by Lewis Mehl-Madrona, MD, PhD.
Major life shifts, including the curing of disease1, do occur following transformative spiritual experiences2. Spirituality has been defined as those aspects of human striving that relate to God, the Divine, the Universe or Largest Whole, Higher Beings, and/or those things that we have construed to be sacred. Spirituality is a process; a verb, rather than a noun; active, rather than passive; in motion, rather than static.3 A definition that can more readily generalize across cultures might see spirituality as the search for connectedness and belonging within a larger context in which physical objects are contained in non-physical realms. This definition would eliminate the particularly Western notion of striving and seeking a goal.
Interviews of seven of 10 known survivors of jumps from the Golden Gate or San Francisco- Oakland Bay Bridge, find that all experienced transcendence and spiritual rebirth phenomena3, suggesting that the confrontation of death in a symbolic and meaningful way could actually heal depression and prevent suicide.
Spiritual transformation refers primarily to a fundamental change in the significance of the sacred or the character of the sacred in the individual’s perceptions, and secondarily to a fundamental change in the pathways that a person takes to the sacred3. Spiritual transformation means a profound change in our sense of higher purpose and meaning. The ability to re-ascribe meaning to a changed world through spiritual transformation, religious conversion, or existential change may be more significant than the specific content by which that need is filled4.
The most common antecedents of spiritual transformation among 3,000 cases collected by the British psychologist Hardy were depression and despair (183.7/1,000)5; followed by literature, drama, fear (82/1,000); illness (80/1,000); and music (56.7/1,000). Spiritual transformation gave people a sense of security, protection, and peace; a sense of joy, happiness and wellbeing; a sense of certainty, clarity, and enlightenment; a sense of guidance, vocation, and inspiration; and a sense of presence (spiritual or other). The consequences of the experience for the 3,000 cases were a sense of purpose or new meaning to life (184.7/1,000), changes in attitudes to others (77/1,000), and changes in religious beliefs (38.7/1,000).
Confrontation of death in a symbolic and meaningful way could actually heal depression and prevent suicide
The language of spiritual transformation has been used to explain recovery from anorexia nervosa, with the most “recovered” anorectics questioning prevailing medical definitions of anorexia and clinical criteria for recovery6. Anorexia and recovery are understood as the negative and positive phases respectively of a ritual of self-transformation. In western culture, where appropriate myths and rituals of re-incorporation are not readily available following a period of symbolic fasting, it is not surprising that recovery from anorexia is not automatic. Subjects referred to anorexia as a spiritual quest. Recovery involved a rediscovery (or creation) of a threefold connection: to self, to others, and to “Nature” and/or the spiritual realm. These connections were the defining features of spirituality. The negative phase of the ritualistic quest (anorexia) involved a confrontation with the inevitability of death as a condition of the positive phase (recovery), in which people actively choose life. Recovery constituted the active and metaphorical “rebellion” against forces of social control. Specific ritual processes affect the self-transformation from suffering to recovery – a series of steps as applicable to depression as to anorexia.
Religious healing has been viewed as a form of discourse embodying a cultural rhetoric capable of performing three essential persuasive tasks: to create a predisposition to be healed, to create the experience of spiritual empowerment, and to create the concrete perception of personal transformation7. This threefold process activates and controls healing processes endogenous to the supplicant in healing, and either redirects the supplicant’s attention toward new aspects of his or her actions and experiences or alters the manner in which he or she attends to accustomed aspects of those actions and experiences. The result is the creation of both a new phenomenological world and new self-meaning for the supplicant as a whole and holy person.
