Jenn Krebs Rapkin, ND

Tolle Totum

As naturopathic physicians, we are taught and mandated to treat the whole person – body, mind, and spirit. Our training, however, has and continues to be almost exclusively focused on the physical and emotional aspects of a person. There is a growing belief and understanding that spiritual crises (defined as significant dissonance between the life one is leading and his/her values, beliefs, identity, and sense of purpose) can contribute to both physical and mental imbalance. If, philosophically, we are physicians who instruct and guide patients toward a healthier life, we have both a responsibility and a unique opportunity to pave the way for a meaningful integration of medicine and spirituality.

Fear of offending or going to an unfamiliar place with a patient can create a hesitancy or reluctance to broach the subject of spirituality. But, for doctors that delve into spiritual discussions, we find patients hungry for connection on a soul level and for guidance on how to live a more meaningful and purposeful life. Integrating spirituality into a naturopathic practice can mean many things, and does not have to imply talking about religion or God. While one patient may rely heavily on his/her religious faith during a health challenge, another patient may call upon spending time in nature to fill his/her spiritual coffers. “Spirituality is accessible to all of us whether or not we belong to any religious group.”¹

There are many spiritual principles, practices, and ideas that physicians can call upon when working with patients to further the healing relationship. Meditation is a great tool for introducing patients to the concepts of being more present and living in the moment. Spiritual practices of gratitude, self-acceptance, and compassion can be incorporated into daily behaviors and daily life. Discussions about letting go of ego and judgment can bring awareness and understanding of how we resist and defend against change. Asking questions about a patient’s relationships and support network can reveal invaluable information about a patient’s sense of community and connectedness, or lack thereof.

Weaving these concepts into patient intakes fosters strong patient-doctor relationships and creates an environment in which patients feel heard and validated. In my experience, patients find vital guidance and insight when applying spiritual principles and practices to their lives and to their health challenges. Incorporating these practices into patient visits and into protocols and recommendations can manifest in individuals making life-changing decisions, experiencing major shifts in perspective, establishing healthier boundaries, and making a stronger commitment to wellness and well-being.

Living in the Moment

During health challenges and stressful times, we often focus on the things that are wrong with our lives, the people who have wronged or wounded us, and the frustrations and challenges of our daily existence. While these things are important to identify, as they can be “obstacles to cure” and rationale for making significant life change, focusing on negative aspects of our lives can also promote feelings of helplessness, hopelessness, and powerlessness. “The mind’s never-ending chitchat eats away at well-being.”²

Living in the moment means being present with ourselves (our sensations, our inner experience, and our feelings) and quieting our mind’s chatter. Our mind loves to wander, and it prefers to spend time in the future, worrying about things to come, or in the past, ruminating about past conversations or experiences. Letting go of attachments, expectations, and regrets is also a part of embracing each moment and living with gratitude. “We spend our lives searching for something we think we don’t have, something that will make us happy. But the key to our deepest happiness lies in changing our vision of where to seek it.”³   Releasing ourselves from a preoccupation with and an attachment to our future and past selves, we exist in the now – in this very moment.

Compassion, Self-Acceptance, & Self-Love

We live in a high-pressure and competitive world. We feed the critical voice within us, with thoughts of “I am not enough” and “I should be doing and accomplishing more.” This critical voice can rule our thoughts and cause us to judge and condemn our bodies and behaviors. When we are critical and judgmental of ourselves, we are critical and judgmental of the world around us, and vice versa. And when we see our lives through the lens of “I am not enough,” our self-esteem suffers, and our capacity for self-care is limited. I am constantly amazed at how a patient’s response to the question “What do you think and believe about yourself?” coincides with how that patient takes care for him/herself; when we don’t feel worthy of love and care, we often respond by not loving and caring for ourselves.

“If you doubt the damage caused by lack of self-love in our lives, you have only to look around you… We poison and numb ourselves with cigarettes, tranquilizers, drugs, alcohol and unhealthy diets, and we seek out relationships that can never work in a desperate attempt to convince ourselves of our own value. No relationship in the world can make us feel worthy if we don’t know that we are.”⁴

When we give ourselves permission to compassionately accept and embrace ourselves in our successes and failures and in our perfection and imperfection, we grow our ability to love and care for ourselves. “There is something wonderfully bold and liberating about saying yes to our entire imperfect and messy life.”⁵ Growing our sense of self-worth results in a stronger commitment to (and a greater motivation for) making healthier choices. This increase in self-care and self-worth translates into improved compliance and commitment to naturopathic recommendations and protocols.

Letting Go of Ego

The ego is the part of us that gets resentful, possessive, jealous, and fearful. Our ego wants desperately to protect us, but often does so in a manner that creates defensiveness and judgment. Ego creates a belief that we need approval, that we need to feel superior, and that we need to be in control. When we see resistance to change in our patients, or when we see patients hanging onto dysfunctional behaviors and relationships, we see egos that are fearful and defended.

As physicians, we inevitably work with patients that are defensive and controlling, and because of that we have an opportunity to, kindly and gently, point out patterns of behavior that may be holding them back from a healthier and more fulfilling life. Talking with patients about their patterns of resistance and control can be incredibly insightful and life-changing; in my experience, patients often take a breath and nod with a sense of relief when I point out, with compassion and without judgment, a defensive or guarded behavior (like a patient’s need to be right or in control). When patients gain awareness of how they react and behave, they begin to be less defensive, more open to change, and more willing to try something new.

