Medical Materialism, Shamanic Healing, and the Allopathic Paradigm
Western Medical practice is a system creating weary professionals and disgruntled patients. Physicians are combating the rising costs of managing an office, while the specters of malpractice insurance and decreased reimbursements are leaving physicians and patients disillusioned.
Kalweit (1987) has described the current state of our medical system; "our bureaucratized and materialistic medicine -- this mechanical model with an active therapist and a passive patient that reduces the patient to an object and relegates healing to the long corridors of the hospital has failed" (p.2). This statement, that Western medicine has active healers and passive patients, is not unique to this part of the world, but it has created a paternalistic and materialistic culture. Western medicine has lost its grounding, and in so doing, has become devoid of the natural healing processes on which it was founded. Care of the patient and community has been replaced with business reports and evidence based medicine (Block, 2008). In fact, many Western Medical societies have gone so far as to say that there is no place for religion or spirituality in medicine (Block, p. 9).
The concept that medical practice has become purely scientific effectively filters out spiritual and transpersonal experiences acquired by the healer and the patient. Medical scientists who have shunned spirituality in medicine in the name of scientific exploration are creating a distorted world view. This scientific world view is described by Wilber (1999-2000) in his discussion of the Pre/Trans fallacy. In his discussion, Wilber makes a parallel argument that scientific or medical materialists assume that human beings do not have access to transpersonal experiences, "once this confusion occurs -- the confusion of "pre" and "trans" -- then one of two things inevitably happens: the transitional realms are reduced to prepersonal status, or the prerational realms are elevated to transrational glory" (Wilber, p. 333).
Maslow (1970) has historically detailed that humans are capable of peak experiences. Peak experiences can take the form of extraordinary healings achieved by shamanic practitioners, and under the scope of medical materialism, these healings are reduced to scientific relationships. Medical materialists have for centuries attempted to explain the healings and psychopomp of saints, mystics, and shamans as simply reactions of the human brain to external stimuli. Pioneers of psychology and extraordinary experiences have made reference to medical materialism in their work.
Medical materialism finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as a hysteric, and Saint Francis of Assisi as a hereditary degenerate (James, 2002, p.16).
Indigenous shamanic practitioners, on the other hand, practice healing with an eye towards imagery and community (Achterberg, 1985). In his monumental work,Eliade (1964) discusses the three stages of becoming a shaman: election, instruction, and initiation. Samuels and Rockwood-Lane (2003) have taken Eliade's three stages and added a fourth, "the practice of shamanism" (p.15).
The first stage to becoming a healer, as described by Eliade, is that of the calling; this call comes from the family, community, or from world beyond. Shamans are called, and then receive rigorous instruction, followed by initiation and practice. Allopathic physicians have similar stages of development: the call to be a physician, followed by the structured education of medical school, the initiation of residency, and ultimately the practice of medicine in the community. In this paper, I will explore the similarities between allopathic medicine and shamanic practice and the call to be a healer.
Is there a reason one is called to practice medicine? Like the indigenous shamans, there are multiple reasons one receives the call. Whether one is a healer in the allopathic model or based in the imagery of the shamanic states of consciousness, there is a healing between the patient and healer. The mechanisms and the practice of medicine differ from culture to culture, but the call to heal transcends culture and materialism.
Eliade (1964) has stated that the call to be a shaman comes as "the hereditary transmission of the shamanic profession, spontaneous vocation, or the prompting of one's own free will or the will of the clan" (p.13). The calling of an allopathic physician is also deeply rooted in ancestral transmission, spontaneous call, or by the needs of the community. In exploring the similarities and differences of the stages of becoming a healer, it would be my hope to bring portions of the indigenous model into Western Medical practice. In exposing the similarities of medicine to the shamanic healer, it may be possible to demonstrate that healing can occur within a spiritual template. In looking at the stage of development for shamans and physicians, one may see that healing cannot occur in a spiritual vacuum.
