Mary Jo Kreitzer on "Creating Optimal Healing Environments" (transcript)
Shift in Action: Welcome everyone to the Institute of Noetic Sciences Shift in Action Program lunchtime teleseminar in the Living Deeply Series. Today our host is Marilyn Schlitz and I will let her introduce her guest, Mary Jo Kreitzer. And their interview is titled “Creating Optimal Healing Environments.” Welcome Marilyn.
Marilyn Schlitz: All right, thank you. And welcome Mary Jo. We’re delighted to have you. As the founder and director of the Center for Spirituality and Healing at the University of Minnesota and somebody who’s done a tremendous amount of research in the area of integrative health and really as a nurse and a leader in the field of health care and somebody who is really trying to help reform, revise, renew, rejuvenate, all those are things that I think you’re doing in your role as a health care professional, an educator and a leader and a voice for change. So thank you so much for taking your time to be with us.
Mary Jo Kreitzer: You’re welcome. It’s a pleasure.
MS: I thought maybe we could just start a little bit with your history. I’d love to hear what drew you into the healing arts and what inspires you?
MJK: Well, you know for about ten years, Marilyn, I was working as a, in an administrative position at a University hospital and what I discovered is that patients and their families as well as staff, were really actually beginning to do and use all kinds of approaches to healing that weren’t necessarily part of the official repertoire of what was offered by the hospital, you might say not exactly sanctioned. Yet, they were very important to people and there was growing research that showed that many of them were efficacious: they worked. So I really became interested in how do we better serve patients, how do we develop the research base for this whole field of holistic or integrative therapies? And then in the biggest picture, how do we then start shaping policy on a national level?
So that’s really my interest, even in this whole big topic of optimal healing environments. I mean, how do we create places, spaces that empower people, offer them integrative therapies that have well designed physical space and then how do we get policy aligned?
MS: Beautiful ambition. How did you come to be, how did your calling to be a nurse come about?
MJK: Well, you know, that’s a fun question to answer. My mother was a nurse and I actually said I wasn’t going to be a nurse. My mother actually went back and got her graduate degrees and became a nurse faculty member and I said, ‘Oh, I’m never going to become a nurse and if I were to become a nurse, I’d never actually go into teaching or administration or research.’ And I ended up doing a lot of those things that actually my mother had done at various times in her own career. And for me, nursing has been a wonderful platform because it is a very integrative, holistic discipline by its very nature. So, you know, I actually think it prepared me very well to do the work I do today because it is very patient centered, but it’s also very interdisciplinary.
MS: Well how did you come about creating and then ultimately becoming the director for the Center of Spirituality and Healing? What is the impulse there in the context of a medical center to bring those kinds of dimensions together?
MJK: Well, what really happened Marilyn while I was in that position of being a director of nursing practice and research at the hospital and my sphere of responsibilities broadened and I became responsible for the spiritual health services at the University and then quality for the health system. And I actually felt like this was a new way to define quality by giving people access to broader, integrative services. So really it was through a process of both looking at the research evidence and really deeply listening to patients and families and health professionals and what they were looking for in a health care experience. And so it was actually in 1995, so about 13 years ago, that we created the Center for Spirituality and Healing to be a container for that work. And I think what was different about maybe how we got started and what our vision was and continues to be to this day, is while our interest always has been around integrative holistic therapies, in a deeper way I think it’s also about ways of thinking differently. And so the whole notion of ways of thinking about health, ways of knowing, creating not only the education platform to educate consumers, but to also educate a new generation of health professionals to advance the knowledge and then to eventually effect policy, that all has been under our interest. So it’s been a little broader scope than just alternative therapies, per se.
MS: Let’s talk a little bit about this notion of multiple ways of knowing and how it is that you’ve been able to straddle this interest in hands on healing role of nursing and then your role as the director of a center for NIH doing research on complementary and alternative medicine. How is it holding those various pieces together and how easy is it to begin to build a research program that involves that kind of human caring dimension?
MJK: Well, you know, when I teach research, Marilyn, I always say there aren’t right or wrong research methods, it’s that the method needs to match the question. And I think it’s so important that we look at things really in an integrated holistic way and not in a reductionist way that sometimes will impede us from answering questions. So having said that, you know there are some things that can very easily inappropriately be studied by randomized clinical control trials, which we often think of in science as being the sort of the gold standard. And even in the field of holistic integrative therapies, there are some things that can be studied in that way. But then there are other things that numbers maybe don’t capture either are precisely or as eloquently as words do, a particular phenomenon. So it’s very important to also be open to qualitative research kinds of methods, methodologies. And so truly the whole notion of the method needs to match the question, if you think about it from that way, then you sort of think about, what’s the question?
And what is it that we’re trying to understand or know to advance our thinking in whatever realm it is and then, how do you design the study in that way to do it?