 Creating and Manifesting the Life We Want

In Chakra theory, there 2 two currents of energy that flow through our chakra system: one is an upward energy that liberates us toward a higher consciousness and growth, and the other is a downward energy that grounds us toward the earth where our thoughts and ideas become words and actions. There must be a balance between these 2 currents in order for us to create the lives we want. “Only through embodiment can consciousness manifest.”⁶

It is a common human experience to feel that we are not living the life we were meant to live. We have all worked with patients who feel stuck, lack motivation, and are powerless to act or make a change in their lives. An example of an individual who has an imbalance in the chakra currents is someone who lives entirely in his/her head and dismisses or ignores the body; this individual may struggle to make his/her thoughts and dreams a reality.

We see patients failing to take action regarding their health, their finances, their personal goals, and so on. Repetitive behaviors and limiting mindsets keep patients paralyzed with fear – fear of taking risks in their personal and/or professional life. Another spiritual lesson awaits us when we can begin to see the world as full of opportunity and abundance, and our lives as pure potential. Engaging in conversations with patients about taking action, and embracing the possibilities in their lives, is where motivation and – perhaps, more importantly, inspiration – is born.

We Are One

For many, spirituality means feeling a connection to something greater than ourselves. Feeling alone in the world creates isolation and fear. The simple fact that we are not alone in our suffering brings enormous relief to individuals dealing with physical and mental illnesses. Group therapy and self-help groups create communities that offer connecting, sharing, and bonding opportunities that heal.

Whether the connection is to ourselves, nature, a community, a god, the universe, or something else, the connection tells us that we are part of a whole, of something greater. Thich Nhat Hanh, a Buddhist Zen master and scholar, talks about the concept of Interbeing, where we are all a part of everything else; we are “empty of one thing only: a separate self.”⁷ These concepts connect us and lift us above and beyond our individual struggles.

Summary

Caroline Myss, an author and lecturer in the field of human consciousness, writes and speaks about how spiritual crisis can be mistaken as physical or mental illness. She explains how clinical depression can be a spiritual crisis of “the dark night of the soul.”⁸ While depression is often treated with medication, the illness may benefit more from being “examined and understood as a progression of self-realization and illumination, in the deepest sense, of what it means to come to know one’s inner self.”⁸ When there exists dissonance between the lives we lead and what we believe or know to be our purpose, our identity, our values, and our beliefs, we struggle, and that struggle can manifest in the body. “The body is the soul presented in its richest and most expressive form.”⁹

Treat the Whole Person, Doctor as Teacher, and Identify and Treat the Causes are part of our naturopathic doctrine. We, as naturopathic physicians, are entrusted with the care of the “whole patient.” Acknowledging that the care of the whole patient includes taking care of our patients’ sense of meaning, purpose, identity, and connectedness allows us to embrace spirituality and employ its principles and practices liberally.

As a naturopathic physician interested in spirituality, I appreciate and value this quote: “Nature is a great teacher. It moves through cycles of death and rebirth without regret, without attachments, with noblesse oblige, a pure spirit regenerating itself over and over again. It beckons man to learn its simple lessons of life and truth.”¹⁰ Naturopathic philosophy is spiritual in nature; after all, we are all part of nature, we are nature, and we heal with nature. We are one.

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Jenn Krebs Rapkin, N.D. specializes in integrative mental health and mind-body medicine. In private practice for over 12 years, she is a graduate of UBCNM and currently teaches mind-body medicine to UBCNM students. She developed and practices her own specialized Narrative Body Therapy and is the founder of A Mind-Body Practice, a private practice that specializes in opening a dialogue and making connections between the emotional, physical, and spiritual aspects of a patient. Dr Rapkin is the author of 2 blogs (The Mind-Body Blog and the Mommy Tune-up), where she writes regularly on the daily experiment we call life. She lives with her husband and 2 young children in Guilford, CT.

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References

1. Gordon JS. Spirituality: The Blessing. In: Unstuck. New York, NY: Penguin Group; 2008.
2. Perrin S. The Goals of Spiritual Work. In: A Deeper Surrender: Notes on a Spiritual Life. Charlottesville, VA: Hampton Roads Publishing Company; 2001.
3. Salzberg S. The Revolutionary Art of Happiness. In: Loving-Kindness: The Revolutionary Art of Happiness. Boston, MA: Shambhala Publications; 1995.
4. Siegel BS. Healing the Child Within. In: Peace, Love and Healing: Bodymind Communication and the Path to Self-Healing: An Exploration. New York, NY: Harper Perennial; 1989.
5. Brach T. Unconditional Friendliness: The Spirit of Radical Acceptance. In: Radical Acceptance: Embracing Your Life With the Heart of a Buddha. New York, NY: Bantam Dell; 2003.
6. Judith A. Introduction: Sacred Centers of the Self. In: Eastern Body Western Mind: Psychology and the Chakra System as a Path to the Self. Revised. Berkeley, CA: Celestial Arts; 2004.
7. Nhat Hanh T. The Gift of Fearlessness. In: Fear: Essential Wisdom for Getting Through the Storm. New York, NY: HarperOne; 2012.
8. Myss CM. The Third Truth: Courageously Navigate the Dark Night of the Soul. In: Defy Gravity: Healing Beyond the Bounds of Reason. Carlsbad, CA: Hay House, Inc.; 2009.
9. Moore T. The Bodies Poetics of Illness. In: Care of the Soul: A Guide for Cultivating Depth and Sacredness in Everyday Life. New York, NY: HarperCollins Publishers, Inc; 1992.
10. Perrin S. What’s Killing You Can Give You Life. In: A Deeper Surrender: Notes on a Spiritual Life. Charlottesville, VA: Hampton Roads Publishing Company; 2001.