eliminate the possible effect of blood pressure levels.

This revealed that burned-out workers were then 4.32 times more likely to get type 2 diabetes.

Dr Melamed said: “It is possible that these people are prone to diabetes because they can’t handle stress very well.

“Their coping resources may have been depleted not only due to job stress but also life stresses, such as stressful life events and daily hassles.

“Knowledge and implementation of stress-management techniques, such as exercising, getting enough sleep, dieting, assertiveness training, may prevent burn-out or reduce it before it becomes chronic, thereby reducing the potential risk of physical health impairment.”

Fat deposition

Natasha Marsland, a care adviser at the charity Diabetes UK, said other studies had also suggested a link between stress and type 2 diabetes.

She said: “Stress can cause high blood pressure, which is a risk factor for type 2 diabetes, but it can also cause fat to deposit around the waist which is also a huge risk factor.

“Working long hours in stressful environments leaves little time for physical activity.

“Unless people find the time to fit in 30 minutes of physical activity a day, the diabetes epidemic will continue to get worse.”

Ms Marsland said type 2 diabetes used to be found only in people over the age of 40, but was now increasing at an alarming rate in younger people.

She said: “Unhealthy and stressful lifestyles are definitely a contributing factor in this.”

It is estimated there are 750,000 people in the UK who have type 2 diabetes, but do not realise it.

We live in a world where we as consumers need to be aware of potential toxins in the environment as well as in our lifestyle choices. Both environmental and life style choices are caustive factors in diseases from the Chinese Medicine paradigm. I have heard concerns about the potential of chemicals leaching into the water of plastic bottles. I will let you decide for yourself. In the meantime, I suggest that you drink from plastic bottles only when no other choice is available. The following article from the GreenFeet Newsletter addresses this concern and makes recommendations.

We all know the importance of staying hydrated. The method of choice for most people these days is to carry around a trendy, colorful plastic sports bottle filled with water. You know, the tough, hard plastic ones that everyone from bikers and hikers to active business folks to on-the-go moms tote around - not to mention students ranging from elementary to college. They’re perfect for an active lifestyle - light, durable and available in a rainbow of colors. However, new research has shown that these plastic sports bottles may pose serious health hazards.

The irony is that the hazard may actually come from the material that makes these bottles so attractive. Lexan polycarbonate resin, a plastic polymer accidentally developed by General Electric in 1953, was and still is a revolutionary material. It’s been used in a variety of products over the last four decades including compact discs and DVDs, bulletproof windows, mobile phones, computers, baby bottles and water bottles. Lexan is a perfect choice for water and baby bottles as it’s durable, doesn’t hold flavors or odors nor delivers any taste from the bottle material itself to the fluids it holds.

The Problem:
This is where the confusion begins. Many folks assume that because it doesn’t impart flavor to the liquid it holds that it’s safer than other types of plastic bottles. Research findings published in 2003 by the journal Current Biology, show otherwise. These findings were the result of a study by Dr. Patricia Hunt of Case Western University in Ohio that questioned the use of polycarbonate plastics such as Lexan.

In1998, Hunt discovered that plastics made from polycarbonate resin can leach bisphenol-A (BPA), a potent hormone disruptor. BPA, a chemical found in epoxy resin and polycarbonate plastics, may impair the reproductive organs and have adverse effects on tumors, breast tissue development and prostate development by reducing sperm count.

BPA can be leached into the water bottles contents through normal wear and tear, exposure to heat and cleaning agents. This includes leaving your plastic water bottle in your car during errands, in your back pack during hikes and running it through your dishwasher and using harsh detergents. And, a 2003 study conducted by the University of Missouri published in the journal Environmental Health Perspectives confirmed Dr. Hunts’ study conclusions but also found that detectable levels of BPA leached into liquids at room temperature. This means just having your plastic water bottle sitting on your desk can be potentially harmful. In this author’s humble opinion, the best thing to do is to avoid plastic altogether. (Side note: baby bottles made from polycarbonate plastics have quietly disappeared from the market despite industry assurances that polycarbonate plastics are safe)

The Solution:
There are two approaches to take to avoid exposure to BPA. First, if you are active and take water with you, switch to a stainless steel water bottle. But, be careful. Many products on the market are lined with an epoxy finish. This defeats the purpose. Make sure that the bottle is stainless steel both inside and out. Stainless steel water bottles are light, durable and hold both hot and cold liquids well.

