This action might not be possible to undo. Are you sure you want to continue?
By Rachel Naomi Remen
I'd like to examine the most ancient of human problems-wounding, illness,
suffering, and recovery-from a feminine perspective. I'd like to start with a premise. We are all wounded. Everyone has pain. There are only wounded people: We all need healing. Our medical system needs healing as well. So here is another part of the premise: Our wounds, and the wounds of our medical system, are very similar. The reintegration of the feminine principle, the feminine perspective, is a major step in our own personal healing and in the healing of our medical system. What I'll be talking about is movement away from health care that is focused on curing and the techniques of curing, toward a health care that is focused on healing and the laws of healing. We all know the power of the masculine principle and we all know the power of the masculine principle in health care. There are many people sitting in this room who would not be here if it wasn't for the current health care system, and I am one of them. Without contemporary medicine I would have died several times, as people with my illness-Crohn's disease-died in the past. So this talk is not about throwing away the masculine principle; it's about becoming whole. Let me begin by sharing two noetic experiences. The first one occurred in the middle of a shopping trip. (That's the nice thing about the universe; it reveals itself anytime it feels like it, so it behooves us to pay attention all the time.) I went to the Furniture Mart to help a colleague buy furniture for his office. As we were looking around he was attracted to the outlet of a Japanese department store. He was approached immediately by the salesperson, who was a tiny, tiny woman in a kimono. She grabbed his arm and began talking to him in a very loud and intense voice. There was something about her intensity that frightened me, so I backed off. He was discussing with her the possibility of buying a painting for his
office. They would drift toward me in their discussion, and I would try to disappear. This went on for a little while, until finally I had to cough. Immediately the woman came toward me and I realized that this was a very, very old person, perhaps ninety. That certainly explained some of her behavior. She took me firmly by the arm and began pulling me through the store. I tried to shake her off, but I was afraid of hurting her. She pulled me into a room in the back of the store which was empty except for four magnificent museum-quality paintings, one on each wall. One of them showed a spray of tiny pink blossoms on a very, very old branch which was covered with snow. Leading me up to it, she said to me, "You see! The plum blossom, the essence of woman, come early, ahead of time. Come in February, winter, cold. Hard. See snow on branch. Come early, hard. Plum blossom soft, gentle, tender. And they survive. Essence of Japanese woman. It is woman who survives." Now at the time I found this puzzling, for several reasons. As a physician, I thought I knew about survival, because, after all, I was in the survival business. As a physician, I knew survival was a matter of action. It was a matter of the masculine principle; one analyzed, and one acted with technical competence, knowledge and skill. But there was another reason why this was confusing to melike the plum blossom, I, too, was born early. In February, 1938, when I was born, I weighed two pounds. I was the smallest infant to survive in New York City for many years afterwards. All through my childhood I had been told that I survived because of the invention of the incubator, which occurred just a few years before I was born, that this new technology had saved my life. But what this old woman said made me wonder: Perhaps it was not only the incubatorperhaps it was something about the baby, the soft, gentle, tender, tiny baby girl, that had allowed me to survive. I had never thought of that before. The second noetic happening occurred while I was at Stanford. It was directly after my third major surgery and a friend, suggesting that I might recover my strength faster with some form of gentle exercise, told me about a tai chi class. This class was taught by an eighty-year-old Chinese tai chi master named Mr. Wu. Tai chi is one of the most elegant of the martial arts; it's a series of ritualized movements that go on for an hour or so. I thought it was wonderful, and I signed up for the class. I worked at it very hard. I did it every day, and I went to class twice a week. I was really proud that I was getting stronger and was becoming very competent at tai chi. But there was one movement toward the end of the series of movements that, no matter how hard I tried, I just couldn't do. I would come to the part where you stand on one foot, and then you kick out the other leg almost to shoulder height. I'd try to kick, and I'd fall over. I was sure I knew why this was happening-it was because I wasn't yet strong enough to do this kick. And then, one day, after three years of doing tai chi in the class, something different happened. As I came to
the kick, suddenly it was as if time slowed down. I was aware of a still center in me that was absolutely trustworthy. As I began the kick, my body moved effortlessly around this center in a sort of natural balance. And for the first time in three years, I didn't fall over.
