JEFFREY MISHLOVE, Ph.D.: Hello and welcome. I'm Jeffrey Mishlove. Today we're going to be exploring "Healing Yourself with Mental Imagery." We're going to look at the role of the mind in treating physical ailments. With me is Dr. Martin Rossman, the founder and director of the Center for Collaborative Medicine in Mill Valley, California; a clinical associate at the University of California Medical Center in San Francisco; author of Healing Yourself; and a scientific advisor to the Institute for the Advancement of Health in New York City. Welcome, Marty.
MARTIN ROSSMAN, M.D.: Thanks, Jeff.
MISHLOVE: It's a pleasure to have you.
ROSSMAN: Thank you for having me.
MISHLOVE: You know, when we look at the growth of the mental approaches to healing -- preventive medicine, psychoneuroimmunology, and of course the use of imagery in healing, which is your specialty -- it makes one wonder whether the medical profession isn't really admitting that the conventional allopathic physical and drug treatments of illness are insufficient, really, or are not necessarily the best way to exclusively approach illness.
ROSSMAN: Well, I think that's true. I think the medical profession, though, on the whole is probably bringing up the rear in terms of what I see as a larger social movement. I think what's happening is that people are aware that the conventional medical approach is not really the answer to a great number of the things that commonly bother them, and they know that because it's not helping them, or it's just helping a little or palliating symptoms. I think that our culture has gone through a period of time -- say, in the late forties, the early fifties, when antibiotics, improvements in surgical anesthesia, cortisone, and some of the early psychotropic drugs like phenothiazines and so on were starting to be used for mental illness -- when there was really this hope that probably people your age and mine grew up with, that there was going to be a pill for every ill.
MISHLOVE: Wonder drugs.
ROSSMAN: Yes, a wonder drug, and a simple remedy for these particular kinds of things that have plagued people for a long time, and some of the newer diseases, or the diseases of civilization, that are the plagues of our civilization now. I think that enthusiasm, along with an increase in research and interest on the part of both the public and profession, lasted through the fifties and sixties, started to turn a little bit in the late sixties and early seventies, and kind of has come into full flower as manifested by widespread dissatisfaction with the medical profession -- the malpractice crisis, the economic difficulties with the medical profession, and so on. I think these are all symptoms that what's out there is just not adequate to meet the demands of the problems, the symptoms, and the illnesses that people have. And I think most practicing physicians are aware of that. I think as an organized institution perhaps, medicine now is somewhat begrudgingly and belatedly having to recognize what's now a tremendous amount of research information, of clinical information, that is still quite a bit anecdotal -- which is treated like sort of a dirty word in medicine. But there's such a surfeit now of anecdotal cases and evidence, and practitioners reporting that people are able to use their mind to help themselves, especially with chronic illnesses, which really are the place where conventional medicine doesn't have that much to offer.
MISHLOVE: I know that you yourself turned to the use of imagery out of your frustration with trying to treat illness just using conventional methods.
ROSSMAN: Well, somewhat. The truth is I was interested in the mind and the effect of the mind on the body even before I went to medical school, in the mid-sixties. When I got out of medical school, I was still interested in it, but was more narrowly focused, let's say, on putting to use what I'd learned in medical school, and getting out there and practicing and treating patients and seeing how that worked. After about three years I was pretty frustrated with what I could do to help people using the tools that I'd been taught, and actually at the same time I got introduced to acupuncture. This was about 1971, when, as David Bresler says, Richard Nixon discovered China, and acupuncture became big news in the States, and I got interested in that for relief of chronic pain and so on, and started to study traditional Chinese medicine -- sort of a circuitous, interesting, synchronistic route. This led me to a connection with a physician named Irving Oyle, who you may know, who's written a number of books.
MISHLOVE: Time, Space, and Mind.