The second approach is to reuse glass containers such as quart sized juice bottles. Yes, they are a bit heavier but are good solutions if you’re in an office environment where mobility isn’t an issue.

Either way, to avoid bacteria build up, wash out your containers with warm water and biodegradable dish soap. Be sure to wipe the mouth of the container and the lids. And most importantly, let the container completely dry before refilling. Keeping any container continually filled with liquid can lead to bacteria developing and potential illness.

Keeping hydrated is extremely important year round - but especially during the summer. It keeps our systems functioning properly and is important in sustaining good health. Here’s a tip on how much water you should be consuming daily based on a formula provided by the Mayo Clinic: Simply take your body weight and divide in half. For example, if you weighed 150 pounds, you need 75 oz (9-10 8oz glasses) daily. Caffeinated and alcoholic beverages are dehydrating so for every glass of these beverages you drink, add an extra glass of water.

So, while you take care to only fuel your body with plenty of pure, filtered water, take the next step and ensure the container holding your water is safe.

Meditations and Visualizations are frequently used as MQ prescriptions to help the patient work with their imbalances. The following article from the Pine Street Foundation, Autumn 2006 highlights Martin Rossman experiences and successes with guided imagery.

Interactive Guided Imagery as a Way to Access Patient Strengths During Cancer Treatment

BY MARTIN L ROSSMAN, MD, DIPLAC (NCCAOM)

In cancer care, as in all medical care, there are two complementary goals of treatment. One, the usual medical goal, is to kill cancer cells and tumors, or reduce their numbers and ability to grow, reproduce, and metastasize. The other, perhaps best called the healing goal, is to support the well-being and resistance of the patient. Here I use “resistance” to stand for all the mechanisms, known and unknown, that protect us from the development and dissemination of cancer.

Conventional medical care for cancer has for too long concentrated on the first goal without paying appropriate attention to the second. The development of an integrated approach to treating the cancer patient is a much-needed response to that oversight and promises, at the very least, healthier people with cancer and, at most, an enhanced response to treatments and better cure rates in the people we treat.

Methods of supporting and enhancing resistance to cancer and tolerance of treatments generally fall into three categories that have received various amounts of research attention: (1) Nutritional support ranging from improvement of diet to generally acceptable levels to sophisticated individualized programs of nutritional supplementation with vitamins, minerals, herbs, essential fatty acids, and natural biological response modifiers; (2) Mind/body approaches consisting of psychological, psychosocial, and psychospiritual interventions ranging from support groups and counseling to meditation, stress reduction, and guided imagery practices; (3) Body/mind practices such as Yoga, Chi Gung, Tai Chi, Jin Shin Jyutsu and graded aerobic exercise; and (4) Systematic approaches from time-honored healing systems such as traditional Chinese medicine or Ayurvedic medicine.

In this brief article, I will focus on three case examples of the unexpected utility of guided imagery as a healing resource to the patient with cancer. Guided imagery in its various forms is becoming quickly and widely accepted as a useful adjunct in the treatment of people with cancer due largely to its ease of use, low cost, and rapid psychological benefits.1 It has also been shown to increase both the numbers and aggressiveness of natural killer cells when practiced over time,2,3 to reduce complications from surgery,4,5 relieve pain,6,7 and reduce adverse effects of chemotherapy,8,9 which in the terms of our conventional dualistic approach makes it not only a psychological intervention but a medical one as well.

A future article will more comprehensively review the range of guided imagery applications and techniques, but my purpose here is to share three brief examples of how an interactive use of imagery helped three people with cancer connect to inner strengths and resources that helped them through their challenges with cancer. These examples have been selected from hundreds of such examples in my practice to demonstrate the power of uniquely personal imagery to access the resilience and coping abilities of the patient.

Guided imagery is a term variously used to describe a range of techniques from simple visualization and direct imagery-based suggestion, through metaphor and storytelling. Guided imagery is used to help teach psychophysiologic relaxation, to relieve symptoms, to stimulate healing responses in the body, and to help people tolerate procedures and treatments more easily.