And that’s where I think it actually takes a number of interdisciplinary creative minds to come up with sometimes different ways of thinking about how do we look at something and measure something? I’ve been interested in the whole topic of ways of knowing for a long time and one way of knowing is science, evidence, randomized control, clinical trials. But we also know that there are other ways of knowing. Direct experience is a way of knowing, intuition is a way of knowing, and so that’s why for the last two years The Center for Spirituality and Healing along with our partner Life Science Foundation, has actually hosted an international invitational symposium on this topic of ways of knowing. Last year we actually explored the topic of intuition in a very deep way. And then this year in the symposium we just had a couple of months ago, we explored cultural ways of knowing because different cultures have had ways of discovering meaning, for example.
And so, yeah, it’s all part of what I would say, Marilyn, is we really want to be very thoughtful in how we think about health and think about these issues.
MS: Well, having had the privilege of coming to you culture conference there and experiencing both the insight and respect that was given to the cross cultural healers that you brought in to be faculty and then having those break-out tables where we had deep conversation with the participants, the audience really, and seeing most of the audience was made up of health professionals, whether nurses, or doctors or administrators and I found that a really interesting kind of reversal of the standard conference fair and was really appreciative of that. What that told me, is that through your work there at the University that you have been building a community of people who are within the health professional domain and yet who also have a real openness to these kinds of experiences. Are you starting to notice a shift in how these ideas of multiple ways of knowing fit within standard medicine and standard health care?
MJK: Absolutely and we’ve had the benefit of some good funding that’s enabled us to do this now for many years. We were one of first universities to get grant, for example from NIH, the National Center for Complimentary and Alternative Medicine to fund bringing integrative or CAM approaches into the education of physicians and nurses and pharmacists. And so we really began that work, now it’s been 8-9 years ago. And absolutely, it is now part of required curricula in those schools and we are starting to see the effect that when students are exposed to ideas early in their training, they begin to look at things differently, they begin to ask different questions and I think ultimately they’re going to be very different health care providers. So what’s fun now, is actually we’re beginning to see the fruit of some of our efforts and that we know that some students are attracted to, whether it’s a PhD, or whether it’s a master’s program or health professional program at the University of Minnesota, because they know that there’s a Center for Spirituality and Healing, that that can help inform their training. So, you know, I think that’s very exciting.
MS: Well, given the challenges that face health care today in all the various ways in which people are speaking about a crisis, are there signs of hope from your perspective and what are they?
MJK: Well, that’s an interesting question. I think there are some signs of hope and some signs that at times have caused me dismay. You know, the whole Chinese symbol for crisis has two characters and one character means danger and the other opportunity. And I do see that where we are in the health care system today is what I really think of as the crumbling of the system. There’s a lot of danger because I think a lot of people fall between the cracks. I think a lot of people can’t access care. So in many respects I think we’re in a very troubled and challenging position. With respect to where health care is today but that also gives us an opportunity because as the walls literally become crumbling, it gives us some time to think about how to do things differently. So that is what gives me hope and optimism.
What discourages me some, Marilyn is even…this is a real interesting time to talk about health care, because we have a national election coming up and we have candidates that are talking about health care and health care reform. And so much of the language around health care reform continues to be questions only about access, how do we give people access?
And the point of view that I take is that giving people access to what we currently have is not a good solution that we really have to rethink the fundamentals and think about what is really important in terms of health care and where are we putting our dollars and where is our focus and emphasis? And I’d like to see much more of a focus on both parties on that kind of health care reform that I think is of a much more fundamental nature than just talking about important issues of access and disparities. And so in a new model of health care, I think that we need to have much more emphasis on health promotion as well as disease prevention, really helping people lead healthy life styles, making full use of a broad spectrum of practitioners including not only physicians and nurse practitioners but CAM or people that practice integrative kinds of therapies. So I think we have a long way to go in terms of health care.
MS: So all of those qualities are what you might define as important for the optimal healing environment? What would be the parameters that you would see as important? You started to map it out but let’s think a little more about what needs to shift and how can we begin to do that?
MJK: When I think about the whole notion of optimal healing environment, Marilyn, I think about who are people, who are the health care providers, what are the skills and the competencies they embody? What are the processes, the care processes in that environment? And I’ll come back to what that needs to include and then what’s the physical place and space in which all of that happens? And then how is the mission, the vision, sort of the ethics of the organization aligned to make really optimal health and healing happen?
And so clearly I think we need to have care providers that are not only educated in the best of western technology and science and what we think we have grown to expect from a health care system, we also need to have people embody other qualities that are important to be a healer. And we know for example, and this is certainly so emphasized in nursing that caring and presence and empathy, some of those skills are real important to bring to the healing encounter, the healing relationship. And in an of themselves can be healing. So, in my work in various ways, I’ve worked a lot around, what should be the competencies that health care providers have in a new system of care?
And then the processes I think need to include more than just what western medicine has had to offer. And I’m so excited about the number of health facilities and hospitals around the country that have begun to bring into, weave into the fabric of care, complimentary, alternative or integrative therapies. And so Healing Touch and massage and guided imagery and Reiki and use of essential oils and aroma therapy, that’s just part of the care that’s offered. And there’s an evidence base for that and we talk in health care about evidence based medicine or evidence based health care, well there’s a growing evidence base for integrative therapies.