Aboriginal culture views health and disease differently from mainstream Anglo-European culture. Similar to developing views in the field of complementary and alternative medicine (CAM), aboriginal culture views both health and disease as facets of healthy functioning. Health is a result of balance and harmony. Illness arises from imbalance and disharmony in relationships to all aspects of reality, and is seen as a healthy response of the person to restore physical, psychological, and spiritual harmony. Disease is not to be avoided, blocked, or suppressed. Rather, it is appreciated as part of a process of personal and spiritual transformation. People get ill because something is “wrong” in their lives. This could occur in a wide range of relationships to environment, food, family, God, ancestors, other spiritual forces, work, and more. Diseases are meaningful states within which people can heal. Instead of being meaningless, people’s problems become diseases of meaning, enabling them to see that things are not necessarily “going wrong” but are, in fact, helping them become stronger and live more fully, with more understanding.
In a study on healing and spiritual transformation, I found dimensions that emerged to differentiate levels of spiritual transformation:
- Reported major changes in sense of self, beliefs, quality of life.
- Increased sense of security, protection, and peace.
- Increased sense of joy, happiness, peacefulness, and wellbeing.
- Increased sense of belongingness in the Universe; a sense of containment; a sense of connectedness with the spiritual world.
- Increased sense of guidance and inspiration from spiritual sources.
- Increased faith, hope, and wellbeing.
- Reported life-changing experiences, in varying degrees.
- Increased sense of spirituality manifested by:
Prayer seen as more important.
Connection to Nature more important.
Stronger desire to feel close to God, Spirit, etc.
A further requirement was that these improvements and changes were related to spirituality as defined in the introduction. Spiritual transformation could be reliably related as absent, minimal, mild, moderate, and profound.
Stories exemplifying these levels of transformation are:
Thomas came to the retreat from Philadelphia. He was taking opioid pain medications to regulate his mood and worried about depression and occasional thoughts of suicide. His doctor and his therapist referred him, attesting that he was safe for a spiritual retreat experience. A powerful and wealthy man in his community, Thomas began the retreat with stories about his own importance. He delayed each experiential exercise by insisting upon talking at length about himself or his problems or his family or his projects. He couldn’t grasp the concept that the leaders were less interested in his stories or his personality and more interested in the skills he could learn. He couldn’t grasp the philosophy of focusing upon the practices instead of the stories about self. Instead of engaging in silence and meditation, Thomas was often talking, to the detriment of the techniques being taught. Thomas argued frequently, had reasons why nothing would work, presented himself as too complex to be moved by the techniques offered, and often engaged in verbal sparring.
The most transformative experience Thomas reported was that he was able to make it through his second sweat lodge without fleeing. The Yaqui healer involved with Thomas did a ceremony to remove his obstacles to healing, the effects of which lasted less than a day, and left Thomas complaining that the Yaqui healer had somehow traumatized him by slapping him on the back too hard. Thomas left the retreat and did not continue any of the practices he had learned. He was too sick, they were too hard to continue in his urban environment, and he needed dental surgery. His depression didn’t change, but he felt proud of his efforts at the retreat and and his ability to last the entire time of his second sweat lodge. He saw the possibility of “spiritual warriorhood” that the Yaqui healer presented to him, but felt that he wasn’t ready to pursue that until his dental and pain problems were resolved.
Thomas reported minimal changes in lifestyle, behavior, or emotional life as a result of the retreat. He still had his dental problems, his anxiety, his opioids, and his mood swings. He had more complaints than enthusiastic comments. He couldn’t really imagine how he would continue any of the practices he had learned (prayer, ceremony, yoga, and meditation). His levels of faith, hope, and peacefulness didn’t change. He didn’t report any particular change in his sense of spirituality. Thomas was rated as having minimal spiritual transformation. He did not experience increases in quality of life, peacefulness, or sense of belonging. He did not report receiving spiritual guidance or inspiration. The retreat was not a life-changing experience. He did not connect to nature, prayer, or God.
