Craig is told that he is suffering from Pneumocystis Carinii Pneumonia, an AIDS-related opportunistic infection. In order to be treated for his condition his doctor recommends that he have a platelet count of 5,500. (Platelets are the blood cells responsible for clotting.) The latest lab tests reveal that his count is below 2,000. While Craig sits in his hospital bed contemplating his situation, the phone rings. The firm and compassionate voice of a woman comes on the line and invites him to take a few deep breaths and relax. She guides his inner vision to his bone marrow where blood cells are being produced; she suggests that he see, sense and feel the ripening blood cells like grapes ripening on the vine, maturing and multiplying at a quickening pace, differentiating themselves as red blood cells, white immune system cells and, especially, platelets. Finally, she asks him to see himself with the platelet count he needs and with the renewed health and vigor that will result from a successful treatment.
After two days of religiously practicing his new mental movie, Craig shows a platelet count of 5,503. He is able to undergo the treatment he wants and recovers from his bout of pneumonia.
Rick is a dynamic, outgoing architect/designer who has tested positive for HIV but who has shown no symptoms. He might be told by many doctors to "go away and come back when you start getting symptoms." Instead, he enrolls in the same program Craig is part of and, though the practice of visualization and other techniques, he brings his T-Helper count from a dangerous low of 400 to a robust 1,700 in a matter of weeks.
The experience of Craig and Rick (whose names have been changed) is but one reported in the annals of a most remarkable institution, the Creighton Health Institute, founded by Maggie Creighton (the owner of the firm and gentle voice). My task here is to look at the unique make-up and significance of CHI's programs for people living with cancer and HIV (the AIDS virus) in the context of an emerging trend in how health providers and researchers look at health and disease.
The '80s may well be appreciated from the vantage of more enlightened ages as the time in which mainstream medical thought finally began to accept the central role individuals faced with serious illness play in their own healing process. Of course, the suggestion that people's attitudes, beliefs, and emotional states have much to do with the state of their health and the progression of disease in their bodies is not new; in fact, it harkens back to the very beginning of modern Western medicine. Hippocrates said, "I would rather know what sort person has a disease than what sort of disease a person has." Louis Pasteur and Claude Bernard, two giants of nineteenth century biology argued all their lives whether the most important factor in disease was the "soil"--the human body--or the germ. On his deathbed Pasteur capitulated to Bernard, admitting, "It is the soil" (see Siegel, Love, Medicine and Miracles, pg. 2). This will come as no surprise to those who consider the now universal stereotypes of the hard-driving type A executive prone to heart attacks, the chronic worrier with ulcers, or the tense and angry migraine sufferer.
That the onset and course of immune disorders such as cancer and AIDS are also closely related to the emotional and mental disposition of the host may be somewhat less intuitively obvious. One of the world's leading researchers in the burgeoning field of psychoneuroimmunology (which focuses on the interaction of the immune and nervous systems), Lydia Temoshok and her colleagues at U.C.S.F. have developed a list of attributes held in common by a group of long term AIDS survivors. It is too early to say with statistical certainty whether these qualities directly enhance immune functioning, yet evidence is accumulating that links effective emotional coping with better immune activity.
One of these "long-term survivors," Dan Turner, was among the first diagnosed with Kaposis Sarcoma, a rare AIDS-related cancer, in February, 1982. (The mean time between diagnosis and death is about 18 months). Dan writes of his experience with STEPS: "What has been needed for the past six years and is finally here, is the STEPS program to help people threatened by AIDS to empower themselves and create a mental and emotional state of well-being in which physical healing can happen. STEPS is designed to break through the blocks which inhibit healing."
The CHI approach is sometimes misunderstood as an "alternative therapy." This is not the case; rather it serves as an adjunct to whatever course of treatment a participant has chosen. In fact the techniques taught in the self-help intensives are designed to maximize the effectiveness (and minimize any harmful side-effects) of the chosen treatment whether it consists of chemotherapy, herbs, acupuncture or any combination of healing regimes. One participant's experience illustrates the dramatic synergy which is possible between visualization and treatment.
Frank was afflicted with severe KS and was not responding well to treatment. When he began to use the visualization techniques he had learned in a STEPS intensive, the chemotherapy began to work wonders, with lesions visibly disappearing from every area of his body. Even more amazing to his physician, the chemotherapy produced NO side-effects. Frank had learned how to visualize the chemotherapy coming in to do its work without damaging his healthy cells, thereby instructing his body on how to effectively use the powerful chemical with no harm to him. In his own words, "In the course of the program I went from a weak, deteriorating condition (mostly housebound, sometimes bedridden) to again being a full participant in a very exciting life--energetic, useful and improving at an extraordinary rate."
The CHI programs, which feature training in visualization, deep emotional release, movement, nutritional counseling, and many other components, apparently make a dramatic difference in quality of life and other psychosocial factors associated with better-than-expected outcome for people living with HIV and cancer.
The more recent of two studies confirming this was presented by William Collinge, M.P.H., D.S.W., a CHI staff clinician, and his colleagues to the Society of Behavioral Medicine on March 30, 1989 in San Francisco. A sample of 47 men and one woman with various stages of HIV disease participated in his study which showed significant improvement in emotional expression, reduced POMS tension, depression, anger, fatigue, confusion and several other psychosocial variables. "Whether or not such factors are found to influence disease progression, there is a need for interventions promoting quality of life, given the expected course of illness." Unfortunately, a shortage of funds has made it impossible up to this point to perform immunological assays before, during, and after the program so as to demonstrate the physiological impact which has been alluded to anecdotally above.