Interactive Guided Imagery (IGI) is a service-marked term registered by the Academy for Guided Imagery to represent a particular approach to using therapeutic imagery. In this approach, personal imagery relevant to the situation is evoked from the patient by a guide trained to do this without providing specific content. Thus the guide might prompt patients to imagine how their body might heal from or overcome their cancer, or how they might want to tell their children about their illness. Because the imagery comes from the patient, it is uniquely relevant and tells both patient and guide how the patient perceives the situation and creates an opportunity for them to work creatively with possible responses to it. The guide aims to create situations where patients can draw on their own inner resources to support healing, to make appropriate adaptations to changes in health behaviors, and to find creative solutions to challenges that they previously thought were insoluble. IGI encourages patients to access their own strengths and resources and tends to lead toward greater patient autonomy and self efficacy.

Battling cancer is frequently a complex journey involving some of the most difficult trials people are asked to cope with in normal life. There is growing recognition that cancer patients benefit from various types of support as they go through their journeys, ranging from informational to decision-making, physical, nutritional, psychological, social, and spiritual support. This article will present three brief cases showing how IGI can help people with cancer access what might be considered to be an “inner support system” at a time when it is most needed.

MAUREEN
Maureen Redl, creator of the “Voices of Healing” program, is a 65-year-old wise woman who was diagnosed with metastatic ovarian cancer 15 years ago. She was already familiar with guided imagery as a vehicle for insight and, in a meditative state, asked her unconscious mind for an image that could help guide her through what she imagined would be a terrible ordeal. She saw herself dressed in ski clothing and skis at the top of a very steep mountain. A lifelong skier, she immediately understood that she was about to push off on a run that would demand all her skill and determination. She also immediately saw that while the effort would challenge her to the extreme, it was clearly possible for her to make it all the way through if she gave it her full attention and focus. She also got the sense that if she did make it all the way down, she would be living life on a much deeper and more effective level than she ever had before.

This image was useful to her throughout many twists and turns of her journey with cancer, reminding her to stay focused on where she wanted to go and not let herself get lost in her fears. She not only “made it” herself, she has become an inspirational and effective guide to many others who are themselves struggling with life-threatening illness.

While this woman knew from previous experience that her imagination was a doorway to her inner life and could be helpful in this way, many people will not know that this is even possible, or their shock and anxiety may prevent them from being able to focus on strengths without professional support and guidance.

EMILY
“Emily” was a patient of mine, a nurse in her forties who had just been diagnosed with a recurrence of breast cancer. She could barely speak through her sobbing, but kept repeating “I just don’t know if I can do this again… I don’t know if I can do it.” She had been free of cancer for four years and had changed her life in many healthy ways after her initial diagnosis. She had improved her diet, clarified her personal goals, cleaned up some personal baggage through therapy, and had been feeling better since her cancer treatment than she had for years beforehand. The recurrence was a shock and a cruel blow.

She was willing to do imagery, and I asked her what she felt she needed in order to be able to deal with the challenges that faced her. She was quiet and said, “Strength and courage… I don’t know if I have the strength to go through this again.” I asked her to go back in her memory to a time when she did have the strength and courage she was missing now, and in her imagination she went back to a time twenty years earlier when her mother had been diagnosed with breast cancer. By asking her to imagine that she was there again, and to notice what she saw, heard, and felt, she was able to recreate the experience fairly vividly. As she described her mother sobbing and being terrified, as Emily had been at the start of the session, I asked her to pay attention to how she felt as she experienced herself there with her mother. She said that she was calm, clear, and encouraging. She felt strength and confidence that they’d be able to take whatever steps they needed to take to deal with this. I invited Emily to notice where she felt these qualities of strength and confidence, of calmness and clarity, and over a few minutes, to imagine that she could feel them very strongly in her body, and she did. We took several minutes to let her feel these qualities even more strongly, feeling them in various parts of her body (chest, face, arms, legs, etc) I invited her to imagine she had a volume knob and could turn up the amplitude of the feeling as high as she liked, giving her time to experiment with it and find the “right level of strength for you right now.” The imagery, being remembered in “present tense” allowed her to experience these qualities in herself, and when she opened her eyes, she said, “You know, I do have the strength I need, I just couldn’t get to it.”