ROSSMAN: Time, Space, and Mind, Magic, Mysticism, and Modern Medicine, The Healing Mind -- which in the early seventies, I think, were really quite visionary. Irving was, and still is, a general practitioner who pulled together a lot of the new physics, the new consciousness, the parapsychology, with biofeedback research, with Jungian psychology, and so on. He really had a gift for seeing how people's attitudes and thoughts and emotions and stress were wound up in their illnesses and their symptoms, and how to approach that to help them to unwind those tangles that we create for ourselves. He introduced me to imagery, really, in a clinical way.
MISHLOVE: Well, he was something of a pioneer in that field.
ROSSMAN: Very much so.
MISHLOVE: Now it seems that there's a new generation of practitioners such as yourself, who are really making advances in our understanding of working with imagery.
ROSSMAN: Well, there are whole societies now. I mean, there's three different societies for the study of mental imagery, in both medicine and psychology; there's the Society for Behavioral Medicine, which is sort of the more mainstream term for looking at attitudes and social interactions and health and so on. There of course are the two major hypnosis societies that have been in existence for thirty or forty years in the United States. But there's tremendous growth. You know this -- maybe five years ago there were half a dozen books on this kind of subject. There's literally hundreds now, and new journals and papers and publications. There's a tremendous avalanche of interest in this area.
MISHLOVE: One of the statistics that you've cited in the past that has impressed me quite a bit is the information that we're getting that when an average, typical patient comes to a medical doctor, what is the likelihood that conventional medicine will help that person?
ROSSMAN: Well, I think I mention this in my book, but when I was at this point in my career, when I was disenchanted and frustrated by what I had to offer people, I kind of took a look at my career, my practice, which was short, but it was enough. I looked back over three years, and I saw people mostly with chronic illnesses, and I estimated at that time that I could probably be of some significant help to maybe one out of three people. Part of my reevaluation of what I was doing in medicine, I kind of wondered, well, is there something wrong with me? Why am I just getting one out of three people, why can I help just one out of three? But I looked around, and I was well thought of; my consultants thought well of me. It wasn't that I was stupid. I wasn't missing things. I was doing things the way I was taught, and that was about it. A couple years later I read an editorial that was published in the New England Journal of Medicine, by a man named Franz Ingelfinger, who was an M.D., who was the editor of the New England Journal of Medicine, which is sort of the bible of conventional Western medicine; it's probably the most prestigious journal there is. He had presided over that journal for about forty years. He'd practiced medicine at Massachusetts General Hospital, in the New England patriarchy of leading fathers of American medicine, so he'd seen a lot of changes go by and a lot of different treatments. He wrote an editorial -- I think he was eighty-five, eighty-eight years old -- and he looked back over his forty years of practice, and his estimation was that Western medicine could help about ten percent of the people who came for help -- the technical aspects of Western medicine. He also estimated that for between nine and ten percent it was harmful. And so his conclusion was, after about fifty years of watching conventional Western medicine, that statistically it was about a wash as to whether it was helpful to anyone. That made me feel better; I thought I was helping one out of three. Maybe I was overestimating; maybe he was underestimating a little bit. But I think it's clear that Western medicine has its strengths, and you also have to look at statistically it might be a wash, but I know a number of people who wouldn't be alive today without good Western medicine -- they've got new organs, they've been brought back to life after a heart attack, after their heart has stopped, they've taken some kind of medicine which has eradicated an infectious disease or even a cancer. These people literally wouldn't be alive without modern medical advantages. I practiced emergency room medicine for seven or eight years while I was investigating acupuncture, investigating guided imagery and hypnosis and nutrition and biofeedback, and so on. I made my living by doing emergency room medicine, where Western medicine is at its strength. The forte of conventional Western medicine is in acute situations, emergency situations, life-threatening situations. Where it isn't as helpful is in the chronic illnesses, which are the major illnesses of our day, and the most prevalent, expensive, and life-debilitating kinds of diseases.
MISHLOVE: If you've got a broken bone, a doctor can be very helpful to you.