But in the third piece that’s interesting and fun to talk about is the physical space or place. And just like we talk about evidence based medicine, there’s a whole new field called evidence based design. And there really is a growing body of research to show that the space makes a big difference. And that space in and of itself can either be healing or can be an impediment to our health and well being. So those are some of the ingredients I think that collectively make up the optimal healing environment.
MS: Well, in that matrix of what you just defined is the health professional and one of the things we’re seeing is how much toil and challenge, trauma really the health professionals are undergoing today both in the demands on them, the time management issues, the inequities of power distribution, you know, all of these kinds of challenges. How do you begin to approach the healing of the healer? I know that’s a topic you’ve spent some time on.
MJK: Well, that’s a huge topic and part of it is how do we teach our healers, health care providers, better skills of self care and resiliency? And that’s a huge issue. Health professionals are some of the poorest role models around in terms of good health care practices. We often don’t eat right, we don’t exercise, we don’t manage our stress and so we’re trying to educate students now to recognize that the important…to be an effective healer, it’s really important to embody some of those qualities on a personal level and to live that in our own lives. So that’s a piece of, I think of what you asked about.
But the bigger piece is how can we engage health care providers in this transformation of health care reform and create a health care organization or context that makes sense that makes meaning? And, you know, I think it’s an interesting time when both physicians and nurses, as well as patients are equally dismayed at where our system is currently. A lot of health care provides feel like they have lost control. And I think if you were to interview a lot of nurses who are employed today they would say they’re not able to do on a day-to-day basis the very thing that drew them into the field of nursing. So we have to do more to get nurses back at the bedside to really providing the kind of care that they were educated to provide. And to spend less time doing busy work or work that other kinds of people can be doing. So that’s part of, I think, the whole needing to rethink and redesign.
MS: As you think about the load and the stresses on a nurse, for example or a doctor and then you add on to it the second dimension, the additional array of tools in the medical bag, is there a danger putting more stress on the practitioners? Because, in addition to all of the allopathic, main stream medical things that they have to master and have competency over, there’s also now a whole array of alternatives. How do people manage all of those choices and the demands that come with it?
MJK: That’s an interesting question. I would say that some things don’t always take more time and can be woven into care and practice as people are doing, for example: presence. Being really therapeutically present to a patient, being fully attentive and mindful, while you’re changing an IV, while you’re doing a bed-bath, while you’re doing another procedure, doesn’t necessarily take more time, but adds a different dimension, adds a richer dimension to that whole care experience. My experience has found that a lot of health care providers look at this as getting back to some of the basics, some of the art of healing in science. They want to merge that with the conventional care that they do. They would see it as a disincentive to be sort of off loading that to other kinds of people. But it’s not all about just physicians and nurses. I think it’s really bringing into that community of healers, other kinds of providers who, I think, have so much to offer. If you’re talking about, for example patients that have chronic pain, whether in-patient or in an ambulatory setting, there are other things, such as acupuncture that really need to be looked at as realistic, viable, important kinds of options.
MS: So, I’m really interested, you know, we started with you talking about the need for real reform at the institutional level and at the governmental level, the policy level. And just thinking strategically with you, about how one could begin to implement a kind of transformation that I’m hearing from you. I think about the importance of optimal healing environments, optimal caring environments, optimal health for practitioners, all of that. And we know now there are good data that support some of the alternative approaches. Certainly there are data that support the idea that nurturing and caring lead to better outcomes in terms of patient satisfaction and so on. What are some of the strategies for beginning to influence the health care administrators and the people that are actually making decisions about how they design the hospitals? Or how they organize the staff or what are the values and philosophies that guide the practice? How can we begin to chart a strategy that might be helpful in shifting paradigm? Do you have ideas about that? I bet you do.
MJK: Well, I do. I think regardless of which stakeholder group or realm you’re talking about knowledge is power. The more we have evidence, the more we have data to show that whatever we’re talking about makes a difference, that can be very impactful. So, in the one area where you asked about when new facilities are being constructed, that’s an interesting one because over the next ten years it’s estimated that something like 16 billion dollars is going to be invested in construction of new hospitals and new health care facilities. So it’s a very rich and ripe time to be saying, what is the evidence that shows some of the decisions we make may not cost us more money in the design process but could provide tremendous benefits and outcomes.
I could actually talk about what some of those things are. They’re things such as giving patients connection to nature, the light and how nature is brought in, what patients have to view – use of art. Providing positive diversions for patients, bringing in space for social support, so patient’s family actually has space in the health care facility, those kinds of things. There’s a lot of data. One compilation of studies that’s been done, Marilyn, that shows there’s well over 1000 studies that show the physical environment can effect health outcomes. So, data can be powerful, but you know, people often say what they want and prove it by showing the data, but personal experience can also be very very impactful. So I think highlighting examples and models of places that have done and done it well can also be a very powerful way of learning. So that kind of addresses it. In a healthcare environment, how do you begin to make changes in a physical environment, that’s how I would approach it.