Beyond "strength" lies balance.
In that moment I had a deep knowing without words, that my ideas about strength, which I'd held all my life, were an illusion. That perhaps there is no "strength"; there's only balance. Of course, I was thrilled. I ran to my teacher, Mr. Wu, and told him this insight, very excited. And this old, tiny man smiled at me, with infinite patience, and he said, "Ah, so. Now we are ready to begin."
I think this is where the Western medical system is today. With a growing
cultural understanding of the power and importance of the feminine, or yin, principle, and with the concept that beyond strength lies balance, now we are ready to begin. What is it that these two old people were grounded in, this old woman and this old man? I think it's basically the Buddhist philosophy, and the concept of "chi". In the beginning, there is the chi, the life force, the totally undifferentiated energy of life itself. As that energy begins a long step-by-step process that will result in form and matter, all of what we experience here in this world, the first step is a differentiation into the two great energies: the yang, or masculine principle, and the yin, or feminine principle. Everything that is, is made up of both of these energies, the wholeness symbolized by the circle that is divided by the "S", the yin and yang together creating all there is. What does this mean in terms of human consciousness? Just that there are two ways of thinking; two ways of perceiving, seeing, and experiencing the world; two ways of understanding; two ways of formulating problems and responses to problems; and two ways of acting with power in this world. This has nothing to do with gender. We all have within us both principles. When I was thinking this morning of how to express this, I was standing in the shower, and suddenly I saw that round shower faucet, with the hot and the cold, and how you can make an infinite number of combinations of hot and cold by moving the handle. We are like that, too. There's an infinite number of combinations of yin and yang. Now, in this culture there's an imbalance, not only in our institutions but in ourselves-we value the masculine principle more. In the current health care system, healing is attributed to the masculine principle. Outcome is attributed to technology. I often ask people who come to see me, "How did you get well? How are you recovering from your cancer?" And they tell me they had surgery, they
had radiation, they had chemotherapy. (And I survived because I was in an incubator.) But to me, healing is not about technology. Technology is like pruning a plant. Pruning is what allows something in that plant to better live, manifest, and bloom. Pruning doesn't make a plant bloom. Surgery doesn't heal a human being. All it does is create more optimal conditions for something unseen, inherent and hidden in that person, to manifest. This faith in technology was not always the way with the medical system. There were times of a different balance. In the old days the physician was thought to need the eye of an eagle, the heart of a lion, and the hand of a woman. That means that the knowledge, the skill and the courage to act is translated to the suffering person through the wisdom of the feminine principle. That's how it connects-through the hand of a woman. What has become of the feminine principle in our culture? We've disavowed it. Why have we done this? Because we couldn't get approval for it. And by disavowing that which we couldn't get approval for, we have all made ourselves less whole. Carl Jung talked about the shadow parts of our wholeness which we disavow. Robert Bly has a marvelous image: Every human being walks around with a long bag of the shadow dragging behind him or her, and in this bag are all of the things we're ashamed of. Our culture is ashamed of the feminine principle in us, and in our institutions. And yet the things in the bag are not shameful-often they're very valuable, the very things that are needed to become whole. And they are available; they can be re-owned, these aspects that we need to heal, and to help others heal. Re-owning the yin is a matter of integrity. Anything unbalanced is wounded. Reowning the yin is restoring integrity to ourselves, and to our world.