ROSSMAN: Yes, or if you have a heart attack a doctor can be very helpful. If you have something that's acute, if you're run over by a truck or you get a gunshot wound, a doctor could be very helpful to you in those situations -- can literally save your life and give you another chance, in the right situations. But in the longer-term kinds of chronic illnesses, in many of these things the major precipitating factors seem to be lifestyle and lifestyle choices. Many people say that these days we've come a long way against infectious diseases, largely through environmental kinds of cleanups and sanitation, also with antibiotics, and that the major pathogen in modern life is lifestyle -- is diet, is unmanaged stress, unresolved conflicts, emotional illiteracy, which is something that I think is really prevalent and that we need to learn more of in our society. And these kinds of stresses, basically stresses and nutritional deficiencies and excesses -- dysnutrition if you may say -- are really the major pathogens of our culture.
MISHLOVE: Well, how does mental imagery play a role in dealing with these issues?
ROSSMAN: Imagery is one of the natural ways that we process information and think, and it can be used in such a wide variety of ways it's almost difficult to encapsulate. But you can start with imagery is one of the quickest ways I know to relax, to induce a relaxation response. It's the opposite of a stress response; it can interrupt the physiologic effects of ongoing stress. Imagery can be used to stimulate specific reactions in the body, and there's a widespread literature, good literature, that shows that many people with imagery can affect physiological functions from heart rate, blood pressure, brain wave function, muscle tension, blood flow to different parts of the body, motility and secretions in the gastrointestinal tract, allergic responses, immune system responses, sexual arousal. So you can have direct effects on many physiologic functions with imagery, and the third major category that I think is so important and fascinating is what I think of as the receptive aspects of imagery, where you can learn to use imagery to learn more about yourself -- to become aware of emotional stresses or conflicts, or solutions to problems that you're stuck with; to use your mind creatively, to move beyond blocks, both internal and external, in your life, which can have direct or indirect health influences.
MISHLOVE: In other words, it's as if, if you're feeling like you're stuck somehow; you're in this condition of illness, and you just don't know what to do, you can relax and get some kind of a mental image which is often the subconscious mind's answer to your problem.
ROSSMAN: Exactly. The first step is to learn to relax, I think, and along with the relaxation to focus and concentrate the mind -- to create a relatively quiet -- and this of course is common to all forms of meditation, relaxation -- to quiet the mind and learn to concentrate. Most of us don't really have a very good ability to concentrate the mind at will, unless something really grabs our attention. Now, few things really grab your attention like a serious illness, and actually my friend and colleague Dr. Naomi Remen has sometimes said that illness could possibly be a peculiarly Western form of meditation, in that it sometimes grabs our attention like nothing else. But in our society we're kind of trained if we get sick, we get very frightened, which is natural; we run to the doctor. We say a symptom is a message. It means: "Run to your doctor." And I'm not saying stay away from your doctor, because I think that diagnosis is important, and knowing treatment options is important; but a symptom is a message from your own system, and imagery can be a way to get in touch with what's your body, what are your feelings, what's your spirit saying to you?
MISHLOVE: In other words, by dialoguing with your own symptom.
ROSSMAN: Yes, exactly. This is one of the skills that I teach in my book, in Healing Yourself, and in the tapes that I've created along with Naomi Remen's help. We teach people relaxation, we teach them to quiet their mind, we teach them to form images of their symptoms, and begin with a simple visualization where they get an image of the symptom. For instance, a person might get a fire in the stomach for a stomach pain, and then they might move from visualizing that to some kind of cool stream of water that would cool the fire -- a very simple fix-the-picture kind of thing. But a deeper level is to kind of explore the fire -- where did the fire come from? -- and look in this inner world, this inner fantasy world of imagery. It often leads people to very interesting places -- to connections with their relationships, with their outer world, with their work, or with their inner dynamics. So most people will agree, most conventional physicians will agree, that a symptom is a signal on the part of the organism that something needs attention and something needs to change, and the question has always been, how do you read that signal? How do you get in touch with the signal? I think that that's one of the major potentials and strengths of imagery -- that quieting the mind, allowing the body to express itself, instead of in the form of a symptom, asking it to convert it into a mental image.
