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Introduction
Imagery has always played a key role in medicine. What is imagery? Imagery is the thought process that invokes and uses the senses: vision, audition, smell,
taste, the senses of movement, position, and touch. It is the communication mechanism between perception, emotion and bodily change. A major cause of both health and sickness, the image is the world's oldest and greatest healing resource.
Imagery,
or the stuff of the imagination, affects the body intimately on both seemingly mundane and profound levels. Memories of a lover's scent call forth the biochemistry of emotion. The mental rehearsal of a sales presentation or a marathon race evokes muscular change and more: blood pressure goes up, brain waves change, and sweat glands become active. Because of this pronounced effect the image has on the body, it yields power over life and death, and plays a key role in the less dramatic aspects of living as well.
In primitive societies, the witch doctor shakes the bones and utters a curse. The victim's heart flutters, his temperature drops, and death comes quickly. An autopsy would show that the hex had the effect of causing the body to shut down—a parasympathetic nervous system death, the physiologists might call it.
The victim dies, not from fright, but from hopelessness, from the vivid working of the imagination.
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terminally ill cancer patient goes to the shrine at Lourdes, France. A woman with severe rheumatoid arthritis crosses the border into Mexico to get therapy that is unproven according to U.S. authorities and therefore illegal in this country. A couple, long childless, pays a first visit to a famous medical school's infertility clinic. In each of the cases, positive changes in the condition in question have been documented that either preceded treatment or accompanied what might be classified as medically worthless intervention.
Patients all over the world are administered placebos of one kind or another.
Often they show decreases in pain, nausea, anxiety, and even in tumor cells. It is not just their attitude that changes; their biochemistry has also undergone a transformation. Far from being the duping of innocents and malingerers,
placebos and the power of suggestion tend to work best in people who need and want to get well.
The common feature of these events—the mental rehearsals, the voodoo curses,
visits to religious or medical shrines and response to placebos—is that they all serve to alter the
images
or the expectancy that the persons hold regarding the state of their health. And in doing so, the images cause profound physiological change, a fact that must not be obscured by the glamour of modern medicine. Regardless of technological advancement, we will always have to contend with this vast complex of expectancies, beliefs, motivations, and the sometimes belligerent, sometimes miraculous, role of the imagination.
There is little argument about the negative power of the imagination on health.
Acceptance for the idea no doubt stems from widely publicized research on stress and disease, as well as personal observation and intuition. Most people seem to have acknowledged at least a tentative connection between causal factors emanating from their state of mind and the subsequent observation of colds or infection or other evidence of diminished resistance to disease. What has not been proposed often in modern times is that the reverse must also be true. Since nature creates few one-way passages, if we can become ill through our misbehaviors, even die from hexes and broken hearts, then we must also be able to make ourselves well.
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renewal of focus on the imagination as at once an ancient and potent aspect of healing will help mark this decade as having initiated the most dramatic advances in medicine the world has yet seen. The forces responsible for bringing about these changes represent a grand confluence of theology,
psychology, medicine, and anthropology, and are embodied in the personages of the scientist and the shaman.
This celebration of consciousness, of the power of the human psyche, and of the imagination as the essence of the universe, is gaining momentum even in unlikely academic circles. Medicine is not the target, nor even the cause of these great changes; but it is a beneficiary nonetheless. Nowhere is there such a concrete manifestation of the illusionary stuff that is mind and soul as in the human body. It is there, in the body, in its state of relative health or sickness, that the harmony of the person with the cosmos is portrayed. The body has no secrets; it never lies. Neither the sins of omission and commission in the environment, nor past and present thoughts, can pass without leaving their corporeal mark. The treatment of this complex landscape of thinking, feeling and being has been the province of medicine, for better or for worse. And so it is on the field of medicine that the new developments, the new understandings of the powers of the imagination, will have their most directed force.
Definite themes have emerged from the study of the imagination as healer, which relate to two basic ways the image is believed to positively impact upon health. First is what I have called
preverbal
imagery.
Here, the imagination acts upon one's own physical being. Images communicate with tissues and organs, even cells, to effect a change. The communication can be deliberate or not. It is preverbal in the sense that it probably evolved much earlier than language, and uses different neural pathways for the transmission of information. The second type of healing imagery is
transpersonal,
embodying the assumption that information can be transmitted from the consciousness of one person to the physical substrate of others.
The scientific method is currently far more applicable to the study of the preverbal type of imagery. The preverbal phenomena can be described using facts derived from physiology, anatomy, chemistry, and the behavioral sciences. The proposition can, and has been, tested using the scientific method.
Transpersonal imagery, on the other hand, requires the existence of channels of information flow that have not been identified by the tools of science. The validation of transpersonal imagery must therefore be sought in the more qualitative types of observational data gathered by the anthropologists,
theologians, medical historians, and others, as well as by intuitive,
philosophical speculation. The greatest support for this theory comes from the tenacity with which humans have clung to a belief in transpersonal healing, and have been reinforced in that belief system, for at least 20,000 years.