What is this yin perspective we're trying to integrate in order to become
more whole? The way yin-and-yang is usually described is in terms of polarities. The yang is said to concern itself with the objective world, manifest reality, quantity, "more is better". The yin is about the subjective world, the hidden, the personal, quality. Begin to think of your experiences of health care as I go through this list. The yang values ways of the objective world: facts, those things acquired by our own individual actions and efforts. The yin values intuition, emotion, and spirit-pathways to wisdom, which are ours by birthright, not by actions and efforts. To stand in the masculine principle is to stand separate. Doctors are trained to stand separate, to be objective, in order to be able to help people-to stand independent, individual, and isolated. That's very yang. What we have today is a medicine of isolation. Most of the people with cancer tell us that one of the hardest things about cancer, as hard as the chemotherapy, is the isolation that
they experience. We have institutionalized individuality and its shadow, isolation, in our medical system. We have a language that nobody else speaks. We have a dress that nobody else wears. I recently bought two new leather lounge chairs for my office. I love them. I was going to lunch with a colleague, a psychiatrist, and I said "Come see my new chairs." He looked at the two chairs, and he said "But they're exactly alike." I said, "Yes!" And he said, "But which one is your chair?" These things go very deep. From a yang point of view, we trust analysis. We learn about the world by analyzing. From a yin point of view, we trust experience. We learn about the world by experiencing it. Yin is about relationship, interconnectedness, belonging. It's about the interdependent nature of the world. The yang is about the how of things. It's about the mechanical, about expertise. It values competence and skill. The yin is about the why. It looks at meaning. What is the meaning, not the mechanism, of events? Meaning is about pattern. It's about the thread that connects seemingly disparate things. The yang has comfort in mastery; the yin has comfort in mystery. The yang is about form and product; it tends to turn the world into things and to act upon those things. The yin is about process. Everything is movement; everything is growing; nothing is finished. Now this form/process thing has a great deal of impact, really, because when you think of it, the concept of "form" opens us to the construct "broken". But if everything is process, nothing is broken, and maybe nothing needs to be fixed. "Broken" is only a stage in a process. Nothing living is broken. Everything is growing, is process. I like to think of this as the "Golden Yet". I say to myself, "I haven't learned compassion . . . yet." I say about someone else, "He hasn't learned to listen to feelings . . . yet." It changes everything; it opens a door for great compassion, and for a kind of expectancy, which I think is a very wise position in life.
The classic yang/yin polarity is that the yang is the active and the
yin is the receptive. We often distort this idea and think of the yin as passive. But the receptive is not passive. Active and receptive are two powerful ways of manifesting the chi, the life force. Two powerful ways of acting in the world: One can act actively, and one can act receptively. The masculine power is about fixing and curing. The feminine power is about healing, about magnetizing, nurturing and evoking innate strength. Healing is very much like education. Educare means "to lead forth the wholeness that is inherent in another human being". First you see the wholeness, you're receptive to it, you trust it's there-because it's often hidden. We meet with the life
in the other person, we cooperate with it. Often wholeness is not apparent, but it's always there. Let me give you an example. Just imagine a tiny little tree, a green, tender thing. If I approach this tiny thing from the masculine perspective, I say "Oh, I am bigger than this thing. It's so small and tender. I need to build a wall around it, made of my own energy, to keep it safe." This is exhausting. The feminine principle approaches this tiny little tree in a totally different way. It looks beyond the appearance, the form. It sees the life force in that tree and responds to the life force with water, and food, and nurture. The tree finds its own strength and grows big. It manifests itself. That's not very tiring for you, not very tiring at all. You can never eradicate the wholeness. It can always be remembered, reowned. The symbol for the masculine principle in us is a circle with an arrow. There's a lot of debate about what that arrow is, but the way I've learned to talk about it is that it's Mars with his sword, or his spear. In my experience of health care, in fact in my experience in general, when someone is dealing with me from the masculine side of themselves, I feel the tip of that spear and I experience their strength. I also feel somewhat diminished and rather grateful. Here's an example of being diminished: Some years ago I went to see the local expert on Crohn's disease at the urging of my friends. When I called for an appointment, he was kind enough to get on the phone personally because I am also a physician. We went back and forth, back and forth, working out a time when we both were free of meetings and talks and patients. At the end of four weeks, we were able to settle on an appointment time. When I came to the appointment he asked me when I first became ill. I said I was fifteen years old. He said, "Tell me your story." Remarkable. No one had ever asked me that. So I told the whole story. It took about an hour, and at the end of this hour, he looked at me and said, "Are you still able to practice medicine a little?" He said this despite all the difficulty we had had in setting up an appointment. He could not conceive that somebody with this problem could be a functioning, contributing member of society. I left that office shaken, because behind the big desk and the white coat he had caused me to doubt my own life experience. It was a house of cards which could collapse at any moment. It hadn't collapsed in forty years, of course, but at any moment . . . The symbol for the feminine is also a circle, but with a "+" below it. This is called Venus' Mirror. When somebody is dealing with me from the feminine perspective in themselves, I see reflected in that mirror my own strength, my own ability to arise and become whole.