As stated above, the stages of shamanic training are the calling, instruction, initiation, and shamanic practice. It is my hypothesis that one can compare the stages of allopathic medical training and find multiple similarities to shamanic practice. The four stages of shamanic training will be compared to a similar stage of medical education in this country.
In many indigenous cultures, shamanism is a hereditary practice and can be transmitted along maternal or paternal lineage. Within these indigenous cultures, even if the shaman is born into a lineage, there are gifts from spirits or gods that instruct the future shaman through dreams and visions (Mikhailowski, 1894). Those who are called through familial inheritance have a different course from those called based on vocation or community need. These individuals are groomed from an early age and are apprenticed through the family. Illness and tragedy will often be the catalysts for entry into the shamanic world. It has been proposed that an individual who experiences severe illness is merely being prepared to become a shamanic practitioner and that the power of the wounded healer aids them in their journey (Halifax, 1991).
For the shaman, training occurs over many years or a lifetime. Training may begin in young adulthood and continues through the teaching of elders; one may also be subjected to experiences in nature, solitude, and apprenticeship to the community shaman. Among the Zulus there are "twelve stages of training and the Blackfoot novice must pass through seven "tents" to become a fully accomplished medicine man" (Kalweit, 1987, p. 20). Exposure to severity is a common theme in the road to becoming a shaman. In Japan, there are certain aspects of training whereby Medicine men acolytes are made to stand under a freezing waterfall for hours a day for 100 days (Blacker, 1975). Basic education in the ways of shamanism, or those of a medicine man, is the oral transmission of knowledge and repetitive rituals that symbolize relationship to the divine.
Shamanic initiations vary and can occur as part of the training process or spontaneously. Initiation creates shamans from those who have been called, but not all who are called become shamans (Pratt, 2007). Four general forms of initiation have been described: traditional or cultural, instantaneous, wounded healer, and dismemberment (Pratt).
Traditional initiation is an ordered progression similar to a medical residency; the shaman will go through graduated stages as deemed worthy. Instantaneous initiation can occur with near death experiences. The wounded healer may have emotional, physical, or mental challenges that result in a spiritual insight or awareness that comes once they have surrendered to their wounds. Dismemberment or spiritual deconstruction is a state whereby the shamanic initiate experiences a spiritual death in a shamanic state of consciousness. The commitment of the shaman is lifelong which adds to the power of the vocation for the community. While the vocation of the physician is powerful and helpful to the community, it is not permanent and is subject to retirement, loss of medical license, change of employment and so forth.
Western physicians are active healers in the sense that they instruct the patients on a course of action. The patient is meant to follow the healing instruction, whether it is in the form of a prescription medication or activity. The shamanic healer is a passive participant with an active patient; the patient is guided in a healing direction. The shamanic practitioner masters control of himself or herself, becomes an advocate for the patient between the spiritual and physical worlds, and participates in community healing.
The many rigors of allopathic medical training have similarities to shamanic training and practice. Within Western medicine, there are the stages of calling, education, initiation, and the practice of medicine.
Large numbers of applicants to Western medical schools have remained stable over the last five years, according to reports from the American Medical Colleges (Association of American Medical Colleges [AAMC], 2007). While reasons for becoming a physician are as varied as the applicants, there are similarities to the call of the shaman. This data is not a representation of the American medical community as a whole. A difference between Western healers and indigenous shamans is that indigenous shamans tend to come from the community at large. Western medical practitioners are from different cities, counties, states and countries; in many instances, physicians do not practice medicine in the community where they lived as children. Children are often groomed by their parents to become physicians; this is true when one or both parents are physicians. Other reasons that individuals are called to medical practice are the desire for a stable income, helping those in need, and the lure of healing.
Medical education begins in a four-year accredited allopathic or osteopathic institution. The educational phase experienced in medical school is followed by the initiation of residency, and then the rigors of medical practice. Education received by medical students is similar to shamanic training; it takes place over many years, and there are tests and rites of passage.