Emily still had recurrent cancer and many decisions and treatments to face. She would get scared and feel like giving up periodically, but now had a tool that allowed her to reconnect with her strength and courage. After a few weeks, she remarked to me that “this is like emotional body-building” and she is right in that the more she practiced feeling those qualities, the more easily they became accessible and present in her daily life.

The shock, disorientation, and anxiety that often come with a serious cancer diagnosis often overwhelm people’s sense of confidence and make it hard for them to feel effective or powerful at a time when they may need to feel this way even more than they normally do. Evocative imagery can help people to reconnect with their own resources and begin to use them effectively in their own behalf. Learning to shift from helplessness to hopefulness at will is an empowering experience for anyone, especially for anyone feeling overwhelmed with the fear of cancer.

People with a cancer diagnosis may not only face an on-going threat to life and well-being, they often need to do this in a situation characterized by uncertainty as to the best treatment, complicated by conflicting recommendations on the part of the best experts in the field. One use of IGI is to help people make good decisions once they have accumulated the information available but still cannot decide. We often invite people in this situation to imagine meeting with a figure that is both wise and caring, the kind of figure we all wish we had in our lives when times are difficult. We call this figure the “inner advisor,” though many people have their own terms for it, ranging from “inner guide” and “inner voice” to “guardian angel” or “the wisdom within.” The following case demonstrates how this technique was used effectively for this reason and provided an unexpected but much welcome bonus in addition.

HELENE
“Helene” was a handsome woman in her sixties who consulted me after being diagnosed with breast cancer. Because of the type of cancer, she had received a number of different treatment recommendations from top level oncologists and surgeons. These ranged from two different types of surgery with or without two other approaches to breast reconstruction followed by radiation and possibly adjunctive chemotherapy. She came to see me to do guided imagery to help her decide from a “deep level” what treatment course would be best for her. As I interviewed her, it became apparent that she was a warm, thoughtful, intelligent woman with a well-developed support system. She was happily married and had been for many years, had two loving grown children, and was a successful professional woman who loved her work. She had many good friends, and had participated regularly in a women’s group for years, calling it the equivalent of another family.

We decided to use IGI to explore what decision might come from a place of wisdom and compassion, which we often do by asking the patient to imagine themselves in a beautiful safe place having a conversation with an image of an “inner advisor,” a figure that has these two qualities of wisdom and compassion. In such an imagery dialogue process, the patient finds a relaxed yet aware position that allows them to explore ideas they imagine come from such a figure. The disidentification created, along with the focus on the desired qualities the figure embodies, often allows information to emerge that the patient may be having difficulty accessing.

Once Helene was feeling relaxed and comfortable in a beautiful imaginary glade, I prompted her to invite an inner advisor image to appear. An angel-like figure came to her mind, large, ethereal yet substantial, and winged. Helene felt a sense of love and wisdom from the angel figure and invited it to be comfortable with her. She discussed all the information she had gathered with the angel and asked it to help guide her to choose the best treatment for her. The angel seemed to respond in a way that made Helene feel that surgery followed by radiation was the best treatment for her—that it had the best evidence behind it and her own intuition had led her to think that was the course she wanted to choose. The angel confirmed that choice and Helene felt surer than she had to that point about that course of treatment. At the end of their dialogue, she thanked the angel for coming and asked if it would be all right to hug the figure in her imagery. The angel figure was receptive and Helene became very quiet for several minutes. She described the angel enfolding her in its large golden wings and surrounding her with a profound sense of warmth and love. She was very moved.

After the imagery part of the session was over, we discussed what had happened. Helene was clearly relieved to have reached what felt like a good decision for her, and I was pleased that the session had helped her achieve her purpose. Toward the very end of the session, I asked her a question I often ask people after an imagery session—”what was the most important thing about that experience for you?” I fully expected her to say that she had reached a decision she could live with, but instead she surprised me and said, “I found out that I am not alone.” A tear fell from her eye as she said this. I was surprised for a moment because Helene was so deeply connected to her family and her friends, yet I knew instantly what she meant. This was about another kind of connection—a connection she later told me she felt with an aspect of life that ultimately went beyond life as we knew it.

The lesson here is that IGI can be used to access a perspective that includes both wisdom and compassion, and that p