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If one looked at manifestations of rhythmic patterns, breath

would be an obvious one. Personality characteristics would be

reflected in an individual's breath, I speculated, and if one

could make a corresponding profile of breath, that might be a

very useful tool.

"I think so, too," Simonton said thoughtfully, "especially

if you stress the person and then see what the breathing pattern

looks like under stress. I would certainly agree with that, and

you could probably do the same thing with pulse."

"That, of course, is what the Chinese do," I observed. "In

their pulse diagnosis, they relate pulse to various flow patterns

of energy that reflect the state of the entire organism."

1 98 UNCOMMON WISDOM

Simonton nodded in agreement: "That also makes sense. If I am receiving, for example, alarming stimuli and I don't express anything, then I am blocking the flow of energy. And that, it seems to me, would be reflected in all of my system."

In the last part of our conversations we discussed multiple aspects of the cancer therapy that grew out of the Simontons' scientific model, their philosophy, and their experience with patients. At the very core of the Simonton approach lies the thesis that people participate, consciously or unconsciously, in the onset of their disease and that the sequence of psychoso­ matic processes that leads to illness can be reversed to lead the patient back to health. I had heard from several physicians that the notion of the patient participating in the development of cancer was extremely problematic, as it tended to evoke a lot of guilt, which was countertherapeutic. I was therefore especially interested in hearing from Carl how he dealt with this problem.

"As I understand it, the problem is the following," I be­ gan. "You want to convince your patients that they can par­ ticipate in the healing process-that's the main thing-but that implies that they have also participated in getting sick, which they don't want to accept."

"Right."

"So if you are forceful in one direction you may create psychological problems in the other."

"That's true," Simonton agreed, "but if they are going to restructure their lives it is important for patients to look at what has been going on and how they got themselves sick. It is important for them to go back and analyze the unhealthy aspects of their lives. So it becomes important in the therapeutic process that they take on a stance of responsibility in order to better see what changes will be necessary. You see, the concept

of patient participation has lots of implications." "But how do you deal with feelings of guilt?"

"It's a matter of not stripping down a person's defense mechanisms," Simonton continued. "With new patients we don't push the concept of patient participation very hard. We put it to them in a much more hypothetical way. You see, it is very easy to build a case for it by looking at stressful events and trying to find new ways of dealing with them. That makes sense to practically everyone."

THE SEARCH FOR BALANCE 1 99

"And that implies the concept of patient participation." "Yes, and if people then are further interested and ask questions, you can show them the role of the immune system, you can mention the experimental evidence, and you can do all that without confronting them strongly. We always attempt to avoid strong confrontation with a patient who is not psycho­ logically equipped for it. That would be very detrimental be­ cause patients would lose the tools they have developed to live their lives without being able to replace them with any other tools. Gradually, as they grow and develop, they will be able to modify their defense system and take care of themselves in new ways."

I found the entire question of patient participation very intriguing from a theoretical point of view as well. I suggested to Simonton that one could perhaps say that the person's un­ conscious psyche participates in the development of cancer but that the conscious ego does not, because the patient does not make a conscious decision to get sick.

Simonton disagreed. "I don't think the ego is central," he argued, "but I do think that it is involved. The more I talk to patients, the more I find that they had little inklings. However, the ego is not centrally involved."

"In the healing process, on the other hand, the ego does be­ come centrally involved," I said, continuing the train of thought.

"That seems to be your approach, to work with the conscious part of the psyche in the healing process."

At that point I commented on the methods of spiritual teachers, Zen masters for example, who use a variety of in­ genious methods to address themselves directly to the student's unconscious. "You don't do that, do you?" I asked Simonton. "Or do you also have ways of tricking patients into these sit­ uations?"

Carl smiled: "Yes, I have some."

"What would those be?" I pressed on.

"I would work through metaphor. For example, I would tell patients metaphorically over and over that we are not going to take their disease away before they are ready to let go of it, that their disease serves a lot of useful purposes. Now, a con­ versation like this really doesn't register much with the con­ scious ego. It is really addressed to the unconscious and this is very important for quieting a lot of anxieties."

200 UNCOMMON WISDOM

Indeed, it seemed strange to me that a physician would have to assure his patients that he would not take the disease away from them prematurely. But it made more sense to me as Simonton elaborated the point.

"Something that happens very often with my patients," he explained, "is that they are terrified when they are told after successful medical treatment and visualization sessions that they have no evidence of disease. This is very common. They are terrified! As we explored this with our patients we found that they had recognized that they had indeed developed the tumor for a reason and were using it as a crutch to live their lives. Now, all of a sudden, they are told that they have no more tumor and they haven't replaced it with another tool. That's a big loss."