Although the dichotomy of imagery into transpersonal and preverbal modes is useful in describing and understanding healing systems, it is only grossly correct. The two types intermingle conceptually and in practice, and there is a considerable amount of variance in the application of both. The complexity of describing the image does not end in its categorization, however. In the following pages appears an unlikely mixture of art and science, history and medicine. As might be expected in the search for knowledge of one of the great enigmas of human nature, uncovering the dimensions of the imagination has required traveling along multiple avenues. Some were frankly bizarre, others offered only tenuous leads, still others were so enchanting it was difficult to move away at all.
This book is the story of my search—spiraling around the idea of the imagination as healer, weaving in threads of metaphor, touching time and again on the primacy of consciousness as a fact of human existence.
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will begin in Chapter 1 by telling the story of the shamans—trying to treat their perspective appropriately, but with a scientific eye. In describing the imagination and healing, it seemed logical to approach the knowledge of these long-recognized experts. Shamanism
is
the medicine of the imagination. The shaman is ubiquitous throughout time,
throughout the world. Shamanism is and has been the most widely practiced type of medicine on the planet, particularly for serious illness. The shamans are the ones who are said to understand, in a spiritual sense, the nexus of the mind, the body, and the soul. Their chief task has always been to heal their people of the ills of humanity—whatever form those maladies might assume. The shamans claim to have special skills for journeying to the planes of the imagination where healing the body and healing the planet are possible.
Most of the shamanic lore is so foreign to the myths of contemporary medicine that it has long been discarded as too fanciful, too untenable for twentieth-century, sensible, civilized, rational humankind. Nevertheless,
shamanic health practices have continued to thrive (or at least survive)
alongside of the mainstream of medical thought.
The traditional concept of shamanism would place it within the classification of transpersonal healing, and it is upon that issue that the shamans have established their reputation. However, preverbal imagery plays a strong role,
as well. The shamans' ritual work has a direct therapeutic effect on the patient by creating vivid images, and by inducing altered states of consciousness conducive to selfhealing. Too, the shamanic concepts of disease and the community involvement in healing deserve consideration in these times when disease has become an entity apart from its host and from the environmental circumstances.
In
Chapter 2, the qualitative, historical evidence for the imagination as a healing tool is explored further, specifically as it is found firmly embedded in the lineage of Western medicine. Asclepius, Aristotle, Galen, and
Hippocrates, regarded as the fathers of medicine, used imagery for both diagnosis and therapy. Their sensitive observations concerning the ability of the image to cure as well as kill provided a legacy that was fully realized by the creative physicians of the Renaissance.
Because we are all significantly influenced by the Anglo-Saxon heritage, I have included a discussion of those healing traditions of England and Europe that reflected upon the imagination. For several hundred years, the Catholic church functioned as the authority in matters of health. The treatments the Church sanctioned were pilgrimages and rituals that still bore the pagan taint of shamanism, although the gods differed. The early and medieval Church incorporated the ancient Greek methods of healing in special temples dedicated to the premise that vision and dreams contained seeds of knowledge regarding health.
Several scholars feel the true roots of shamanism in Western civilization lie in the practices of the wise women, who were considered the ultimate purveyors of the supernatural, and hence, of the imagination. In Celtic times they were priestesses, but their successors were condemned as witches. The ebb and ultimate dissolution of women's influence on medicine and science were pivotal in directing healing away from the classic womanly virtues of nurturance,
intuition, empathy, and emotionality—all seen as threats and impediments to progress of the new scientific order. Their specific knowledges, however, were borrowed and sustained for generations by physicians, quacks, and the Church alike.
This history of health practices is fascinating in and of itself, but more important, it provides us with ground; it tells us that the imagination has always been an integral part of the healing process, regardless of cultural disguise. In each instance of history, the gifts of the imagination took primacy over pharmacy and surgery, and those who were skilled at wielding the powers of the image were awarded the greatest stature in the healing hierarchy.
The scientific age brought this acclaim to a screeching halt.
It has only recently become quasi-respectable again to ask (and answer) questions about the mind and medicine. Chapter 3 describes the work of those who are involved in such query, and who might best be called shaman/scientists. They were and are in the midst of mainline medicine, and have combined the ancient wisdoms with modem technology. For the most part, these practitioners are no strangers to the terrain of the spirit, and with their help, the humanistic,
naturalistic practices are gradually returning from the fringes of medicine.