What are the roots of this work? The pioneering work of the early '70s, Getting Well Again, by the Simontons and James Creighton first focussed national and international attention on the power of visualization in dealing with cancer. Through a step-by-step procedure, people were instructed in how to create an effective visualization routine to be practiced several times daily. The idea is that there is always a natural conversation taking place between the hypothalamus (the part of the brain which registers attitudes, feelings, and emotions), the endocrine system and, in turn, the immune system. The idea is to stimulate the messages emitting from the brain in the form of neuropeptides through a metaphorical experience of that conversation. "You are sending messages all the time to your immune system," says Maggie Creighton. "The message might be 'I don't really care about you,' if you are constantly overworked, for example. Through visualization, you can say to your white cells, 'Hey guys I really care about you, now get in there and get the job done so we can get on with our lives.'"
The daily practice of visualizing, say, a lion eating the little pink cancer cells, as well as seeing, sensing, and feeling oneself free of the cancer, were shown to be very effective in halting and reversing the course of even the most entrenched carcinomas. Lawrence Steiner, an architect in Portola Valley writes of his experience: "Ten years ago I was diagnosed as having metastatic cancer of the pancreas. The prognosis was incurable and inoperable. I was given six to eight months to live. Learning the message of the book, Getting Well Again, I expanded my belief in self-healing and thereby expanded my life experience and extended my life. Ten years later, I am working at CHI, and have seen many people take charge of their lives and surprise the medical profession by not only living, but living a fuller life than before being touched by cancer."
The more recent bestseller, Love, Medicine and Miracles by Bernie Siegel, M.D. emphasizes a theme fundamental to the work of CHI: serious illness is potentially a wonderful teacher. Exceptional patients, those who "beat the odds", take this opportunity to update outmoded views of themselves and the world, many of them dating from the experiences of early childhood. If I believe that I am unworthy of love and withdraw from others, for example, having been raised as a child of an alcoholic, this will produce stressful reactions to life events which can contribute to the onset of illness in my life. The pattern of self-protection may be a perfectly adequate response for a child of 10 but inappropriate and positively detrimental for a man of 30.
Several sessions of the CHI's courses are devoted to uncovering and updating these beliefs. This point underscores the importance of dealing with emotional blocks as a component of a systematic approach. Visualization must have an emotional charge to it to be really effective according to the earliest studies by the psychocyberneticists. If someone visualizes without much feeling because they're blocked, this will undermine the efficacy of the process. Maggie Creighton, founder and director of CHI informs us, "Every time you cry, your white cell count goes up!"
The importance of bringing the visualization into lived experience is brought home dramatically in the movement section of the training. Here, world-famous movement educator Anna Halprin teaches people to dance out their relationship with the cancer or the virus. They take their drawings and learn to physically embody the power of their healing symbols. For example, I become a lion, roaring and pouncing, rather than just thinking about one in my bloodstream. This is also an important congruence check since it's possible to have a very powerful symbol on paper without really being able to experience its power on a level of body knowing. This makes for profound theater as well, to such an extent that Anna has founded a theater program based on people's experiences in dancing their relationship with HIV.
By looking within yourself to discover how you may have contributed to your illness through immune-suppressing activities like withholding feelings, you can discover the keys to an enhanced level of functioning. This is an important point which has been misunderstood by some who naysay the current resurgence of "soil"-focussed holistic healing. "You are just making people feel guilty for making themselves sick. That will only make things worse!" goes the refrain.
The clincher is that to ask someone to reflect on how they participate in their illness is to ask them to make conscious what has heretofore been a largely unconscious process. "Very few people sit down and decide to grow a tumor or to contract AIDS," says Danny Less-Zielinski, the director of STEPS in San Francisco. "Many do, however, contribute to their illness through behaviors which are not life-sustaining, based on decisions that were wise at the time they were originally made but no longer serve. We're not about blaming or pointing fingers; we just want to uncover the processes that have contributed to illness so that new, life-sustaining ones consciously chosen by the participant can replace them."
The growth of CHI and its recent extensions to deal with the AIDS crisis mirrors the gradual acceptance by the community at large of its principles. Over a decade ago, a remarkable woman named Maggie Creighton decided to take a stand against the odds. She began her work with people with cancer, assisting them in learning skills that would empower them to challenge the belief that a diagnosis of cancer was synonymous with death. Not only was this belief challenged, it was very often proven wrong. This early work of hers gave birth to CHI (formerly the Cancer Support and Education Center), where hundreds of participants of the Cancer self-help intensive register a survival rate twice the national norm.
From there, CHI has established a flourishing program in Brazil and has been extended to the AIDS crisis with the STEPS program in San Francisco. No doubt this unique approach to healing will continue to expand and to transform the prevailing myths about"terminal illness." As society and medicine continue to evolve, what is now perceived as radical may well become commonplace in a few years. Certainly the idea that illness can be an important chapter in the meaning of a human being rather than just a horrible, fearful shadow has only begun to emerge.