"So now they have to face their stressful life situation again."

"Yes, and without the tumor. They are not ready to be

well; they are not ready to act in a healthy way; their family and the society they live in are not prepared to treat them any differently, and so on."

"In that case," I observed, "you have only eliminated the symptom without dealing with the basic problem. It's almost like taking a medicine to get rid of a sore throat."

"Yes. "

"So what happens then? "

"They get a recurrence," Simonton continued, "and that is an extremely upsetting episode. You see, they had been say­ ing to themselves: If I get rid of my cancer I will be okay. Now they got rid of it and they feel worse than before, so there is no hope. They were unhappy with the cancer and they are even unhappier without it. They didn't like living with cancer; they like living even less without it."

As Simonton described this situation, it became clear to me that his cancer therapy is much more than the visualization technique that is usually associated with his name. In Simon­ ton's view, the physical disease is a manifestation of underlying psychosomatic processes that may be generated by various psychological and social problems. As long as these problems are not solved the patient will not get well, even though the cancer may temporarily disappear. Although visualization is a central part of the Simonton therapy, the very essence of the

THE SEARCH FOR BALANCE 201

approach is to deal with the underlying psychological patterns through psychological counseling and psychotherapy.

When I asked Carl whether he saw psychological counsel­ ing as an important therapeutic tool for other illnesses as well, he was quick to respond.

"Yes, absolutely," he said. "It is important to point out that we don't give people permission to seek counseling. Psy­ chotherapy is still considered unacceptable in most segments of our society. It is more acceptable than a few years ago but still not enough. I was taught that bias in medical school, but since then I've come to see counseling as an essential part of the future holistic health-care system. Until we have adopted new, healthier ways of living, psychological counseling is going to be vital over the next generation."

"Does this mean that there will be more psychothera­ pists?" I wondered.

"Not necessarily. Counselors do not need to be at the Ph.D. level; they simply need to be skilled in counseling."

"It seems that this was the function of the churches and the extended family in the past."

"That's right. You see, basic counseling skills are not diffi­ cult to acquire. Teaching people basic assertiveness, for exam­ ple, is an important skill that is easily taught. How to deal with resentment is fairly easy to learn; or how to deal with guilt. There are pretty standard techniques for these situations. And, most important, just to be able to talk to somebody about one's problems is of tremendous help. It leads one out of the sense of helplessness that is so devastating."

At the end of our three days of intensive discussions I was deeply impressed by the truly holistic nature of Simonton's theoretical model and the many facets of his therapy. I realized that the Simonton approach to cancer will have far-reaching implications for many areas of health and healing. At the same time I also realized how radical it was and how long it would take for it to be embraced by cancer patients, the medical estab­ lishment, and by society as a whole.

When I reflected on the contrasts between Simonton's thinking and the views commonly held in the medical com­ munity, the statement I had come across in the writings of Lewis Thomas came to my mind-that every disease is domi­ nated by a central biological mechanism, and that a cure would

202 UNCOMMON WISDOM

be found once that mechanism was discovered. Carl told me that this was a widely shared belief among cancer specialists. I asked him whether

he

thought that a central biological mech­ anism of cancer would be discovered. I assumed I knew what Simonton would say, but his answer surprised me. "I believe that this is a distinct possibility," he said, "but I don't think that it would be particularly healthy for our culture."

"Because we would then just find something else?"

"Exactly. The psyche would replace cancer with some other disease. If we look at the history of disease patterns, we see that we have done that throughout our history. Whether it was the plague, or TB, or polio-whatever the illness was­ as soon as it was handled we moved on to something else."

Like many of Simonton's assertions during these three days, this was certainly a radical view, but one that made per­ fect sense to me in the light of our conversations. "So, the dis­ covery of a biological mechanism for cancer would not invali­ date your work at all?" I continued.

"No, it wouldn't," Simonton affirmed calmly. "My basic model would still be valid. And if we develop and apply that model now, regardless of whether or not a biological mecha­ nism is found, we have the chance of really changing people's consciousness. We can make a major evolutionary change in health around this disease."

In document UNIVERSIDAD DE EL SALVADOR FACULTAD DE CIENCIAS ECONOMICAS ESCUELA DE ECONOMIA ESTUDIO COMPARATIVO SOBRE EL ENVÍO DE REMESAS DE ESTADOS (página 54-59)