MISHLOVE: It's as if the body has a language of its own.
ROSSMAN: It does have a language of its own.
MISHLOVE: It's not the linear language of our words and our normal thoughts. It's more symbolic.
ROSSMAN: Yes. I think the symbolic dimension is an interface language, in a sense, between what we call the body and what we call the mind -- which aren't really that clearly delineated, you know. It's as if you hold up a nickel, and where does the head end and where does the tail start? It's pretty hard to figure out. But for conversational purposes we talk about a body and we talk about the mind. They do express themselves in different ways. The mind has typically learned the language of the culture, and expresses itself in a linear, logical way, whereas usually -- and this is an over-generalization, but I think it's probably true ninety to ninety-five percent of the time -- if a physical symptom or illness is a manifestation of something that is stress-related or emotional or psychological or spiritual, the expression of it can be translated into a symbolic form. You can ask it, in other words, if you get quiet enough to listen, and say, "If you have a message for me, here I am. I'm getting quiet, I'm opening my mind, I'm creating a receptive space. Will you please tell me directly what you need? Is it a physical need? Is it an emotional need?" And in the emotional need I would include a variety of psychological and spiritual needs, because I think the emotions are the chemical alterations by which what have been called psychosomatic manifestations are mediated. The emotions are chemical states of the body -- chemical, electrical, energetic -- and by and large, I think, without an emotional reaction, if there's no emotion involved, I think by and large what we would classify as a psychological symptom is not about to make somebody sick. Likewise, without reaching the emotion, I think we are much less likely to help create a change that can allow the person to regain their healthy balance. And imagery seems to be a symbolic language of the nervous system that's very closely related to the emotions. This has been shown in many studies. We often talk about it as a right-brain language, and that metaphor, I think, is useful -- that the right brain in most people is specialized to recognize affect, to express affect through facial expression, tone of the voice, music. It recognizes and expresses affect, and imagery is a natural language of it. Some people think that using these inner dialogue techniques, you can think of it as a way of quieting your left brain and allowing the right brain to be sort of the liaison for the body and express symbolically what the nature of the need is that's being expressed in illness.
MISHLOVE: So it's really a process of self-exploration and self-knowledge.
ROSSMAN: Absolutely. It's a process of self-awareness and exploration.
MISHLOVE: In that sense it would seem to me that I wouldn't be over-generalizing to suggest that everybody who might be a medical patient could benefit from that.
ROSSMAN: Well, everybody who's not a medical patient could benefit from it. I think imagery is the ability to use -- let's say to relate to our unconscious mind, which I think is something that's vastly under-utilized in our culture. Partly I think that may be due to the Freudian description of the unconscious, which was in vogue for the first part of the century, where Freud tended to see the unconscious as sort of a repository for bad, caca ideas that were repressed and held out of consciousness. Then you had Jungian thought, and then Roberto Assagiolo, who developed psychosynthesis, and later thinkers, and transpersonal psychologists, who realized yes, there are repressed emotions and conflicts in the unconscious, but also the unconscious is the source of the conscious mind, and the unconscious is the source of creativity and inspiration and new solutions to old problems, and we can tap into that by learning how to use imagery. Imagery seems to be a relatively direct route to that.
MISHLOVE: One of the techniques that you've specialized in that I'm particularly fascinated by is the use of the inner advisor, or the inner guide.
ROSSMAN: Right.
MISHLOVE: It almost sounds like a lot of the new age discussion of spirit guides.
