Book Review: The Illness is the Cure

What sense do mental health professionals make of physical ill health? How would you regard a client who tells you she is being treated for throat cancer and wants to understand why she got it? Do you believe cells in her throat suddenly began to multiply and divide uncontrollably, turning into tumors, because she smoked in her youth? Or is there a psychological rationale –repressed anger perhaps; do you share her belief that she brought the disease on herself because she was never able to speak up for herself, especially in the presence of her mother? Does she have a typical 'cancer personality'? Will she need a positive attitude to 'fight' cancer and 'beat' it? Or perhaps you think the cancer was 'God's way', or bad karma from past lives, or the work of evil spirits? Or just chance?

The axis that these arguments revolve around was sharply drawn four centuries ago when Rene Descartes penned the words Cogito, ergo sum. Today, in the 'body' camp, are adherents of the biological/medical model, the prevailing positivist orthodoxy of healthcare provision in the Western world. Sick people are treated like broken machines. Dysfunctional body parts are examined, tests are performed, the powerful doctor tells the grateful patient what is wrong, then arranges for medications, operations or other treatments. The patient is the passive recipient of the illness and the cure; their phenomenology, knowledge and meaning-making of themselves and their symptoms, the context of their lives and their current situation – such matters are considered irrelevant.

In the 'mind' team, by contrast, illness is seen as a deeply psychological process. Symptoms are symptomatic of something unresolved in the unconscious, a pain in the psyche, a sickness of the soul, a suffering spirit. The high priestess of this kind of psychological determinism – let's call it psychofascism – is the recently departed Louise Hay. 'I believe we create every so-called illness in our body,' she wrote in You Can Heal Your Life, which inexplicably has sold over 50 million copies. If you can limit yourself to having only 'joyous, loving thoughts', she says, you won't get ill. And if you already are ill, you can cure yourself, as she claimed to have done with an uncorroborated diagnosis of cervical cancer in the 1970s. All you have to do is 'consciously release any mental patterns… that could express as dis-disease in any way'.

In an extraordinary interview in The New York Times (Oppenheimer, 2008), Hay was asked to what extent people are responsible for their own deaths – did victims of genocide, for example, or people murdered en masse in the Holocaust, get what they deserved? 'Yes, I think there's a lot of karmic stuff that goes on, past lives… Yes, it can work that way,' Hay said. 'But that's just my opinion.'

Coming similarly from the outer fringes of credulity and credibility is Peter Wilberg's The Illness is the Cure (2012). Wilberg makes illness sound rather jolly, 'offering patients an opportunity to gain important insights into themselves to bring about healing transformations in their lives and not just their bodies'. Indeed, the central metaphor of this preposterous book is that illness is like a pregnancy, something that precipitates a new and improved you – unless of course you are foolish enough to go to see a doctor and receive treatment that terminates the 'foetus'. Presumably the news of a loved one's diagnosis of, say, cancer or heart disease is properly to be met with much jubilation.

Whatever your physical complaint – details are sketchy – healing takes place through feeling, apparently. If you meditate on specific symptoms and cultivate whole-body awareness, all will be well. Never mind all the pain and suffering. And the inconvenient fact that illnesses kill people is brushed aside: it only happens when they are ready to die. And not to worry because their 'soul-body' is eternal, says Wilberg, who describes himself as an independent author, teacher and therapist, and has a masters in humanistic psychology but no medical or therapeutic qualifications or professional affiliation.

The first third of his book is a comprehensive assault on Western medicine. Wilberg doesn't just throw the baby out with the bathwater, he renounces the whole concept of bathing. Medical treatment is a leading cause of death, ahead of cancer and heart disease, he asserts. Most drugs do not work. Chemotherapy is ineffective. Doctors are waging 'a veritable medical Holocaust'. They don't listen to patients, they are too short of time, too quick to diagnose, too eager to medicate. They commit 'communicative iatrogenesis' – people become ill because that is how they get to see a doctor; a few precious moments of human contact is what is sought, yet those same doctors, argues Wilberg, are incapable of empathy. 'Most doctors,' he writes, 'literally cannot bring themselves to utter even the most basic and commonplace empathic phrases.'

There is, of course, much to critique in Western medicine. It is massively compromised ideologically, politically and financially. The racket of pill-pushing pharmaceutical companies and their aggressive marketing dressed up as 'research'; the inhumanity of some hospitals; the devaluation of the healing power of kindness and human relationships. But I am also incredibly grateful for Western medicine. I have two unrelated chronic, degenerative and incurable neurological conditions, and no amount of meditation, journaling, chanting, crystals, hypnosis or yoga will change that fact. The only thing that might is medical science. From the NHS, I have received a staggering amount of excellent care. I have met many brilliant, kind and empathic doctors and nurses. I take various medications, without which I would scarcely be able to function.