But in the bigger realm, I think all of us, whether we’re consumers or health care providers, there are strategic things that we can do to make a difference. And one is, personally the choices we make in our lives, how we lead our own lives in terms of personal health and the choices that we make. But then people often look to the health plans and 3rd party payers and those are the doors we need to be knocking on. But more and more those are actually not the decision makers. The people who are really making the decisions are employers. Because it’s the employers that actually make the decision about what’s going to be included or not included in the health plan. So I often say to consumers that’s where you need to have your voice heard, on benefit committees for example and participate on that level. But then as we’re faced this year with a really important national election that I think in many respects is a referendum on a number of issues. To be really informed citizens so that we could make good choices at that level about what our policies are going to be on a national level for next 10-20 years. I was in Washington DC last week at a NIH meeting and it’s really troubling what has happened to funding from the National Institutes of Health over last 8 years. And as choices have been made, where we spend our dollars in this country and a lot of it has been on defense and a lot of it has been on war there has been much less money for health care related research. And that really affects every one of us because in this whole realm of integrative therapies or alternative medicine, access is very driven by reimbursement and reimbursement is very driven by research evidence. So I often say to people, if you really want to have access you need to support research. Because research is going to help us know what works and what doesn’t work. So I hope that’s encouraging and positive news, as consumers there are so many levels we can participate, certainly our own lives, organization with which we’re affiliated and ultimately the national conversation.
MS: What role do you now see the internet playing in this role of transformation?
MJK: I think the internet plays a huge, huge role and I love the open access that’s given to people for information. As with anything there are positives and negatives and I think in the case of the internet, far more positives than negatives. The negative is that not everything you read is true and there certainly are websites and web information that’s not only false, misleading, but potentially could be dangerous. And so people need to approach things with caution and seek objective, balanced information. But I really trust consumer’s ability to make good decisions and good judgments. We created at the University of Minnesota with our partner Life Science Foundation, a website that’s actually called “Taking Charge of Your Health.’ And it’s really been a fun website to develop because it really gives consumers the message of why it’s important to take charge of your health. And there are three major streams of information. One is, how do you navigate the health system? We all know it’s not easy, whether you’re a parent, or whether you’re a caregiver for a parent or whether you’re facing your own health crisis, to know how to find a provider and have your records, navigate the system. We have lots of information, tools and tips and how to do it. Then we have another whole section on how do you explore complimentary therapies? And so if you’re interested in acupuncture or massage or guided imagery or essential oils, what is it and how do you find a provider? What’s the evidence? So we have information on that. As well as, we direct to lots of other websites and tell people how do you judge the quality of a website, are there certain criteria that you should look for? And then the third part of the website is, how do you develop a personal plan for health and well-being? And people have the ability, Marilyn, to actually go online and answer questions about their diet, their exercise, their attitude, their relationships, stress, the role of spirituality in their lives. And really carve out, what is a personal plan for making change, for making a difference? And our website “Taking Charge of Your Health” is only one of a number of very wonderful, powerful tools out there for consumers. I think that’s made a huge difference for people. They have access to information and sometimes we have consumers that are going in to see their physicians or nurse practitioners and it presents a bit of a dilemma, because they’re more informed than their providers.
MS: I had conversation with somebody who had been a very powerful administrator in a large HMO and I had said to him… he’d given his prognosis of the future of health care and I asked him, I said ‘What about the role of the internet?’ And he said, “Well, it was a lot easier when we were God.” And it was a joke but it was also a statement about how fundamental the internet is in reversing the power relations.
MJK: Yes. So, one thing we actually try to do Marilyn is teach our health professional students, why it’s good that consumers are doing that and how to not be threatened by that. And how to take an approach of interest and curiously and trying to be helpful in guiding people and recognizing your role is to be a partner in care, not sort of as you said, it was easier when we were God. Not to be the end all be all that dictates to patients what they can do and choose. That’s a huge shift in the mindset in what the role is of a heath care provider.
MS: I wanted to go back to strategy and evidence and thinking about how good are the data for bottom line arguments? To say something like more caring, more time spent in that meaning segment of the therapeutic relationship is actually cost savings? How good are the data to say that these kinds of mind/body interventions or complementary and alternative interventions are really that kind of integral map that involves a combination of different things? Are there data to say to those people in the C Suite, not only can we show you that it improves health outcomes but it also changes/effects your bottom line?
MJK: You know, it’s a big continuum, so I would say the level of rigor and in terms of the evidence, varies, so it’s very hard to answer question. Yes, no, it sort of exists, it doesn’t exit because you have to drill down and say which of the therapies and approaches? You look at something like mind/body approaches and we have a solid almost 2 decades of research. The whole field of psychoneuroimmunology, we know that our minds, our thoughts influence the functioning of our immune, our neurological systems. And there’s really irrefutable evidence of that whole mind/body effect. So hundreds of studies, thousands of studies have been done whether with meditation or imagery, bio-feedback or other mind/body approaches, that’s very solid. You take something like acupuncture, is acupuncture good for everything? No. I don’t think there’s anything that’s good for everything. But there’s very solid evidence that acupuncture is very effective for chronic pain, for chemotherapy induced nausea, for a variety of other kinds of conditions, migraine headaches. And so you really have to look at what is the therapy and what is the approach and what is it used for?
