INTRODUCTION
In holistic health we are looking for a science capable of studying persons as wholes. To study as a whole is real science, not a part. No longer is it tenable to think of any body system as separate. All effect and cause interact and function as an integrated whole. For this reason we will not follow existing allopathic research method in this chapter and the succeeding ones.
Clinical research in holistic healing is needed to test the effectiveness of different treatment regimes, to educate the public on different non-drug therapies, and to develop a method which treats people as wholes. Holistic approach includes the following principles:

• Research and healee are equal partners in the research and share all knowledge; it is a co- operative, experiential inquiry.
• Reality is a process, always emerging.
• Knowledge is subjective-objective and varies widely from person to person.
• The healee must accept self-responsibility for healing and work together with the healer in the process.
• All aspects are include to study persons as wholes: the atmosphere, community, work place,family, culture, and so on.
• Beliefs, attitudes, expectations, and values play a major role in healing.
• The spiritual realm evoked by a variety of interventions is at the heart of healing.
• Symbols, myths, metaphors and stories utilize the biology of hope in the healing process.

In reviewing the literature, a pattern emerges of the importance in holistic healing of the following aspects: the healer/healee relationship; the spiritual realm; symbols, myths, and metaphors; and the mind/body connection.
As these form the basis for the development of a holistic research method, we will deal with them first.

THE HEALER/HEALEE RELATIONSHIP
Peter Reason and John Heron in their Whole Person Medicine, report on an one year research study of the principles and practice of holistic medicine. They studied persons as wholes using a five part model of holistic medicine:

1. Concern for the patient as a being of body, mind, and spirit seen in historical, social and political contexts.
2. The patient as a potential self-healing agent.
   What we include is the more radical principle that each person as a mental and spiritual being has the potential capacity consciously and intentionally to facilitate healing in their body by a variety of internal and external actions.
3. Power sharing between doctor and patient - shared responsibility for diagnosis and treatment.
   In diagnosis the doctor has the medical view, and the patient a personal view, and can understand and give meaning to their illness in terms of their own unique knowledge of their total life situation.
4. Ability to offer a wide range of interventions.
   This includes competence in alternative therapy as well as the conventional.
5. The doctor as self-gardening.
   This means the principle of personal growth--the practitioner of holistic medicine needs to be holistic in their personal development, behaviour and life-style, and to be consciously involved in the process of holistic self-developing and social awareness Holism apires to see things whole, so Reason and Heron wove these five principles into three models of how they wanted to move in their study. .
   _________

1. Peter Reason and John Heron (Eds.). Whole Person Medicine : A Co-operative Inquiry. British Postgraduate Medical Federation, University of London, July 1985.

In this model, both deal with their own growth and healing process. This creates the right condition for change; power is shared; the model is symmetrical; both doctor and patient give and receive care, understanding, recognition, and acceptance. A mutual personal relationship develops which is ongoing and hopefully will develop into the model.
When we move beyond the myth of the all-powerful healer, an intimate relationship can develop where both sense their limitations and their strengths.
It is the power of this relationship that heals. It is a living archetype--a polarity exists within both--the healer and the healee. There is in everyone something to be healed. The cure depends ultimately on this relationship. Here again these polarities in doctor and patient, the yin and the yang, the dark and the light, the strengths and weakness, merge as they flow. The doctor becomes the teacher who is touched by the patient and vice versa. The power of healing, built on this intimate relationship, is an ever increasing experience of Faith, Hope and Love-in a caring and compassionate manner.
Healing in its most fundamental character has less to do with `doing’ -- that is employing physicalistic techniques -- than in assisting with the `being’ and the `knowing’ of the patient.
Shah and Mankad₂ speak of the opposite effect when the doctor patient relationship is not healthy. "The negative aspect of the patient-doctor communication is usually not taken seriously by most of us. Not that we do not care, but we are often not aware of the powerful impact our words or pronouncement or even gestures might have on the patient’s disturbed and vulnerable psyche. This very vital aspect in patient-doctor relationship is hardly ever even hinted at by our teachers. An unguarded statement or an obvious look of concern on our face, however fleeting can create panic and increase the apprehension in the patient’s mind. Such a patient, whose morbidity and suffering are increased because of the doctor’s behaviour can undoubtedly be said to be suffering from an iatrogenic(doctor induced) disease, or an iatrogenic complication of an already existing disease. Thus doctor-patient communication assumes greater importance, perhaps as much as drug treatment, not only in serious or potentially fatal conditions, but in our day to day dealing with routine cases .... we talk with the patient, not to the patient and talk in his own dialect at his own level of comprehension. The art of communicating with the patient is not an easy task, for one has to assiduously cultivate it over a life time.... " Norman Cousins wrote "I pray that the medical students will never allow their knowledge to get in the way of their relationship with their patients......I pray that when they go into a patient’s room they will recognize that the main distance is not from the door to the bed, but from the patients’ eyes to their own, and that the shortest distance between those two points is a horizontal straight line, the kind of straight line that means most when the physician bends low, to the patients loneliness, fear , pain, and the overwhelming sense of mortality that comes flooding up out of the unknown, and when the physician’s hand on the patient’s shoulder or arm is a shelter against darkness.... Ultimately it is the physician’s respect for the human soul that determines the worth of his science".
__________

