A Healing Space for Caregiver and Patient

A Healing Space for Caregiver and Patient

This paper proposes a novel therapeutic clinic model that embodies and operationalizes an interdisciplinary approach to healing that transcends traditional biomedical paradigms. Drawing upon critiques of Cartesian dualism in modern medicine and the integration of spirituality, music, and attentive listening into clinical practice, this paper offers a comprehensive framework for a healing environment. The proposed model emphasizes the essential unity of mind, body, and spirit while creating spaces for therapeutic encounters that honor the full personhood of patients. Through architectural design, staffing structures, clinical protocols, and technological integration, this clinic represents a practical manifestation of a holistic healing philosophy, offering a template for healthcare delivery that addresses the limitations of reductionist approaches to healing.

The Absent Healer

The Absent Healer

This paper argues that clinicians can draw on these diverse intellectual traditions to develop more nuanced approaches to patients experiencing spiritual crises, trauma, and existential suffering. Through case examples and theoretical integration, we demonstrate how these frameworks can help clinicians navigate questions of meaning, purpose, and ethical responsibility when working with patients confronting profound suffering. Drawing on original research examining the liminality of the suffering experience, we propose a therapeutic stance that acknowledges the value of witnessing, the generative nature of absence, and the ethical implications of concealment in clinical practice.

Comparing and Integrating the 12 Step Recovery and Classical Medical Models

Comparing and Integrating the 12 Step Recovery and Classical Medical Models

This paper explores the historical development, theoretical foundations, and practical applications of two prominent approaches to understanding and treating addiction: the 12-Step recovery model, which conceptualizes addiction as a "dis-ease," and the classical medical model, which frames addiction within allopathic healing paradigms. Through critical analysis of their respective strengths and limitations, this paper proposes an integrated framework that harmonizes these seemingly disparate approaches to enhance treatment outcomes. The integration acknowledges the biological, psychological, social, and spiritual dimensions of addiction, offering a more comprehensive approach to recovery. This integration framework is particularly relevant for physicians and other medical practitioners seeking to provide more holistic care for patients with substance use disorders.

Sacred and Profane Space in the Therapeutic Encounter

Sacred and Profane Space in the Therapeutic Encounter

This article examines the therapeutic relationship between physician and patient through the lens of sacred and profane space. Drawing on anthropological, sociological, philosophical, and theological frameworks, we analyze how the rigid distinction between sacred and profane domains creates unnecessary tensions within healthcare settings. By reconceptualizing the therapeutic encounter as a liminal zone where these categories blend and transform, we offer healthcare practitioners a framework for understanding and improving patient-provider relationships. The metaphor of "patient as sacred text" is explored as a hermeneutic approach that respects both the scientific basis of medicine and the interpretive nature of the clinical encounter. The article concludes with practical implications for clinical practice that acknowledge both the technical and relational dimensions of healthcare.

Hermeneutic Approaches to Medicine

Hermeneutic Approaches to Medicine

This paper examines various hermeneutic frameworks applied to the medical context, comparing approaches that focus on the interpretation of medical literature with those that view the patient as a text requiring interpretation. Beginning with Matthew Links' analysis of evidence-based medicine as analogous to religious textual interpretation, we expand the comparison to include narrative medicine, anthropological perspectives on illness narratives, the Buddhist concept of upaya (skillful means), and the emerging concept of the "patient as sacred text." Through this analysis, we identify common threads and distinctive contributions of each approach, arguing that the metaphor of patient-as-text offers unique insights into the ethical dimensions of clinical practice. We conclude that an integrated hermeneutic approach to both medical evidence and patient encounters may enhance clinical practice by combining scientific rigor with interpretive wisdom.

The Crisis of Language in Therapeutic Spaces

The Crisis of Language in Therapeutic Spaces

My own clinical work has brought these theoretical concerns into sharp relief. In my therapeutic practice, I have repeatedly encountered the limitations of conventional clinical discourse when working with patients with chornic neurological disease whose experiences resist categorization or exceed the boundaries of diagnostic language. My patients experiencing profound spiritual crises, existential uncertainties, or trauma that defies articulation often struggle against the very linguistic frameworks intended to facilitate healing. My recent essays document this ongoing tension between the therapeutic imperative to speak and the frequent inadequacy of words to capture lived experience. These professional challenges have led me to explore mystical traditions not as abstract alternatives but as practical resources for expanding therapeutic dialogue beyond its conventional constraints. This paper thus emerges from both scholarly inquiry and pressing clinical concerns about how language both enables and constrains the healing process.

Evidence Distortion and Clinical Decision-Making

Evidence Distortion and Clinical Decision-Making

This paper examines the complex interplay between placebo and nocebo effects in pharmaceutical treatments and how these psychobiological phenomena are leveraged or obscured through pharmaceutical industry influence. We integrate neurobiological research on placebo/nocebo mechanisms with analyses of industry marketing tactics, regulatory approval processes, and impacts on the therapeutic relationship. The robust evidence of placebo responses across various conditions is contrasted with less-studied but equally important nocebo effects, revealing how industry influence can systematically amplify perceived benefits while minimizing apparent risks.