Morgan came to the retreat for a problem with chronic sinusitis of 18 years duration. She continued to question how the practices could help her sinuses clear. Consistently the Native healer who helped us insisted that whether or not they cleared was unimportant. What mattered was to feel connected to the world of nature around her and to the spirits. She struggled with her need for an intellectual understanding of how the practices would help her versus what the healers ask her to do 一 to abandon her self to the process. In a sense, they were asking her to lose herself and her identity, which was hard for her to do. In the sweat lodge ceremony before her last day, her left sinus drained, which she labeled a minor miracle. Then just as she was leaving, her right sinus cleared and she breathed normally for the first time in years. She was astounded. The healer encouraged her to take it in stride, because things could change in a moment. We urged her to continue her practices in a mindset of unconcern for whether or not “they worked.” She continued to struggle with this on her return home and came back to the practices when congestion returned, losing her motivation when health took over. Her understanding of the spiritual dimension remained on the level of technique rather than life-changing experience.
Though Morgan was skeptical, she participated in the retreat. She described feeling some degree of difference after the retreat and was somewhat enthusiastic about her experiences. She was unsure if she would continue the practices but was considering doing so. Immediately upon returning home, she took up dancing. Her sense of faith, hope, and peacefulness did improve somewhat. Her sense of spirituality was mildly different.
Bipolar disorder and years of related medication was the reason Mary arrived at the retreat.
Whether or not that diagnosis was correct was not our concern. We aimed to teach her practices that she would continue for life and that would change her life. Mary stopped worrying about the outcome and embraced the practices. She found herself feeling an intensity of emotion that had never been present for her before. She felt connected to the land, the mountains, and the animals. Coyotes sang for her. The wind talked to her. She found herself having a conversation with a great-great grandmother and neglected to wonder if it were real or not. She took to the practices with fervor and found that her value system was evolving. On her return home, Mary quit a job that she had found oppressive. She recreated her life to have meaning. She started a healing circle in her community so others could support her in continuing and she could share what she learned. She returned twice, one year apart. On her last return, she was studying to become a healer so she could pass on the gifts she had found to others. Over four years, Mary came off all her medications, including the benzodiazepines she had taken for over 20 years. She felt like a new woman. Her transformation was considered “moderate” since her spirituality did not undergo a sudden, profound change, but rather, deepened and was put into practice on a daily basis, producing slow, steady change.
Noelle came for spiritual retreat with a diagnosis of metastatic colon cancer. She felt lost. She had been raised Roman Catholic, but had lost her faith in that religion. Saint Teresa had been her patron saint as a child. She felt a close connection with that saint. She had busied herself with a husband who traveled extensively to Africa to set up an international business while she raised their four children at home and worked in the town where they lived. She resented him for his absences and felt that her job was stressful and meaningless. The cancer had almost been a relief in that it gave her permission to quit her job and focus on the meaning of her life again. In the retreat, she immersed herself in the morning meditations, the yoga, and the ceremony. She prayed in the sweat lodge ceremony for her multiple liver tumors to converge into two larger tumors that could be removed.
The next night, a Yaqui healer did a ceremony to remove the spirit of the cancer from her body. I was privileged to attend that ceremony. In the midst of his rattling and chanting over her, the clouds appeared to take on the image of a face. We smelled roses. Noelle looked up and said, “There’s Saint Teresa. I smell her roses. Now I’m healed.” From that moment on, she was convinced her prayers had been answered.
On her return home, the oncologist was amazed to find that her tumors had in fact converged into two respectable ones. Surgery was scheduled. Afterwards, she dove into the practices she had learned on the retreat and renewed her Roman Catholic faith m a form that seemed to work for her. She started a new kind of work that paid much less and had less status, but made her feel more valuable in a different way.
After a year, she began to diminish the intensity of her practices and got caught up in family conflicts. Tumors returned in her liver. She returned for another intensive retreat, went for alternative therapies (intravenous vitamin C) and the tumors disappeared. The retreat renewed her commitment to her practices and to her Roman Catholic faith. She continues to struggle with the possibility of tumor recurrence but has found peacefulness and a sense of meaning that transcends whether or not the tumors return.