The feminine principle is about the power of relationship. From the feminine perspective we are always in relationship with everybody and everything; there's no place to go to be out of relationship. What we believe about each other, how we see each other, is as important as an MRI, or coronary bypass surgery, in terms of our recovery. What we believe about each other is empowering or limiting in ways we don't fully understand, but which are pure examples of the yin principle.
Something that is very close to my heart is a story about the impact of
the yin in the healing of sixteen physicians. Commonweal is a nonprofit organization whose programs include week-long retreats for people with cancer. Through these retreats we have learned over the years about the ways people heal, the ways the medical system has served in their healing, and the ways this system has failed them. After this long period of learning, I thought it might be interesting to develop a pilot curriculum at Commonweal for health professionals who work with people with life-threatening illness. With the help of The Fetzer Institute we set up the Institute for the Study of Health and Illness, a program of five workshops. The first is called "Beyond Professionalism: Building Healing Relationships". The second, "Rekindling the Flame", is about loss and grief. The third is about emotions and is called "Reclaiming the Heart of Medicine". The fourth is about the power of intuition. The fifth, "Reclaiming the Intangible in Health Care", is about spirit. In reality the first workshop is about healing and the second is about seeing the world as process. The other three are about three great subjective ways of knowing the world: through emotion, through intuition, through spirit. The curriculum is about rebalancing, re-owning the yin, though we don't talk about it that way. Cancer and other life-threatening illness bring out the full force of the current medical system-industrial strength yang approaches. We poison cancer, we radiate it, we cut it out. Commonweal takes a very yin approach to this same circumstance, and we see the power of this. So we thought we'd try to enable people to integrate this into their own work. The curriculum is for health professionals, but the first group that showed up was not what we expected. We expected nurses, psychologists, some physicians. The first group that showed up for these five workshops were all traditional physicians who were taking active roles in the medical system. They were gynecologists, oncologists, internists, psychiatrists, pediatricians, but not one person who would describe themselves as a holistic physician. The Commonweal community doesn't get thrown by very much. We accept and receive all comers. But when these physicians showed up in their ties and jackets, the community was intimidated-because their wounds didn't show, just as mine don't show. The case history I want to tell is about these people remembering about healing by healing themselves and each other-healing
themselves of wounds, some of which were caused by their training, and reowning the shadow in a group of colleagues. In the first workshop we start drawing with crayons and confronting the archetype of professionalism. We spend the first morning discovering, through the experience of our drawings, that we all expect the same things of ourselves, no matter where we were educated. We were trained all over the country, yet we all drew the same drawing. It's a powerful training . . . Following this, in the afternoon, we work with the sandtray. This is a technique we use a lot with people with cancer at Commonweal. It makes visible the unconscious mind, the deep wisdom. It's like a waking dream. If you were using the sandtray you'd take a basket and walk along a number of shelves, selecting any objects on the shelves that attract your attention. The experience is very interesting because certain objects seem to just leap out at you. They are resonant with something in the unconscious mind. Then you put the objects down in a scene in the sand and you talk about what's there. Through this talking you may get very deep insights into yourself and your process. This old Jungian technique has its rules, and we break them all. Marion Weber of Commonweal has invented what is called the group sandtray. This is a round table, about six feet across, filled with sand. We lay sticks across it on the diameter so that it's divided up into "slices", and each person has a slice of the sandtray to do their work in. In the Institute workshops, I take the sandtray one step further and I give a topic. I say, for example, "Okay, sandtray is something we use with people with cancer and you've come here to learn how to work with people with cancer. Let's do a sandtray together on the topic of healing. Pick objects that speak to you of the nature of healing." So eight