Category: Gerald Epstein, MD

First, Find Your Direction

The last several posts were inspired by the book I am currently reading by Jonathan Sacks, Morality. I find that many of the ideas in this book can be directed towards understanding a healthy path for healing in general. I would say that he would describe his book as a way of healing society and I would say that the lessons of healing society can also be reflected on the physical and psychological healing of people and communities.

In an interview about the book, he describes what it was like growing up among Holocaust survivors in the area of London, I believe, he grew up in. One of the many things that stood out to him was that they all focused first on building the future before tackling the enormity of what happened in their past. This choice would ensure survival for them and for their newly created families, a choice informed by both Jewish values and practicality,

In media, we have all seen scenes in movies and TV that show the person visiting their “therapist” endlessly rehashing what happened to them in the past as a way to gain insight into the present. My main teacher, Gerald Epstein, MD was initially a psychoanalyst but eventually changed once he met his teacher. His perspective on working on people’s “stories” of the past, fell away to work with people on their being more aware of the present and actively working to let go of the past.

When it comes to health of the body and mind, I am not neglecting factors of the past that play a role. Taking a good history is a starting point in any medical examination. What I am suggesting is that when it comes to making decisions for today regarding your health, a focus on finding a direction to move towards after letting go of your past tends to be most effective for individuals.

Forward movement becomes much easier when you have let go of the past. The past can be an anchor dragging you backwards. It’s dead and gone, now is the time to focus on forward movement and the best you can do is to decide on a direction and take your first step. It is liberating and is what your body needs. Take baby steps, it could be after a few baby steps you will need to re-adjust. Maxwell Maltz, MD used to explain that people on pursuit of a goal are like a self-correcting missle that endlessly corrects. In the beginning, you may zig and zag before finding the true direction. The key is to get going and a baby step is the way to go.

And with all I have just said, dealing with your past can eventually be done just as those Holocaust survivors eventually started to discuss their experiences many years later. Gerald Epstein, MD taught many strategies for “reversing” how your body reacts to past memory so it neither defines you nor affects your movement towards the direction you want to go. In fact, whenever I would start to reflexively hypothesize why something was the way it was based on the past, he would just utter the word “STORY” to bring me back to the moment so that I could get back to the present moment to focus on the direction I wished to go. We are quite good at constructing endless narratives / justifications / rationalizations to find reasons why something happened. Perhaps, this endless search for answers to the problems of our past are better left in the past. First, find the direction that is healthy for your mind and body and then take the first step.

A Covenant of Health

There are quite a number of well known physicians who have spoken extensively about how public policy (read politics) should be used to change the dietary patterns of the population to improve the overall health of the nation. Perhaps, there is another way.

In his book “Morality : Restoring the Common Good in Divided Times” Rabbi Lord Jonathan Sacks, describes 3 general ways in the public sphere that one can lead people to a desired goal. There is economic, where one pays for someone to do something. There is political, where one makes one to do something. And there is moral sphere “where we persuade them to do so because they and we are part of the same framework of virtues and values, rules and responsibilities, codes and customs, convention and constraints.”

The problem with failing back on politics and economics to implement change is that it ignores the moral dimension even if that very intention in the first place comes from a place of deep caring and concern for the health of the nation. The economic sphere has also been used through tax penalties to avoid certain foods and then there is the whole world of food subsidies from the government which exposes all too well how families’ health has been damaged by the influence of special interests.

Sadly, like all big institutions the healthcare system tends to depersonalize both those it seeks to service and the service providers, not out of a some evil conspiracy, it’s just the nature of huge institutions like healthcare, big business, big government, large organized religious institutions, and large educational institutions.

Many years ago I read a book on a program called the White House Fellows. Many names you know went through this program. I don’t recall the name of the book. Two names that come to mind that went through this program are Colin Powell and Sanjay Gupta, MD. This program gives talented men and women access to see the workings of government in ways unprecedented in civilian life and those who come through the program go on to make significant contributions to public life. My point here is that there is most certainly a role for people who understand government influence and want to use that system to achieve change. It’s one route to change just like financial. I’d like to look at change from another perspective, the moral one.