One receives a degree to practice medicine upon graduation, but this does not singularly convey the power to practice medicine in this country. In our culture, after completing medical school, one must obtain a medical license by completing board exams and a minimum number of years in graduate education ("Your doctor's education", 2000).
The allopathic healer learns through ceremony and ritual. An example of ritualistic education in medicine is seen by evaluating the ritual of the operating suite. The patient is instructed to fast before the surgery in order to prepare the body, and at times, the physician is also fasting because of strenuous work schedules. The surgical suite is structured with the patient in the center of the room with arms outstretch in a Christ-like crucifixion posture, while the room is continuously sanitized by air filters. The attending physician escorts the medical resident in training into the surgical suite; both are garbed in the traditional surgical gown. In many instances, the resident physician will only monitor the elder physician's healing practice of surgery.
Shamanic initiates and medical professionals are transformed according to their cultural norms. The word "resident" physician is so coined because the physician lived in the hospital. The hospital would provide food and lodging for the young healer, and in exchange, the resident physician was to live in the hospital and work in the healing arts. As stated earlier, indigenous shamans also live in the community where they practice. Residential practice is chosen based on the desires of the physician upon completion of medical school. The residential system is a ranked system that slowly adds increased responsibility to the resident based on their ability. A major difference between shamanic and allopathic initiation is that shamans are initiated for life. Western medical doctors take the Hippocratic Oath, but there is nothing in that oath that states it is for a lifetime that he or she is a healer; recently physicians have been leaving or contemplating leaving their healing practice over the next five years (Reuters, 2008).
Personal experience has taught me that medicine is a graduated learning process. Unlike the indigenous shaman who tends to practice alone in a community, physicians gravitate towards larger groups. Private medical practice is the status one achieves upon the initiation and completion of residency; however the allopathic healer is in a state of subclinical practice until he or she becomes board certified. The process of board certification will usually take place in a written, oral, or combined examination process. Elder physicians, through the power of the examination process, confer the rights of the Western healer upon the initiate physician.
Obstetrics and gynecology has a written examination immediately after graduation from residency. The next two years are spent in private practice; during this process the physician is recording every patient encounter. These encounters are then submitted to the American Board of Obstetrics and Gynecology as the template for the physician's oral examination. This oral examination is a six hour encounter with six elder physicians who question the examinee about his or her healing failures and successes.
Shamanic practice has similarities to this process of certification; "before the Tenino of Northern Oregon can begin his practice, he must prove his gifts before a committee of older shamans" (Murdock, 1965).
The purpose of this investigation was to evaluate the call to be a physician. Medical students and resident physicians participating in an elective in integrative medicine at the University of Arizona were asked to participate in the study. Throughout the month-long rotation, participants were exposed to multicultural healing modalities such as homeopathy, Reiki, chiropractic, osteopathic manipulation, Huna, and Traditional Chinese Medicine and acupuncture. At the end of the rotation, sixteen participants were taken to Sedona, Arizona. In Sedona they were exposed to Huichol healing traditions under the guidance of author and guide James Endredy.
Time in Sedona consisted of silent hiking, traditional Huichol healing ceremonies, smudging, open dialogue with spirits, and fire rituals. Participants were invited not to only become patients in the ceremony, but to heal and bless their colleagues as well. Closing ceremony was performed with fire initiation, where each participant was asked to converse with the fire and divulge past, present, and future acts and desires. The cleansing of the fire ceremony was a closing and an initiation back into the world they were now re-entering. During the ceremony the students and residents were asked to discuss their calling to heal and become a physician. The sacred fire, as described by Endredy (2007), allows a "primal connection that creates a holistic state of consciousness with the power to advise, heal, and nurture us on our anointed path" (p. 311).
After exposure to the elements and being surrounded by the blessings of the red earth, students were asked to privately reflect on their call to be a healer, and why they decided to follow this path. Participants were advised that their responses would be handled as a group and there would be anonymity. Within the group there were six males and ten females ranging from 22 to 49 years of age, representing the United States, Canada, Israel, and India. Of the sixteen participants, six were medical residents in their last year of training; the remaining participants were medical students in their fourth year of school. All participants had spent at least three weeks in each other's company and were comfortable sharing personal reflection.