As a whole, I would say we’re early in knowledge generation. While some of these therapies, like traditional Chinese medicine or Ayer Vedic medicine have been around not for hundreds but for thousands of years. Their knowledge base was embedded in a lived experience environment rather than what we look for in terms of written empirical evidence. So, I would say we’re very early in trying to capture and document what that way of knowing is. What that learning is, that understanding. So, while I think that since the NIH established the National Center for Complimentary and Alternative medicine, we’ve made significant leaps, but we have a long way yet to go. But I often say, sometimes people say, ‘Gosh don’t you think this whole field should be held up to the same rigors as western medicine, that we should base everything on randomized controlled critical trials?’ and I often respond to them and say, ‘Absolutely and we need more evidence. But how much of western medicine is based on randomized controlled clinical trials?’ And a number of analysis have shown that that’s only about 15%. That we often think in dichotomous ways that western medicine is science based and CAM and integrative health is non-science based. And the reality is we need more science, we need more evidence in both realms. But it’s not such a simple ‘either or.’
MS: Absolutely. Again you think about the different ways in which people shift their world view and that first person experiential aspect is so powerful. But I’m going back to your comment about the field of mind body medicine is so well established and thinking about something like John Astin’s work. Where he did this huge survey of thousands of physicians and then looked at medical students and really tried to evaluate the extent to which they were aware of the data and then how much they were integrating these kinds of interventions into their practice. And while people had an awareness of the data, they were not in terms of the majority of the people he surveyed, actually integrating these things into their daily practice. And one of the things I’m aware of as I think about how one would foster a revolution, is that it’s important that we collect these data. It’s important that we give people more opportunities for first person experiences because that’s what then gives them a frame of reference out of which to operate even if the paradigm is different. But I think that one of the things, and I think there would be different ways of getting at these data, is to really demonstrate for those people who are making decisions, that in fact, you can save a lot of money. Not only for the people who run the companies that pay for the insurance, because one of the difficulties there is that people see that the cost savings come 20 years later. So if somebody does preventative mind/body stuff today, the consequences are really reaped when they live longer and are healthier in an older age. And that’s not necessarily an incentive to the business person who is making decisions about their company this year. But how can we begin to amass data from different segments that would show that there actually are huge cost savings at each level of the process? The long term impact it’s going to have on the national health care system as we’re all the Baby Boomers growing older. But even today as you see that a little bit of human caring leads to greater satisfaction, which leads to…do you see what I’m saying? How we get at those bottom line issue.
MJK: There’s not an easy answer. Certainly I hope that there’s a role that universities can play in helping to disseminate that information, as well as organizations, IONS and others that can serve as effective ways to not only collect some of that data in terms of the research that we do. But really shape the conversation by disseminating that information. You’ve really hit on something Marilyn, that’s really huge and is sometimes kind of discouraging and that is that a lot of good research happens and it sits on shelves and sits on computers and notebooks and really doesn’t get into the field. Some people who have done analysis have shown that it takes sometimes not just a number of years, sometimes it takes almost generations before some of this big change happens. So I think that’s a really good challenge to pose to all of us. I mean, what can we do to help advance that conversation by ourselves becoming aware of what the information and knowledge is? And really take a powerful role in helping to disseminate that. Certainly the whole political realm and again getting really engaged and active in those conversations and bringing some of this evidence and data forward is also a real important leverage point.
MS: Can you give us your website for the various programs that you just…I know you have one for the center, but for the program you just talked about?
MJK: “Taking Charge of Your Health” The website for the Center for Spirituality and Healing is: www.csh.umn.edu from the center’s website you can just click on the icon “Taking Charge of Your Health” and that will bring you right to the “Taking Charge of Your Health” website. That’s a very easy way to get there.
MS: So it’s CSH, which stands for Center for Spirituality and Healing, at…what is it? .umn.edu
MJK: That’s the email address. So the URL would be www.csh.umn.edu and the ‘Taking Charge’ website you can either get on directly though the Center for Spirituality and Healing or you can just Google “Taking Charge of Your Health” and it pops up as the number one, or the URL is: takingcharge.csh.umn.edu so it’s not too hard to find.
MS: Tells us a little bit too about what’s exciting for you right now. I know as an educator you’re seeing a lot of new and excited young people…so what’s exciting for you?
MJK: One of the things that’s very exciting is that in addition to the work that we do in educating health professional students like doctors and nurses and pharmacists, we actually have a whole graduate program complementary therapies and healing practices and a track within that on health coaching. And that program has just grown immensely over the years. It’s a graduate minor, so students can be taking a masters or PhD in almost any field in the University of Minnesota and take this as a supporting program. Or about 25% of our students are just people who are interested in looking at health or health care in a different way. With our graduate program, the first semester that we offered courses about 8 years ago, we had 32 students, this past semester we had over 450 registrations. So it’s been a huge success and we’re drawing students from business and law and counseling and social work and architecture because they want a more holistic, integrative way of thinking to inform their practice. And so I’d have to say, that’s very, very exciting to me.