In his book Rabbi Sacks talks about society needing a shared morality. This can be extended to the health sphere as health involves alleviating human suffering. While the news everyday makes it difficult to understand dietary guidelines, everyone basically understands what junk food is and that they need to eat fresh or fresh frozen produce. So how do we extend our sphere of influence by including the moral dimension?

I think we do so by empowering people to be able to make their own choices when it comes to health. The first step is clearing up the conditioning around health. As Jonathan Sacks explains, we can’t outsource our morality to the state, and I’d like to add, we can’t outsource our bodies either. It is this mindset that robs our fundamental responsibility we have to ourselves, to become our own authority. We need experts and specialists who understand that the force and effectiveness of treatments and health guidelines are heavily influenced by how involved the person is in their own care not just for themselves but for their loved ones and for society as a whole. Dr. Kelly Turner, in her remarkable book, Radical Remission documents 9 features of people who healed from cancer despite the odds. One of the 9 is “taking control of your health.”

How can we, then, reconfigure the healing relationship between doctor and patient. I think again Rabbi Sacks in his book, Morality gives us an idea in his discussion of the family. The solution is to transform the contractual relationship into one where there is covenant, meaning where 2 come together to form an “us.”

In this relationship, there can be profound healing. I have deep gratitude for the patients I am privileged to establish just such a relationship. Each one changes me forever and allows me a glimpse of the immense possibility, miracle and learning that comes with healing. It recalls to me something from Ethics of the Fathers. “And this is what Rabbi Ḥanina said: I have learned much from my teachers and even more from my friends, but from my students I have learned more than from all of them.’ Just change “students” to patients and it expresses just one result of a covenantal doctor / patient relationship.

What is needed are healers who see and cultivate the covenantal relationship with their patients. Patients also play a role, the depersonalization of the healthcare model and the advertising of big Pharma has led to a situation where patients have very high expectations of immediate cure for most of the problems that plague them.

Healing as my teacher, Gerald Epstein, MD would remind me often comes from the root of a word that means wholeness and even holiness. That does not come from a pill but in establishing a relationship with your healer where your healer understands and respects your primary role and the ongoing journey to wholeness that needs to be undertaken.

Relative Health

In my dealings with patients, I have come across a phenomenon that needs explaining. People who feel fine are often unaware that they are in fact not functioning at a very high level of biological wellness. An MSQ (medical service questionnaire) can be helpful to bring some objectivity to the evaluation and also to track process.

My teacher of blessed memory, Gerald Epstein, MD used to pay very close attention to the images evoked by peoples choices of words. Expressions like “a weight on my shoulders” or the like express things in a way that can be very deep to the underlying issues. This can often highlight other issues that might be pertinent to the problem at hand and point me towards getting to a deeper root to helping people heal.

He was also very fond of explaining that tackling one aspect of your life and health often has significant ripple effects on other aspects of your being, those being physical, emotional, intellectual, spiritual, and social.

The challenge here is a profound one, identify one aspect of your life, perhaps it is some aspect of your health and with gusto correct it. Don’t worry about all the things in your life that seem to be awry, “that’s life” as Frank Sinatra said. Life is tough and as that saying goes “Be kind for everyone is fighting a great battle.” The other side to this quote is, forget the great battle and focus on that aspect of your life / health that you can fix. It could be as simple of avoiding sugar for 21 days or walking 20 minutes a day, or even getting rid of some food in your house that is no good for you.

Then, watch what happens. First, expect some resistance, this is the nature of this world. Second, let go of expectations of when and what the positive change will look like, just be patient and know that it will come. Third, be on the look out for an additional simple thing you can do to improve your health because what will happen if you follow the above steps is that with time, you will imperceptibly be taking on harder and harder challenges.

The reward is that you will find other aspects of your life start to open up. You also start to realize that how you felt before in many cases was far from vibrant! Could that one first challenge be the first domino to fall in a change where your whole life transforms? Yes, in fact it is the only dependable way change ever happens.

Please comment below. I am seeking to become a better writer and appreciate critical comments on the presentation of this short blog posts. Personal attacks will just be deleted so please stick to the ideas and the writing.. Read my post Speech as Spiritual Practice for my thoughts on that.