Helping Patients with Psycho-Spiritual Dilemmas, Part II

Damned If I Die Syndrome

In the Damned If I Die Syndrome the patient feels they will go to hell when they die. This PSD afflicted a woman in her fifties who came to see me. She had advanced breast cancer. The doctors gave her a few months to live. Upon telling me of her case, the woman threw up her arms and said, “I CAN’T die! I have sinned so much, I know I am going to hell as soon as I die. Doctor, can you save me?”

This case demonstrates the main problem in psycho-spiritual dilemmas. There is a lack of consistency between the patient’s belief system, and their actual personal beliefs or feelings. A Catholic priest could easily explain the fallacy in this woman’s line of thought. In fact, anyone with a basic knowledge of Christian beliefs could help this patient… if she had trust or faith in them. It just requires the use of logic, like this:
Doctor: “So, you are a Catholic?” (This is on the intake forms.)
Patient: “Yes.”
Doctor: “Do you believe in the teachings of Jesus Christ?”
Patient: “Yes.”
Doctor: “Well, don’t those teachings say that He died on the cross for your sins?”
Patient: “Yes.”
Doctor: “So, you have nothing to worry about. When you die, whenever that is, your sins will be forgiven and you will go to Heaven. Right?”

At this point the patient may or may not say “Yes.” But the strategy is to keep asking simple questions, to which the patient has to answer yes or no according to their belief system. Then you will discover the real issue or obstacle. In this case, the patient agreed with the last question, but went on to say that she herself would not be forgiven, because she was unable to forgive someone who had wronged her. At this point, I suggested that even not forgiving could be forgiven. Then I gave her a flower remedy and urged her to talk to a priest.

Too Busy To Die, or Controlling Life To Avoid Death Syndrome

We all know patients who are so busy, they don’t take time to rest, sleep, take medicines, exercise, and so on. Such busy people also tend to be controllers: they try to control other people, themselves, and events. They may also be hedonists. These people suffer from the Too Busy To Die Syndrome, or its corollary, the Controlling Life To Avoid Death Syndrome. In both cases there is a fear of death underlying the behavior. They think or feel that they can cheat death by being too busy to die, or by controlling everything around them. Often they are wealthy or “successful” business people. They try to amass wealth as a protection from death. This is obviously a dilemma, because they know that everyone does die, sooner or later.

I had a patient once who was a retired police officer. He had developed angina, high blood pressure, insomnia and depression. I asked him if he was afraid of death. First he said no. He had been in many dangerous, potentially deadly situations as a police man. Then I told him a story about how I thought I was not afraid of death, until one day something happened that really scared me for the first time. The patient thought for a moment, and then recalled that his symptoms started soon after he was shaken by an earthquake. That scared him because it was a power beyond his control. Being shot at did not scare him, because he thought he was in control of the situation. Just by talking about the issue, he started to recover. Then I suggested that he create a five year plan for setting goals. This helped him to recover totally, because it empowered him to feel in control of his life again. I didn’t try to change his controlling nature, which may have been impossible at this stage of his life. I just gave him healthy ways to channel the need to control.

Another treatment strategy includes discussing the inevitability of death, and the futility of avoiding it with behaviors. Since such patients are often business people, it may help to direct them towards adopting a warrior’s ways as a business strategy. There are numerous books on this subject, but the basic idea can be easily explained: the soldier or warrior takes the attitude that their life is already over. It is just a matter of time before they are killed in battle. They are living on borrowed time. And we all are, if we see it that way. This view allows us all to fight more effectively, without the fear of death. The warrior make friends with death and uses it as an ally, for death gives them courage and strength. Acceptance of death makes the warrior – and the over busy, controlling, driven patient – more likely to succeed. If the patient can be convinced of this fact, she or he may be able to turn around their fear… and their behaviors.

Another strategy to help patients with faith is to help convince them of the beliefs of their faith. If they believe in going to Heaven, then help them feel that they will go to Heaven, according to the teachings of their religion. If the patient believes in reincarnation, then tell them that going from one life to another is like waking up from a dream: we are still the same person who went to sleep the night before. When the spiritual master, Ven. Chogyam Trungpa Rinpoche, was “dying”, to comfort a distraught disciple he said, “Don’t cry… nothing happens!” He meant that with awareness, there is no loss of consciousness going from one life to another.