It is a graduate program but we’ve been getting more and more interest from undergraduates and so a couple of years ago we began teaching an undergraduate course on holistic health and healing every semester and we were getting 70-90 students per class. Even when offered it at 8 in the morning, which is not college student’s favorite time. So because of that we decided to expand our offerings at the undergraduate level and we’re developing a concentration in what we’re calling: “Whole Systems Healing” because so many people and young people are recognizing the important connection between health and the environments. And so under this whole systems healing initiative, we’re looking at not only what is the connection between health and the environment, but how can we actually put our vision and values to work in terms of making an impact in the world and service learning? So, that’s a real fun team I’m working with and a real fun series of courses on whole systems healing. So that’s a very new edge.
MS: That is beautiful. I just, as I said, I had such a great time at the Conference on Culture and Healing and I really appreciated both that cross-cultural perspective, hearing from healers from the Kahuna, and the African, a variety of different perspectives that you brought together there about what is healing? And how that then compared with what I felt was a lot of the disease or discomfort that a lot of the health professionals that were there were feeling about their own profession. And so it feels very vital to me that you’re trying to bring together these insights about healing and delivering that right to the health professional who bring healing but also are so much in need of their own healing. I just really want to acknowledge and appreciate you for all the great stuff that you’re doing in the world. It’s really very inspiring.
Q: Hi, I have a question. I wonder if you could speak a little bit to where the spiritual is in the healing? The Center for Spirituality and Healing has wonderful and exciting stuff going on, it looks a little reductionist to me. The spirit: if you could talk to that, I’d appreciate it.
MJK: Sure. Over the years we’ve questioned if we named center in the right way because by intention we really named it spirituality and healing because we really do believe that’s what it is about. And terms like complimentary, or alternative, or integrative medicine, feel like they are much more reductionistic and capture a smaller scope than we were interested in. I would say that spirituality really informs everything that we do, not so much of what we do, but everything we do. We integrate spirituality very much in the education we do of students, in terms of talking about the importance of spirituality and how do you explore spiritual questions with people and recognize their relationship between spirituality and health. We actually have a whole online module for health professionals on our website on spirituality and healthcare and another one on culture, faith traditions and healing. I think we recognize that it’s important in that realm. in graduate program, we actually have a whole track, a series of courses that focus on spirituality and two of the most popular that have been really impactful for students. One is called forgiveness and healing and the other, peacemaking and spirituality. Both of them taught from a restorative justice point of view. We collaborate very much with spiritual care providers from a variety of traditions, as Marilyn had mentioned. Many of the cultural healers in our recent symposium came from very, very deep spiritual presence and base. We also actually collaborate very much with chaplains who bring a very rich and deep spiritual perspective. So we have a number of chaplains who are very actively engaged not only as faculty in our center but are very engaged in teaching as well. So I look at this approach of holistic care as body mind and spirit. It wouldn’t be very effective if we only looked at the spirit and didn’t look at the body and mind. And it’s equally ineffective and dysfunctional to say we’re only going to care for the body and ignore the spirit and the mind. It’s about really attending to all three.
MS: Great. Thank you. I see it as a very holistic and integral approach that you’re taking. Anybody else out there?
Q: Hello, it’s Filip in Salmo. Hi Mary Jo, I loved your talk today. Are you familiar with Patch Adams and his Gesundheit Institute?
MJK: Yes, I am. I haven’t had… Patch Adams, for everyone who doesn’t know, is actually a physician who has gone on to do very very wonderful work. He actually looks at many rich realms of how health care can be enriched including the use of humor. And he becomes embodied as a clown. So, I am aware of work and regard it. He’s done some great things.
Q: In terms of my experience, in looking at this whole thing, and it is a complicated story, because human beings are complicated. He’s got the most advanced ideas in terms of developing a free hospital and developing a hospital in a setting that is so highly oriented towards healing. I believe they’ve got a piece of land and they’re really trying to integrate this whole environment of nature, with pools and gardens and that whole aspect. And it’s astounding to see the reaction that he has from the established physicians and nurses, especially interns and students. They would just love to work with him and work in this free hospital for really minimal, almost survival type wages. But he has a great deal of difficulty trying to get the funds necessary to get those things built in the first place
MJK: Yeah. I know that has been challenging. I know that piece of his history. And then I think the other question people often have is: once we create models, whether it’s something that Patch Adams or somebody else might do, how do we create models, they can be unique models, but can they be models that are replicable? Because, obviously, to touch the population base we have in this country or really around the world, we have to look at: what are the kinds of models that can be replicable? But I love learning from small experiments. And so I think there are some important lessons to be derived from the work that Patch Adams has done. Likewise, there are some other hospitals and health systems around the country that are really doing some powerful and profound work and the more we can do to highlight some of those beacons of light, I think we can collectively advance our knowledge.