Noelle embraced the philosophy of the retreat fully. She felt completely transformed as a result of the retreat. She was very enthusiastic about the retreat and was committed to continuing the practices at home. Immediately upon return home, she stopped working as she had done and completely changed her daily life. She related these changes to her increased sense of spirituality. She reported her faith, hope, and peacefulness as having all improved dramatically. Noelle was praying daily and feeling that her prayers were being answered. She felt more connected to Nature and with a strong connection to God. She felt connected again to the spiritual realm. I was very impressed with the depth of her spiritual convictions and how much that had changed as a result of the retreat. She described in detail how she had rediscovered her childhood Catholicism in a way that was deeply meaningful to her.
People do have profound spiritual experiences, many of which preceded physiological change. Diseases were cured in some cases and improved significantly in others. Despite conventional social upbringing, stories abounded of spirit and ancestor encounters, consistent with Native American philosophies. Anglo-Europeans appeared to have little trouble stepping into this other culture and participating rather fully.
These narratives arise as part of a movement within medicine that is shifting the location of illness from the classical mechanical view of time and space and matter in which there are linear causes and effects and mechanisms of action that resemble the famous game of “Mousetrap,” to a way of thinking about illness and causation in terms of arrays of people and sequences of speaking.
This shift is more toward the insights of quantum physics and the philosophy of Lev Vygotsky. A psychologist, was born in 1896 in Orsha, Belarus, then a part of the Russian Empire, Lev Vygotsky worked extensively on ideas about cognitive development, particularly the relationship between language and thinking. His writings emphasized the roles of historical, cultural, and social factors in cognition and argued that language was the most important symbolic tool provided by society.
Vygotsky’s philosphy positions biology as responsive and responding to assortments of human beings and sequences of language that emerge as story. This movement relocates biology to the realm of social relationships, suggesting that biology and psychology are virtually inseparable – that they are different aspects of the same story.
1. Dossey, L.(1997) Healing Words: The Power of Prayer and the Practice of Medicine. New York: Harper Collins.
2. Pargament, K.(1997). The Psychology of Religious Coping. New York: Guilford.
3. Rosen, D.H. (1976) “Suicide Survivors: Psychotherapeutic Implications of Egocide.” Suicide Life Threat Behav. Winter; 6(4): 209-15.
4. Marrone R.(1999). “Dying, Mourning, and Spirituality: A Psychological Perspective.” Death Studies, 23:495-519.
5. Leytham G., Alistair Clavering, Hardy and Spiritual Evolution. At www.datadiwan.de/SciMedNet/Leadarts/Leytham—Hardy.htm. Last accessed 15 May 2005.
6. Garrett, C.J. (1996) “Recovery from Anorexia Nervosa: a Durkheimian Interpretation.” Soc Sci Med. Nov; 43(10):1489- 506.
7. Csordas, T. (1983) “The Rhetoric of Transformation in Ritual Healing.” Culture, Medicine, and Psychiatry 1983; 7: 333-375.
This article appeared in the Diving in the Moon Journal, Issue 5, Summer 2008.
Coming from indigenous origins, Lewis Mehl Madrona, MD, PhD, graduated from Stanford University School of Medicine and completed his training in family medicine and psychiatry at the University of Vermont College of Medicine. American Board Certified in these specialties, he has taught at several U.S. medical schools, including the University of Arizona and the University of Pittsburgh. He currently is an associate professor of family medicine and psychiatry at the University of Saskatchewan College of Medicine. In addition, Lewis is the author of four books: Coyote Medicine: Lessons from Native America (Firestone, New York, 1998); Coyote Healing: Miracles from Native America (Bear and Company, Rochester, VT, 2003); Coyote Wisdom: The Healing Power of of Story (Bear and Company, Rochester, VT,
2005) and Narrative Medicine: The Use of History and Story in the Healing Process (Bear and Company, Rochester, VT 2007). For more information, go to mehlmadrona.mysite.com