From subject matter as diverse as hypnosis, autogenics, biofeedback, general medical practice, and the placebo response, it is apparent that the imagination enters health care in ways not dissimilar to those described in the history of healing. First, it is a part of all health care, in the sense that every interaction with health care personnel, every diagnosis and treatment, creates some kind of an image in the patient's mind. These images, in and of themselves, can turn the course of the disease. Second, imagery is once again being used as diagnosis. Because of their intimate contact with the physical body, images appear to express a body wisdom, an understanding of both the status and prognosis of health. Third, imagery is used as therapy—its most controversial application. And finally, the imagination is employed to systematically rehearse anxiety-provoking events such as natural childbirth and the painful treatment for severe burns.
Before moving on to the innovative research and practice that will likely become the foundation for the medicine of the future, I relate evidence for the imagination and health, told from the special vantage place of the scientist.
The scientific findings by no means explain away the effectiveness of the imagination in health, but rather describe the events in different ways. The study of the imagination, involving as it does the external verification of intrinsic, private events, is especially susceptible to the whimsical nature of personal need, as well as the foibles of human beings in reporting such events.
Therefore, the scientific method is not only necessary, but absolutely critical for establishing accurate, replicable, valid information, which can be used in a productive sense in health. Science, when well practiced, is a ballet of discovery, an elegant accoutrement to the rest of the world's knowledge. More important, it provides a prohibition on self-delusion, which distinguishes the scientific methods of observation from other ways of seeking information.
Even with the safeguards of the scientific methods, the descriptions the scientist
(as well as the shaman) gives of the imagination and the healing process are myths. Scientists, artists, mystics, and poets still use their own special media to describe the imagination. They paint pictures on the canvas of their choice. The stories that come from science are no more nor less true than those from the great traditions of culture, but they are different in both the methods used to obtain and view the data, and the level at which the description is given. Using information from the basic sciences, in Chapter 4 I
have provided a description of the transition of mental images into physical change—or mind into matter, as some would have it. While the answers are clearly not all in, enough information is available from neuroanatomy and physiology, as well as biochemistry, to substantiate the existence of the pathways. Images, indeed all thoughts, are electrochemical events, which are intricately woven into the fabric of the brain and the body.
In considering science and the imagination, we are confronted with the facts of differing levels of description, all obtained with the scientific method. The behavioral and social sciences, too, have studied the function of the imagination in healing systems, but in terms of the behavior of the individual,
and within the context of the social milieu. Their position deserves note, and is outlined in Chapter 5. Rather than considering the imagination in either a mystical sense (as the shamans would) or as a physiological, biochemical phenomena, it becomes a hypothetical construct, a nonthing, which is measured only through the observable behavior of persons and their societies. Analysis of the image tends to revolve around psychological, rather than physiological,
events. Because of these scientists, we realize the important distinction between illness and disease, with the former being the unique personal impact of mental or physical pathology, and the latter being the pathology itself.
Techniques that use the imagination to achieve health are most likely regarded as affecting the illness, but not necessarily the disease. From the behavioral scientists, particularly, comes a wealth of experimental work and studied application of the imagination as therapy in psychological disorders.
In
Chapter 6, I have concluded with information on the frontier of health: the field of immunology. As more and more is known of this magnificent system of defense, it appears the major diseases of humanity could be conquered if the immune system could be trained to function effectively. Diseases of the immune system include cancer, allergies, infections, the autoimmune disorders such as multiple sclerosis and rheumatoid arthritis, and a multitude of other conditions that are a consequence of either a sluggish or a hyperactive immune system.
We have a thirty-year research effort from scientists such as Walter Cannon, Hans
Selye, and many others, showing the potential for stress to hamper the immune function. There are series after series of animal trials from the most respected laboratories in the world showing that under stressed conditions, the compromised immune system can result in disease or even death. We even have growing acceptance for the notion that stress exacerbates the growth of cancer in humans, triggers flare-ups in patients with rheumatoid arthritis, and sends asthmatics off to the emergency room for oxygen. Stress is implicated as a factor in both onset and exacerbation of all of the autoimmune diseases—those conditions where the immune system can no longer discriminate self from nonself, friend from foe.
Fortunately,
even though the immune system is violently assaulted by many types of behaviors and thoughts, there is information that it can also be enhanced and programmed through conscious acts. According to new research, a variety of techniques—
specific images, positive feelings, suggestions, learning to respond to stressors in a relaxed way—all have the potential for increasing the ability of the immune system to counter disease. Very current studies have shown that the immune system itself is under the direct control of the central nervous system, particularly those areas of the brain implicated in the transmission of the image to the body.
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profound relationship exists between the brain, behavior, psychological factors, and the immune system, although the exact nature of the relationship has yet to be specified. New behavioral therapies that highlight the imagination, such as guided imagery, hypnosis, biofeedback—all with a distinct tinge of shamanism—have been shown to influence immunology under controlled testing situations.
There is drama, here, as the elusive mysteries of the human mind begin to unfold—drama unparalleled on the battlefield, or in space, or in politics, or in any other arena. The scientific paradigm shifts, the metaphors blend. It is a good time to be alive.