MS: I think this also brings up challenge that a lot of integrative and alternative type of programs have faced, which is: most of the integrative medicine clinics in the major medical centers don’t really make a profit, let alone even break even. And it becomes very challenging to figure out what is the best business plan that allows these things better integration as well as support and funding? I think that still represents a challenge for many of these programs like we just talked about.
MJK: I think it does, Marilyn, and again, it’s not a simple answer because sometimes people say: is this going to cost us money or save us money? And I say both. Because, if you’re talking about a woman diagnosed with breast cancer and she’s going to potentially need surgery and chemotherapy and maybe radiation, and if she has acupuncture it might control her nausea. There’s mind/body approaches if she has chronic pain, that’s an additive model. But will we improve quality of life? Absolutely. And there was a story of a woman that I worked with a number of years ago who talked about, while conventional approaches cured her cancer it was these integrative approaches that saved her life. It wasn’t until she tapped into some of these other kind of integrative approaches…she was a young mother, she couldn’t even care for her kids, much less work because she had so many symptoms and was so impaired. So that’s one level of conversation in terms of the impact. On another level, if you talk about somebody who has migraine headaches and acupuncture is effective, that can save money because we know that there are high cost of drugs and sometimes complications from drugs. So that’s where I think people just have to approach these things from a point of view that we really have the knowledge and the facts and don’t sometimes try to look for simplistic answers: is this going to cost money, save money? It’s deeper than that
MS: Beautiful. Anybody else out there?
Q: This is Karen in Umatilla, Oregon. First of all, thank you very much, wonderful presentation. My question is: with social organization now starting to organize on themes of re-organization, sustainability, I’ve seen a lot of groups start to come together around those themes. Everything from permaculture to alternative transportation, things like that. My question is: how these groups that are coming together could in some way bring in and act for health care reform? That’s a broad question, but if you could field that, I’d appreciate it.
MJK: I love the question. And I think that there is enormous potential in both what the individual and small groups can do. I think that this is a time, from a deep value perspective, the ideas that we’ve been talking about in this conversation on the phone today about health care, those same values of whole person integrative approaches, I think we could have had that conversation about education, as you say, about the environment, about transformation, I think that there’s some deep values that are transcending many aspects of our society. So I think that community organizations and groups… it’s wonderful to see them with, again, information tools that they can apply. I’ll mention a new initiative that I’m very excited about. Some of you, I’m sure, remember Eric Utne from the Utne Salon and the Utne Reader. The Utne Reader spawned the Utne Salons and the salons really became conversation groups to explore these deep issues. Well, Eric, who is no long with the Journal, per se, but still very active as a social entrepreneur and he’s a senior fellow actually at the Center for Spirituality and Healing, is starting a new venture called Community Earth Council. Where he’s really helping to engage seniors and Youth together to make a difference in their communities, on projects that could be healthcare, could be the environment, could be any of the issues you talked about. But it has an intergenerational aspect that I think is very exciting. And so that to me is another example of what I think of as a really new model, to begin to make the change.
Q: Excellent. And an add-on question to that: Does anything come to mind for you as far as specific community actions as to support heath care reforms? At the local level, regional level, how to somehow connect up with what will be, hopefully be a national agenda of health care reform? Is there anything that could be especially effective at the small community level to contribute to that reform?
MJK: I think educating people at a community level about what would be the ideal in terms of a health care experience or a health care package, as part of health care reform? And even looking or creating report cards that would judge candidates on those kinds of things, engaging within communities, community leaders on conversations about these topics. We’ve done that in Minnesota through the center for a number of years through a community advisory network. It was really powerful to get in one room, politicians, heads of health systems, consumers, and really have a conversation about what matters in terms of health care. So I think whether it’s disseminating of facts, more education, serving as convening people and pulling people together, there’s a lot that can happen on the local level.
Q: Thank you.
MS: Thank you. Anybody else out there?
Q: This is Nancy Walton-House in Snoqualmie, Washington, and I am just thrilled with your presentation today. I’ve worked at seven medical centers, some of them academic, and my last academic environment about 8 years ago and during the time that I was there, I remember a huge flap came up around having an alternative health care provider, a naturopathic physician appointed to board of directors and all this conflict between the medical school and whether or not that was going to happen. So it’s really, really exciting to see that in space of 8 years or so to see there’s been this growing research interest in the National Institutes of Health and spending research dollars to really get into the data and provide the evidence that’s necessary to give more legitimacy and credibility and funding and medical support for these methods within the academic medical centers and others. So, I just applaud you for your work, it’s so important and it’s really exciting to see the change taking place. Thank you.
MJK: Thank you very much. That’s really very welcome feedback. Thank you.
Q: Hi. This is Marcia in LA.
MS: Hi Marcia.