Wilberg's determination to bellow at everyone in the establishment makes him hoarse. But then, in the final parts of the book, with the hysteric demonization of doctors and idealization of illness exhausted, Wilberg unexpectedly slips into a less zealous key with more measured and modest claims for what he calls 'Life Doctoring'. He defines this as 'therapeutic counselling for serious or chronic illness'. It is about 'treating the patient and not the illness – by exploring links between illness and life-in-particular the relation between the emergence of symptoms and significant life changes'. A Life Doctor 'will never seek to prevent a patient seeing or seeking advice from an ordinary doctor or medical specialist'.

Life doctoring pays attention to the patient's experience, cultivates their own felt sense of themselves, assisted by some body psychotherapeutic interventions, and helps them to make sense of their symptoms and illness in the context of their lives and current situation.

Instead of the thesis of the medical model, or the antithesis that too often veers into dangerous new age quackery, what is needed is synthesis. The black-and-white thinking of Cartesian dualism is to be rejected; we ignore the delicate, complex, mysterious interplay between mind and body at our peril. Writes Suzuki (2010: p 7): 'Our body and mind are not two, and not one… Our body and mind are both two and one.'

In Why Do People Get Ill? Darian Leader and David Corfield (2007: p 3) write 'No single major illness is exclusively caused by the mind, just as few illnesses will always be completely exempt from the mind's influence'. They advocate holistic treatments that may include traditional medical approaches but that also engage with the individual, their psychology and the context of their life. Arthur Frank's The Wounded Storyteller serves as a kind of manifesto and how-to guide to illness narratives; Havi Carel's Illness, which beautifully recounts her story, is a fine example. In The Illness Narratives, Arthur Kleinman, a doctor, similarly urges a resuscitation of the latent art of symptom interpretation.

Sadly, in practice, synthesis is rare. In my experience, even on a neuropsychiatric ward of patients with unexplained 'functional neurological symptoms' – otherwise known as somatoform or conversion disorders – the supposedly multidisciplinary approach consisted of medication plus a nominal amount of CBT and physiotherapy. There was scant interest or attention directed towards unconscious processes, the possible meaning of symptoms or indeed psychotherapy itself. The sheer variety and audacious creativity of symptoms begged to be explored as visceral expressions of distress; a way to prevent the person from having to do something difficult, or keep them safe, or cared for, or loved. For a lot of the patients, I felt that if they could have been helped to find their voices, their bodies would not have to do all the talking.

As therapists, we can help clients make sense of their illness (or that of a loved one). I believe we must honor their experience but we are not obliged to collude in self-blaming explanations or unhelpful metaphors which all-too-often, as Susan Sontag points out in her landmark essay Illness as Metaphor, can be moralistic and punitive.

Perhaps asking why is the wrong question. Sometimes we are 'thrown' into disease and there is no reason. Unrepressed rodents still manage to get cancer in colossal numbers (and presumably do not regard it as an opportunity for personal growth). With life comes disease, disability and death. It just does. No one is to blame.

More useful is to ask how. How are you going to accept your illness – and your mortality? How are you going to integrate these givens into your identity, your 'being in the world'? What are you going to learn? How are you going to live? However dire the situation, Viktor Frankl (1946/2004) taught us, we still retain the freedom to choose how to respond.

It is true that our symptoms have much to tell us. With the help of therapists, we can discover useful interpretations, authentic narratives and enormous capacities for transcendent spiritual growth. But one of the important things your symptoms are telling you is this: go see a doctor.

John Barton

References

Carel, H. (2008). Illness. Durham: Acumen.

Frank, A. (1995). The Wounded Storyteller. Chicago: Chicago University Press.

Frankl, V.E. (1946/2004). Man's Search for Meaning. London: Rider

Hay, L. (1984). You Can Heal Your Life. Carlsbad: Hay House.

Kleinman, A. (1988). The Illness Narratives. New York: Basic.

Leader, D. and Corfield, D. (2008). Why Do People Get Ill? London: Penguin Group.

Oppenheimer, M. (2008), The queen of the new age. The New York Times, May 4.

Sontag, S. (1977/1991). Illness as Metaphor. London: Penguin.

Suzuki, S., Dixon, T., Smith, H., Baker, R. & Chadwick, D. (2010). Zen Mind, Beginner's Mind. Boston: Shambhala.