Psychiatry, Native American traditions, and Integrative Medicine
Answering this question, as part of a larger inquiry into integrative medicine, psychiatrist and integrative physician David Kopacz, and Native American visionary Joseph Rael (Beautiful Painted Arrow), have written Walking the Medicine Wheel: Healing Trauma & PTSD.
The book includes a list of ceremonies, as well as didactic content from the psychiatric perspective and beautiful story-telling from the Native American traditions, and imagery drawn from the dreamed paintings of Joseph Real.
The reason I am writing this review is that Dr. Kopacz originally contacted me as an integrative medicine lawyer, and asked me to post my thoughts on the book. To do it justice, I would have to do the exercises and ceremonies, in toto, and let the currents of experience wash through me; then probably write a new volume about the results. Meanwhile, let me absorb what I can and report out. This is going to be idiosyncratic.
Offering of the Heart
The book opens with an image from Joseph Beautiful Painted Arrow entitled, Offering of the Heart. The entire book is thus a heart offering to those suffering from trauma and PTSD. It should be of interest to psychiatrists, social workers, and other clinicians as well.
When I see the inscription to many individuals, to those who pray for world peace, and to “the two-legged, the four-leggeds,” I am reminded of how Native American spirituality and traditions have influenced my life.
I’ve had cats, and dogs – or rather, as these have been my companions, I have seen them as “four-leggeds,” soulful creature like me, who share space and their heart-offerings, with four instead of two legs.
I first came across these rich treasures of layered thought and emotion and spirituality from Native American traditions while a student at the Barbara Brennan School of Healing. I was a Wall Street lawyer, with narrow Italian leather shoes, a yellow power-tie of the times, a Brooks Brothers suit, and in denial of the fact that the voice of Spirit was already coursing through my being, whispering in dreams and visions and in daylight as well as the night. This shamanistic journeying had been going on since my days as a freshman at Columbia University, back in John Jay Hall (and probably even earlier, to the age of 7 when I had an out-of-body experience, or possibly back to a traumatic incident at 3), but it took four years of study of energy healing, supported by teachers and fellow mystics journeying into the Self, even while still working as a Wall Street lawyer, to absorb and acclimate and acknowledge my inner heritage.
At Barbara Brennan’s school, I was drumming and chanting and bowing to the four directions, even as the styling gel pressed the hair to my head (metaphorically) so that I could safely navigate the corridors of my Wall Street law firm, and the pressing securities law issues that I was called to master as a first-year attorney. In those four years, I traveled what the book’s authors call the longest journey—that from head to heart.
The book’s next image is called, Planting the Seed of the Heart – and this is indeed where it all began for me, and where the warrior’s journey of healing begins in the authors’ eyes.
Walking the Medicine Wheel opens by talking about Orientation: this means “we know where we are and we know our relationship to the world around us.”
In a broad sense, isn’t the fundamental affliction of humanity (including political leaders), the lack of orientation? We attack when we don’t know who we are. We are disoriented – personally and collectively:
When we are disoriented, we lose our bearings and the world no longer makes sense, even our own lives make no sense. We are lost. When lost, we need to find our bearings and re-orient ourselves. There are inner and outer worlds and re-orientation requires walking in both realms. The outer realm’s directions are north, south, east, and west. The inner realm’s directions are spiritual, emotional, mental, and physical.
This is the fundamental premise of the book. Trauma disorients us, and to regain our orientation, we must travel inwardly as well as outwardly. The medicine wheel emblemizes both journeys.
This is one of the great teachings of the book.
We are all Earth and Sky. War of any nature separates us from our true nature. Ceremony restores us.
Joseph uses light, breath, imagery, and sound; he draws on visions to channel wisdom and initiate healing.
David brings his skills and insights as a clinician to bear on this powerful collaboration. He looks at PTSD from one perspective, that of Joseph Campbell’s monomyth, as a hero’s journey of “story, culture, and initiation rather than purely as a biomedical mental disorder.”
As he explains:
During my intensive medical education, I felt like I was losing important parts of my humanity through my training to become a medical technician. This scientific and materialistic curriculum taught me to view the body only as a machine. I felt dehumanized and lost my sense of spiritual nature as a human being as I learned to see illness only in terms of biological and chemical management. In response to this biomedical curriculum, I developed a “counter-curriculum” of rehumanization. I actively sought to renew my sacred human nature through poetry, art, literature, and meditation.
Integrative medicine doctors, can you relate? Patients, does this make sense? Here an MD is saying that he “learned to see illness only in terms of biological and chemical management.” How dis-heartening.