A New Vision for the Physician-Patient Relationship

A New Vision for the Physician-Patient Relationship

Contemporary healthcare exists at a crossroads. Despite remarkable technological advancements, there remains a profound disconnect between practitioners and patients, between clinical protocols and lived experiences of illness. This article proposes a new paradigm for the therapeutic relationship that transcends the limitations of the current biomedical model. Drawing upon a body of work that spans neurobiology, spirituality, philosophy, and clinical practice, I present an integrated framework that reimagines the physician-patient relationship as a sacred encounter characterized by presence, intuition, and mutual transformation.

The Unspoken Terror

The Unspoken Terror

This paper examines the paradoxical avoidance of mortality discussions in clinical settings, particularly with patients facing chronic disease and degenerative neurological conditions. Drawing on theological frameworks of divine presence manifesting through absence as articulated in the author's previous works, this analysis proposes that clinicians' systematic avoidance of death-related dialogue creates an "elephant in the therapeutic room" that undermines effective care.

Navigating the Depths

Navigating the Depths

This paper explores the unique dimensions of grief experienced by physicians and healthcare givers throughout their professional careers. Drawing from the foundational grief work of Francis Weller and integrating clinical experience, this paper proposes a framework for understanding and processing physician grief. The medical profession's culture of emotional stoicism and the cumulative impact of unprocessed grief are examined, alongside practical approaches for individual and systemic healing. The integration of grief work into medical training and practice is presented as essential for physician wellbeing and sustainable caregiving.

The Compromised Healer

The Compromised Healer

This article examines the moral ambiguity inherent in the physician's role through comparative analysis of literary narratives and historical events. Drawing on Rumi's parable of the lovesick maiden, Zohar's midrashic teachings on spiritual healing, and the historical reality of medical atrocities during the Holocaust and later in Russia and China’ state hospitals, the paper explores how physicians navigate the tension between their healing mandate and potential for harm. The physician archetype emerges as paradoxically capable of both profound healing and devastating destruction, particularly when moral autonomy becomes compromised by external authority or ideological capture.

"Coming to Believe" in a Post-Belief World

"Coming to Believe" in a Post-Belief World

blurb: This paper examines the theological and existential tensions embedded in “Step 2” of the Alcoholics Anonymous 12-Step program within a clinical framework, particularly exploring the neurobiological, psychological, and spiritual dimensions of recovery from trauma, addiction, and chronic pain.

Drawing on a multidisciplinary approach that integrates evidence from addiction medicine, Jungian psychology, post-Holocaust theology, Hasidic mysticism, and Eastern contemplative traditions, this paper explores how patients navigate the paradoxical nature of belief in a "Power greater than ourselves" within a fragmented and morally compromised world.

The Absent Divine and the Problem of Evil

The Absent Divine and the Problem of Evil

The Spiritual Space Between Nurse and Patient

The Spiritual Space Between Nurse and Patient

This essay explores the complex, often unacknowledged spiritual dimension that emerges in the nurse-patient relationship. Drawing from phenomenological research and clinical narratives, we examine how meaningful connections transcend clinical interventions, creating a sacred intersubjective space where healing extends beyond physical care.

Divine Presence in Healing

Divine Presence in Healing: A Kabbalistic Approach to Compassionate Care

As healers, we stand at the intersection of science and spirit, technique and presence. The way we conceptualize the divine—whether as a personal being or an impersonal force—profoundly shapes our approach to patient care. Drawing from Kabbalistic wisdom, I have found that integrating both Western and Eastern understandings of divinity can transform the healing relationship. This synthesis offers a framework for compassionate care that honors both personal connection and transcendent awareness in the sacred space between healer and patient.

Divine Presence and Concealement

Divine Presence and Concealement

In the space between the caregiver and the patient is a matrix depending upon your worldview- of emptiness, presence (I-Thou) or divine presence. A theoretical framework for the possibility of the divine within our interactions with patients requires a basic understanding of the theological and philosophical issues.

The Influence of AI in Medical Ethics and Warfare

The Influence of AI in Medical Ethics and Warfare

In thinking about the future revolution that is currently underway in artificial intelligence and its impact on our lives, we must imagine the ethical implications when non-human systems make what was until now human choices. Nowhere will this impact humanity than in the field of medicine and warfare. In these two poles of human action, saving life, and destroying life, AI will exert its influence for the better or for worse. In this review article I will compare these two opposite paradigms of human activity, those of healing and destroying.

My Own Spiritual Crisis II

My Own Spiritual Crisis II

In my prior essay I claimed that until I understood my own inner spiritual crisis I cannot begin to entertain a therapeutic space with my patients that allows for a spiritual healing beyond the physical symptoms and history as presented by the patient. To continue the inquiry we dig deeper into the subtext and real anguish presenting itself requires a self-understanding of those psychological and spiritual barriers I myself suffer from first.

My Own Spiritual Crisis

My Own Spiritual Crisis

It has become clearer over the years that until I understand my own inner spiritual crisis I cannot begin to entertain a therapeutic space with my patients that allows for a spiritual healing beyond the physical symptoms and psychological barriers to health.

Crisis of Soul II

Crisis of Soul II

In my prior essay I claimed everything we know is embodied and cannot be abstracted without distorting its essential nature.

In this essay I develop the possibility for a neuro-anatomical basis for spiritual encounter within clinical practice based on recent science.