ROSSMAN: Exactly right, and many people believe that these are spirit guides, and other people don't, and clinically and practically I don't find that it matters at all. I find whatever a person is comfortable with, that belief system is perfectly fine -- whether they're a devout Catholic and they believe it's a holy guardian angel, or they're a new ager who believes it's an astral entity that's disembodied, or they're psychologically minded and they think, "Here's a way to tap into my own inner wisdom," or they're neurologically oriented, and they say, "Here's a representative of my right brain." The technique is very simple. I teach it in the book and in the tapes. It's a matter of relaxing, getting quiet, going through a process to do that, going to an inner place that you imagine as being very quiet and peaceful, and then imagining that you're there with a wise, loving figure that knows you very well. This could be a religious figure, it could be someone you know, it could be an animal, it could be a tree. I encourage people to allow the figure to manifest itself, and then to have a conversation with it, follow it out and see where it goes. It's fascinating where some of these conversations go. I think of the inner advisor as a way to get in touch with the vast store of information and knowledge we do have stored about ourselves, that we rarely if ever use. It's a way to get to another perspective about ourselves.
MISHLOVE: Are there any negative side effects from this kind of work? I mean, do people get bad advice from their inner advisors?
ROSSMAN: Yes, once in a while. You have to be discriminating about the kind of advice you get from inner voices. You know, Son of Sam had inner voices. People have inner voices that tell them to crawl up on a gun tower and shoot twenty people. So there's an ethical component to it. You explore within yourself, and find what is the inner demand that's being expressed in terms of these symptoms. Usually what you'll find is that there's some obstruction to manifesting that demand. Now, psychologically you could easily say this is a classic conflict between basic instinctual urges and socialization, and what we can and cannot do. We all need to form a healthy balance with that. Many people have a big war going on there that's unresolved. I've never had an inner advisor give anyone advice like that, but sometimes an inner advisor will give people advice that's kind of risky for them. They might say you need to talk more frankly with your husband. They might say, you need to change your job -- that this isn't right for you, that you have to move on in your life, you have to let yourself be more assertive and expressive of your emotions. Typically you'll find that there's some resistance to that, Jeff. My observation, and it makes sense to me, is that if there weren't resistance to it, there wouldn't be a symptom or an illness -- that if it was an unobstructed desire, it would just be manifest in our life. So a lot of the imagery work -- and I try to teach skills that are applicable to this as well, within the practice and in the book -- are how to keep this dialogue going, and then bringing the advice back, taking a look at it, seeing what would happen if you acted on this in your life, what would be the risks, what are the benefits, what are the barriers, is it an ethical thing to do, is there another way to deal with the situation?
MISHLOVE: In other words, it seems to me that through this process of imagery, that what you're saying is that you honor the symptom as a teacher for you in your life, and if you feel resistance to what the lesson is, you honor that resistance.
ROSSMAN: You honor that too, exactly right. The process that I have found most congruent with my own belief system, and that of most of my patients, and that works the best, at least in my hands, is one of honoring everything that comes up, and in a sense allowing it to take an image, to clothe itself in an image. You see, "Take an image, so that I can begin this dialogue with you. Why are you here, and what do you want? What's important to you?" You let the images actually answer. Because in a sense -- another way of looking at things -- we have this illusion that we're sort of one person, whereas you could also look at us as really a community. Some people talk about that we're a different person to our children, we're a different person to our parents, we put on a different face or a different role. We're a different person to our boss, we're a different person professionally -- not that we're multiple personalities, but we're a committee. We display different aspects of ourselves, and they're all very real. The trouble is they have to share one body, and sometimes some part gets left out, and it gets blocked access to the body, it's blocked access to expression in the life. And if it has enough energy behind it, if it's an important enough need, it will mobilize enough energy to somehow get itself expressed.
MISHLOVE: Right, as a symptom.
ROSSMAN: As a symptom. And basically what it's saying is, "Hey, me too. I'm here. You can't just go on and ignore me." You say, "Come to me, take an image; let me know why you're here. What do you want?" And you begin what's really a negotiating process.
MISHLOVE: So in other words, the use of imagery in this sense is a question of being whole again, is bringing the committee together into a sense of oneness. Well, Marty Rossman, we're out of time. A good note to end on. Marty, thank you very much for being with me.
ROSSMAN: Thanks for having me, Jeff.
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