doctors sit in a circle, each laying tiny figures and objects in the sand. At first people don't realize the meaning of what they've done. But as they talk it begins to come to them. Someone had put a bird's nest in the sand. He looked at this and said "I have a nest here. I don't know why I have this nest. . . . Oh, I think it's about the conditions for healing, making that nest." Another person had put a plastic ear in the sand. He looked at it for awhile and then he said, "You know, I think perhaps the greatest tool of healing is receiving and accepting another person." Someone else had two little plastic people touching and when his turn came he said, "All healing is mutual. Perhaps it comes out of relationship It's always about two people traveling a path together. I'd never thought of that before." And there is another level of the experience-people were listening deeply to other people, some of them for the first time. When we finish the sandtray everybody stands and then moves one place to the left. Up to now you've heard everybody speak, but this time you stand in their unconscious wisdom. You move again to the left, and again, until you've gone
around the whole circle back to your place. Marion and I lift the sticks and there is the sandtray as a whole. This is a very profound and powerful moment. Many people tear-up in this moment. When we did this at the first curriculum workshop there was a silence and then one man said softly, "Gee, it's sort of sacred, isn't it? We never named what it is. We did not need to. It is, of course, an altar. It's sort of sacred, isn't it? And that's the most profound insight about the nature of healing. This was deeply reassuring to me because this one group of people-these eight doctors-had collectively one hundred sixty years of conditioning and socialization in the masculine principle. These are people who have been pressured into a yang perspective, who act from that perspective a lot in their daily lives. Yet they can go beyond that to the archetype of healing in the wink of an eye. You can never eradicate the wholeness. It can always be remembered, re-owned. In the workshop in intuition, there was enormous resistance at first, with physicians saying such things as "It's unethical to use your intuition in medicine. You might kill somebody." And yet this workshop turned out to be one of the most powerful because these are all very intuitive people. Most healers are. A man who is head of a medical clinic at a very large hospital in San Francisco told what had happened to him after this intuition workshop. He said that he had gone back on Monday to his clinic and had an appointment with a woman he saw every week-Mrs. Hernandez, an older woman with cancer. Since there is nothing further to be done for her he sees her every week, adjusts her pain medication, and sends her on her way. This time, however, he decided to look at her through his intuitive eyes. We call this "getting a second opinion". He got an immediate intuitive hit that what was really needed was for him to pray with her. He said that he started to sweat . . . and he went down the checklist about what's dangerous, what's not dangerous. Should he do it? Surely there was no harm in it at all. So he said to her, "Mrs. Hernandez, maybe we should pray together." She said, "Oh doctor," and began to weep a little. Now, he did not do what he had been trained to do when someone cried, which was to get a nurse. What he did is what he had learned in the emotions workshop-he simply received her feelings and took her hands. She said, "Doctor, I'm a Catholic, can we kneel down?" In his white coat, he kneeled on the floor with this elderly woman and prayed, and she blessed him. And he felt very strengthened by that.
The very last exercise of the fifth workshop is about uncovering the
meaning of your work. We ask people to draw a picture of the meaning of their work, a good yin principle. People draw a picture, and then we say to them,
"Please write a poem or an invocation that captures the meaning of your work. Then we'll read them to each other." Here is one, written by the director of an AIDS clinic: Creator, you have instilled in me A rainbow, for your children to walk on, To see and experience you. Open my heart that the fullness of light and color Be reflected in me. Remind me Of the joy I feel in your presence Comfort me When Clouds block the light And I cannot see the colors within. When I am disheartened, Bring me your pot of gold That I might see again with new eyes, Trust again the purpose of my service with you, Hope again in your love For all your children and the Earth. What these physicians are really doing through their poetry and work is rewriting the Hippocratic Oath. That is the step that is needed: Rewriting the Hippocratic Oath to be a prayer of wholeness-a prayer each physician creates in his or her own way.