Materialist/Atheist Depressed About Death Syndrome

There are many PSDs concerning death. One is the Materialist/Atheist Depressed About Death Syndrome. An elderly patient with this problem had been depressed most of his life. As time went on the depression grew worse. He had tried various anti-depressants without any results. Psychotherapy had not worked. After a long interview, I he was depressed at the idea of death. He felt it was horrible that he would just “disappear” into nothing. He had no beliefs about an after-life, Soul, Spirit or re-incarnation. Technically this is termed a materialistic world view. I pointed this out to the patient. I told him that the source of his depression was a fear of death, without faith in any kind of after life or immortality of the Soul. I asked him if he might be able to adopt some sort of spiritual view or tradition. He got very upset with me, saying that he absolutely could and would not. He wanted a pill to make him better. I told him there was no pill to fix his problem, but that he could try to resolve it by adopting a natural view of life. He could think of himself as a part of the cycles of Nature, in which all living beings die, but are part of a greater force or process that goes on. This is, in fact, the ecological model of life. Unfortunately, this did not appeal to the patient, either. He decided to seek help elsewhere, and I was unable to help him resolve the dilemma. At least, though, I gave him an honest diagnosis before he left.

Prayer Without Faith Syndrome

A case of the Prayer Without Faith Syndrome presented as a woman in her sixties, who suffered from environmental illness and chronic fatigue. She also had various pains that came on when she was anxious and stressed. This patient was a devout Christian. She prayed throughout the day in order to reduce her anxiety. But what did she pray for? How did she pray? I ask my patients these kinds of questions. I also ask what her denomination’s teachings are about prayer. My goal is to find a way that she can have consistency within her own faith and religious or spiritual path. As it turned out, she prayed “correctly” from an outer perspective, but she didn’t believe she was worthy of God’s love, and so she felt her prayer’s would not be heard or answered. Yet she still prayed! What a dilemma! I helped her resolve it by asking things like, “Doesn’t God love everyone equally?” She nods her head, yes. “So, if that’s true, then aren’t you one of those who are equal to everyone, whom God loves?” Another nod, yes. “OK, then doesn’t that mean that God loves you, too, and will hear and respond to your prayers?” She answers, “Yeah… I guess so…”. At this point, the dilemma is revealed, but not resolved. The patient is mouthing the words but it has not sunk in. I wrote down an affirmation, repeating what we had just discussed, and asked her to repeat it at least a dozen times before and after praying. I also asked her to pray for God’s help in resolving this issue.

Wrath at God Guilt Syndrome

The Wrath at God Guilt Syndrome is a common dilemma that arises after a loss: the death of a loved one, damage from disasters, disease, financial ruin, and so on. People who believe in God get angry at God for either causing the problem, letting it happen, or not answering prayers to be protected, healed or saved. It is an emotional response that is in conflict with rational beliefs. Or it is based on incorrect beliefs, such as “God makes us suffer.” Some people are in denial about their anger at God, while others are fully conscious. It may even cause them to leave their faith.

Helping a patient with this PSD requires two tactics: logic, and emotional healing. The anger has to be dealt with one way or another. I like to use flower essence formulas that also contain homeopathic remedies. But almost any therapy can help, including time. The anger is a part of the grieving process. Pointing this out to the patient may also help.

The other tactic is, once again, to use logic. Find out what the patient believes about why bad things happen, even to “good” or innocent people. Is it God’s will? An opportunity for growth? A punishment? Karma? Chance? No matter what the patient believes, there is a way to show that being angry is inconsistent with their beliefs. It may help to suggest new ways of thinking or believing, so that the patient can stop generating anger in the first place.

Pre or Trans Incarnational Post Traumatic Stress Syndrome

Patients with Pre or Trans Incarnational Post Traumatic Stress Syndrome have a vague to clear feeling or idea that they were not supposed to be born into this world. Many patients have told me this directly. They say things like, “I always felt out of place. I remember not wanting to be born again into this world.” Or, they may just feel that way subconsciously, without knowing why they find life so painful. I had one patient who repeatedly brought this feeling up in our visits. We never seemed to address it until one day, after he had read a Buddhist book that described a realm of existence called the Heavenly God Realm. In it, beings experience great bliss and pleasure for a very long time. It is similar to the Christian idea of heaven, but it is not permanent. When their time comes to leave that realm and be re-born again as a human, they have great anguish. Their friends abandon them, and they suffer greatly at seeing where they are going next. This patient actually remembered that experience, which he repeated in this life as a pattern of fear of abandonment. By discussing it openly and confirming his own beliefs and experience, the patient was able to resolve the issue. All he had to do was realize where the feeling came from, and recognize that, like a dream, it was no longer a part of his present life.