Nine of the participants claimed they had either one or both parents who were physicians. Within these nine participants there was a majority that claimed their parents influenced their decision to become a physician in some manner. The remaining seven participants claimed that it was the vocation itself that called them to the practice; healing practice called to them. None of the participants claimed that an illness had been the reason for entering medicine.
Participants were encouraged to write responses to the above question, but they were also being observed throughout the day. More than half of the participants claimed they were skeptical of shamanic practice prior to the trip to Sedona, but all claimed an increased sense of self-awareness and their surroundings by the end of the trip. They claimed that the healing rituals performed gave them an increased sense of community . As the students called out verbally to the ancient spirits, Tate Wari (Grandfather Fire), Takutsi Nakawey (Grandmother Growth), Kauyumari (Deer Spirit), and Tatei Yurianaka (Mother Earth), there was a verbal connection to the earth and universe.
During the healing and fire ceremonies, participants reported emotions such as love, anxiety, fear, anger, and sadness. All agreed that they felt more connected with their body and that sensations of hearing and touch were elevated. Final analysis at the end of the rotation showed an overwhelming consensus within the group of a connection with allopathic medicine unlike their perceived connection before the trip to Sedona. This was not reported as an understanding of shamanic practices, but as a deeper connection to their own allopathic practice.
Medical students and residents become wounded healers through the rigors of training. They are wounded by long hours and a disconnect from basic health, healing, and holiness that medicine has offered them. "Healing itself has little to do with the surgeon's scalpel or antisepsis. Wholesomeness and basic health are attained, rather, only through inner purification" (Kalweit, 1987, p. 1). Through the process of shamanic ritual, medical students and residents may learn that healing is first for the community, then the individual, and finally for the illness (Kalweit). The allopathic model is a reversal of the shamanic model that focuses on the patient and not the illness. Allopathic medicine has become materialistic and has become less humane. The humane healing practitioner becomes a passive participant in the healing process and acts in accord with the patient's destiny and individual intent (Meyer, 1996).
I have attempted to correlate the call to become a physician with the call to indigenous shamanism. Exposure to the healing shamanic arts opens allopathic healers to their own inner healing. Training for the shaman is community based, and this may be where the soul of medicine was lost. Medical schools have an important role in reducing the isolation of their students from alternative health beliefs like shamanism that are a part of our community (Poland-Lakin & Cosovic, 1995). The call to indigenous shamanism has similarities to that of the Western Medical professional. At some point in the medical training of a physician there is a disconnect from the community. This disconnect or wounding can be healed, or the wound utilized to bring the trainee back to their healing roots. Shamanic practice can be a portal for recovery of the wounds inflicted in medical training.
We could say, without too much exaggeration, that a good half of every treatment that probes at all deeply consists in the doctor's examining himself, for only what he can put right in himself can he hope to put right in the patient. It is no loss either, if he feels that the patient is hitting him, or even scoffing him: It is his own hurt that gives the measure of his power to heal (Jung, 1951, ¶ 239).
The call to heal comes from the familial bonds of the shaman-physician, healing vocation, or from wounds of the past. In any case, it is the spiritual glue that provides physicians with the ability to become healers. The continuation of spirituality in medicine is a critical conduit to healing the physician. Inner healing of the physician is an important aspect of bridging the gap towards healing the community. Shamanic practice is a potential first step in bridging the gap between the wounded healer and the disembodied local and global communities.
Association of American Medical Colleges (2007). U.S. medical school applications and matriculants by school, state of legal residence, and sex. Retrieved December 02, 2008, from http://www.aamc.org/data/facts/2007/2007school.htm
Reuters (2008). Many doctors plan to quit or cut back: Survey. Retrieved December, 12, 2008, from http://www.reuters.com/article/newsOne/idUSTRE4AH1CE20081118
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