Q: I too am really appreciating not only the topic but wonderful embracing and arms around a subject that is vast and terribly hard to get ones arms around anyway. I’m forming a question as I’m sharing a little of my experience. I have a sister, who, out of our parents, both being terminally ill the same year, 16 years ago, ended up becoming a national expert and helping to form the idea that there is a field to study with care giving. And I wandered into the health care and aging fields as a former singer and entertainer who began to do musical healing in a number of kinds of facilities including skilled nursing facilities, sub-acute wards and doing threshold singing. Over the last 8 years have been advocating and educating and doing everything I can with enormous frustration because I can’t tell whether sometimes my experience of it, being very difficult to enter into because I didn’t come into it with certain credentials, or it is in fact that it is such a scattered approach and there is so much resistance and seemingly so little money to bring people who have holistic, whether it’s aging and or health care because it overlaps. I have a lot of credentials but no particular one, and I am left a lot of the time with, even wondering as I’m getting older, if something happened to me and I needed to be cared for, long term, I don’t know anywhere that is green enough, holistic enough and I have talked with other people from activity directors who are more holistic, there are a few of us to some of the nurse, caregivers who happen to be more of a spiritual bent that noetic science people and others who are on this conversation are like. Whether we could find ways to create prototypes, even if it was single houses, what we would call six packs, where you would have maybe up to six people who need assisted living and adopt the principles and be able to conduct research or show somehow, because we don’t know of any prototypes like that. We know that there is a pioneering movement, a culture change movement, the Eden alternative, there are all kinds of wonderful programs at hospitals, but some of us on a day-to-day basis working in this industry are trying to find some way to impact it. Without being able to get hired to even consult because we hear there’s no money or even the raised eyebrow that they shouldn’t even be entertaining our notions.
MJK: Well, certainly getting your foot in the door is sometimes the most challenging part in terms of getting access. And I guess, probably my biggest advice is just to working at developing relationships. It’s relationships that open door more than policies per se. But what you talk about in terms of the new models for people in terms of aging, and the aging of our population, I do think there’s some really wonderful and encouraging things happening with the whole Eden alternative movement. There also are a number of communities that are looking at, how do we set up healthy community initiatives. Sometimes focused inter-generationaly, sometimes focused more on the aging. And my sense is in those experiments that are set up, they’re going to look for: What are the qualities that make and optimal living environment for people and they’ll find that beauty and music and aesthetics and some of those other kinds of things are real important. One resource that I would direct you to that has come out in last couple of years that I think is just wonderful, is a book by Dan Buettner called The Blue Zones and what he did is he traveled around the world and he actually found four places where he found people living to be octogenarians. And what he did is then he went back and drilled down to study, what is it in those environments that made for, being environments where people not only could live not only so long but in a healthy way. And I think there’s some really… he calls them Power-9 or Power-8 lessons learned that he’s abstracted from wisdom in there that can then be translated into what are some creative models for living.
Q: Thank you. May I ask another question, maybe of Marilyn too there: Is IONS getting directly involved yet or getting involved in any of these kinds of programs or creating some research for either aging and/or health care and aging?
MS: We are in the process of develop an educational program at the IONS Retreat Center, our goal right now is to put heads together and figure out how to maximize the 200 acre campus that we have which allows people the emergence into nature and that sense of quiet and stillness with then the research insight and our decade of work, actually two decades of work in the area of consciousness and healing, mind/body medicine and then with the idea of educational programs for a variety of different types of populations. And so certainly healthy aging is something that is on the agenda. There have been several programs through the retreat center that have focused on healthy aging. And I do really appreciate your comment and I think it’s important to start thinking about innovative ways of organizing social groups around optimal health. So the notion of sort of creating pods that have access to resources on internet but allow face to face calibration with the development of community and social support, which I think is absolutely fundamental to how we can promote this kind of transformation. So I guess my answer to that is: yes, it’s in the works and yes, we’re thinking about it. There are some initial programs that are already happening on the campus and you can just look at the Noetic.org website to see what the calendar is. But I think you should be looking forward to, in the future, some more activities around that coming out of the institute. Clearly we have a long term interest and passion around consciousness and healing. We have a research program right now in which we are bringing together thought leaders to look at how we could develop strategies for facilitating the kind of transformation we’ve been talking about today from a disease centered model to a healing and wellness centered model and I think there are various pieces to that. So again, I would say stay tuned to Noetic.org and we’ll keep you abreast of some of that.
MJK: You know, Marilyn, I can just add that in November we’ll be having a conference at University of Minnesota on positive aging. AARP nationally is co-sponsoring it with us. Part of what we’ll be doing is bringing together the thought leaders around the country to look at these issues of positive aging and how do we create models to support that. What’s interesting and going to be fun about that is we’re going to be telecasting it live through the web and people can actually, either individually or as a site, log on to the website and participate in conference. If you want more information about that you can email me at the University and I’ll direct you to the people that are organizing that.
Q: What is your email address?
MJK: Kreit003@umn.edu
Q: Thank you.
MS: Well, my dear, thank you for all the great work you do in the world, you are just awesome.
MJK: Oh, thanks Marilyn. It’s been a pleasure.
MS: And thank you for taking your time. What we’re going to do now is I’m going to get off the line and you’re welcome to stay. We move into community dialogue now so people can just talk and share ideas and it feels to me like there’s a lot of fertile territory here for people to begin to build upon in terms of their own conversation. And I just wish you oodles of success in all the various ventures and thank you for taking your time today.
MJK: You’re very welcome.