Ready To Go “Home” But Not Gone Yet Syndrome

Patients with the Ready To Go “Home” But Not Gone Yet Syndrome believe they are very spiritual. They feel that they no longer need to be on this planet, and are ready to be taken “home” to Heaven, some other planet, or another spiritual realm. A patient in her twenties once told me this in just these words. I asked her, “So, how are you going to leave? You seem fairly healthy, what will you do to go home?” Then she said that sometimes she walks out into the street without looking, with the intent that if a car or truck hit her, that would be OK. She gave other examples of endangering her life, also. At first I went along with her, acting as though I understood and sympathized with her plight. But then after she finished her story, I said, “You are not ‘spiritually ready to go’. You are depressed! You are suicidal! A truly spiritual person is ready to die at any moment, but they also want to live until they have fulfilled their life purpose. They try to keep going.” Then I used examples to illustrate my point, like that of Mother Teresa, other saints, and enlightened beings that I knew of. Fortunately, the patient agreed with my assessment, although reluctantly and with an air of surprise. I was able to treat her successfully with homeopathy, flower essences, and counseling. Finding her life purpose(s) was also an important part of the cure, because it gave her the will to live.

Some people have this syndrome because they have a temperament that is too sensitive for living a “normal” life in society. They find life so harsh, that they want to stop living. In order to reduce stress, they may have to live a more secluded or reclusive life. Or, they may need a spouse who can protect them from the harshness of the world. Some people are not capable of living by themselves. If that is the case, then recommend that they find a spouse, live with relatives or friends, or in a group situation. These people can also learn to cope better, but it is hard to change a leopard’s spots.

Bowel Cleansing Guilt Syndrome

The patient with Bowel Cleansing Guilt Syndrome feels that he or she is physically impure. These patients are always fasting, getting colonics or using bowel cleansing products. They want to “clean out”. Such feelings and actions are not based on any actual toxicity or bowel obstruction. The patient’s near obsession with “purifying” is a metaphor for how he or she feels about themselves, spiritually. They feel that they have sin or the devil inside of them. Often these patients are Catholics or ex-Catholics, although any religious upbringing can condition someone to feel guilt, shame and unclean or impure. The patient may also have been abused. It takes some careful and sensitive detective work to find out where these feelings come from. And it is important to do so. Otherwise, the patient will go on harming their health, disrupting intestinal integrity with self-punishing treatments. The doctor will also lose or not get such patients if she or he tells the patient “Oh, I think you should stop those colonics,” without addressing the deeper underlying motivation. A differential diagnosis should consider PTSD or Obsessive/Compulsive disorder, or even Schizophrenia, as well as real conditions that the patient may be intuitively trying to treat. Worms, parasites, allergies, tumors, bowel obstruction, or toxicity could be the underlying cause, rather than a psycho-spiritual dilemma. But when it is a PSD, the doctor must treat it as such.

Purging is often caused by the same issues as the Bowel Cleansing Guilt Syndrome. The conventional view is that people who purge do so because of a problem with body image, known as Dysmorphic Syndrome. However, I have found that more often, the cause is a feeling of having to get something out of their body. Something that is unclean, or negative. This can be the conditioning from other people: the negative words, actions, and behaviors that the patient has “swallowed”, and wants to regurgitate or expel. This can also be a problem of the present or in real time, if the patient is still exposed to the person or people who “feeds” them impure, undigestable thoughts or words.

In order to help patients with this or any psycho-spiritual dilemma, one only needs to use logic; be non-judgmental; and work with the patient’s own religion or spiritual path, if there is one. Towards this end, it is helpful to study the various religions and their denominations, so as to know the fundamentals of their teachings. Lacking this, at least one can ask the patient. Find some key that you can use to unlock the dilemma, using logic and reason. If the patient has no religious or spiritual affiliation, then use principles of natural law (i.e., Nature), or examples from the patient’s profession or cultural background.

In conclusion, I would urge all wholistic doctors to address psycho-spiritual issues as a fundamental part of a basic work up. The human mind is pre-disposed to creating dilemmas. This is how the ordinary mind works. It is our job to recognize when these dilemmas are pathological and an obstacle to cure.