In response, he reconnected personally with his own heart. Now, professionally, as a clinician and educator, he offers a “primary paradigm shift” of “seeing trauma as an opportunity for deeper human initiation rather than only as a ‘disorder.’”
The Medicine Wheel
The Medicine Wheel “is the circle of life.” It embodies the four directions yet also mirrors our inner trajectory.
The story of war is archetypical, and ancient.
The Medicine Wheel organizes experience, including suffering which is part of life.
In its circular journey, the Medicine Wheel facilities reintegration into wholeness and health.
Dr. David draws the distinction between healing and curing, and states that healing “is about transformation and new growth:”
Walking the Medicine Wheel is a way of changing one’s paradigm and one’s story about trauma, pain, and loss … leading to new growth, meaning, and purpose.
The goal is to “again find peace in our bodies, our hearts, our minds, and our souls.”
War, Trauma, and PTSD
I have barely dipped into the richness of the book. It has to be read slowly, carefully, savored. There are many insights, and healing in the stories and imagery.
The authors state that the “source of war is fear.” The “antidote … is to reconnect to home … a physical place as well as a place we reconnect to in our hearts.”
As a clinician, Dr. D does discuss such clinical matters as avoidance, re-experiencing, hyperarousal, and other symptoms of PTSD. He writes about his experience with VA patients. Grounded in conventional treatment methods, he then ventures into therapeutic approaches that incorporate spirituality, transformation, and healing. He cites Jung and Campbell as progenitors of therapeutic approaches that locate the source of healing in personal transformation. He notes that anything can serve as “medicine,” if properly used for that purpose – including a story, a poem, a thought.
Part of the method focuses on “play,” which means “strengthening oneself:”
As adults, our work loses its joyfulness and self-expression, and becomes drudgery.
By focusing on inner work with a sense of play, healing is given space.
Jung is central to Dr. Kopacz’s work (Kopacz apparently means “digger,” he tells us):
Jung believed that people do not tackle many different problems in their lives, but rather they work on the same problem repeatedly from different angles and deeper perspectives. The answer to a person’s central “problem” becomes their life and work.
Brilliant and true. And Dr. Kopacz backs this up with his own story. He takes off the mask of the psychiatrist who is busy diagnosing others, and tells his own journey of healing and transformation. In this way, the book is also an autobiographical journey of a healer from college questioning and deep self-inquiry through professional life as a mainstream psychiatrist.
Even from this perspective alone, the book is rare and valuable. A kind of Augustinian Confessions snakes through the narrative.
I relate. This has been a form of my own writings, including Healing at the Borderline of Medicine & Religion, to which Medicine Wheel alludes with a reference to “medical pluralism.”
There is a trauma, it seems to me, in the way our professional lives rip us apart from our deepest yearnings to be, to actualize, to trespass conventional boundaries. The roles give us order, organize our skills to bring us outward into the world, and in ideal circumstances, channel our inner being in paths of service (that also provide sufficient monetary reward for a life in the world). Like any form of socialization, they also tame the wild beast within, the primal voice that seeks unbridled expression; as Nietzsche might have said, the Apollonian subdues the Dionysian, or at least channels it in socially acceptable form. This creates tension. We want to be who we are; we also live in a certain ordered, albeit chaotic, world.
Dr. Kopacz refers to this tension as “inside/outside,” and asserts that it is a powerful wave that veterans seek to harmonize as well. Like shamans, veterans have “stepped outside,” and “may never fit back in.”
PTSD—death and rebirth
Dr. Kopacz writes:
PTSD often creates nightmares and flashbacks in which images of traumatic situations echo and repeat throughout time.
He quotes Rilke:
Work of the eyes is done, now
Go and do heart-work
On all the images imprisoned within you
He then speaks of the tasks of “giving, receiving, purifying.” Trauma is like the Tibetan bardo, an in-between state of death and rebirth.
The book gives specific instructions for walking the medicine wheel of healing trauma and PTSD. These, I’ll leave to the reader. Their intention is to restore “sacredness.”
Importantly, the book notes that “the real importance of ceremony is that we are not just going through meaningless motions, but that our motions are full of deep meaning, our motions are the motions of creation.”
Healing not only helps the person – it changes the cosmos.
That is why this is such an important book. Walking the Medicine Wheel shares wisdom from two divergent traditions—one clinical and the other focused on healing through imagery, sound, poetry, introspection, visioning. The quest is nothing less than clearing the fog of the aftermath of war, instilling sacredness, and reclaiming the whole self.