1. See for instance in Larry Dossey. Beyond Illness. New Science Library, Shambala. Boston and London, 1984. pp. 193-206.
2. Jayant N. Shah and Kishore M. Mankad . " Iatrogenesis and Doctor-Patient Relationship" in Gujarat Medical Journal, Special Issue:
: latrogenic Diseases, April 1987, pp. 197-299.

Reason and Heron₂, carry the idea further - from the doctor-patient relationship can come cooperative experiential inquiry which is a new paradigm of research methodology. Their referring us to Indian advocates of participatory research reinforced our thinking on this aspect of research and empowerment.₃ Awareness and empowerment are central to participatory research. Awareness is an understanding of the problems affecting oneself as well as the underlying cause of problem. Awareness has both an intellectual and an emotional aspect. This brings a sensitivity to the problem and their causes. Empowerment by collective self-confidence and respect for one’s abilities is the aim of participatory research. Potency is felt. Participatory research, evaluation and training, empowers people to take initiatives in their common interests.
_________

1. Norman Cousins. The Healing Heart. WW Norton & Co., New York, 1983.
2. Peter Reason and John Heron. "Research With People" in Person-Centered Review Vol. 1, No. 4, November 1985, pp. 456-476.
3. Rajesh Tandon. Participatory Research. Society for Participatory Research. Society for Participatory Research in Asia, New Delhi, 1982

It makes them self-confident, skilled, aware, and knowledgeable.
In participatory research, the healer and healee are involved in all the thinking and decision making that generates, designs, manages, and draws conclusions from the four phases of participatory research: 1

Phase 1 : A group of researchers agree on a course of enquiry and identify some initial research propositions. They also agree to some set of procedures by which they will observe and record their own and each others experience. This phase involves primarily propositional knowing.

Phase 2 : The group then apples these ideas and procedures and records the outcome. They need to be particularly alert for the subtleties and nuances of experience and to ways in which original ideas do and do not accord with experience. This phase involves primarily Practical knowing.

Phase 3 : The co-researchers become fully immersed in this activity and experience. There will be ups and downs. They may change their beliefs, and attitudes. This phase is mainly experiential knowing.

Phase 4 : After an appropriate period, the co-researchers engaged in Phase 1 to 3 (several cycles), return to consider their original research propositions and hypotheses in the light of experience and modify, reformulate, reject, and adopt new hypo-theses, etc. They may also amend and develop their research procedure more fully to record their experience. This phase is a critical return to propositional knowing.

In participatory research, it must be remembered that power sharing must be done appropriately. The roots of power-leveling and demystifying strategies include skill-sharing; explaining and teaching; changing the environment; being less formal; being warm in relationship; being personal - telling about personal life; changing seats, role - playing - to experience the other’s constraints; increasing autonomy by access to feedback loops; and doing all evaluation together. Since co-operative inquiry is so different from traditional research methodology, we highlight the nature of involvement which is openly negotiated. All contribute to the creative thinking : invention, inward movement, processing and testing; deciding on what is to be looked at; determining the methods of the inquiry; making sense out of what is found out; contributing to the action which is the subject of the research encounter; and reflecting, analysing and communicating to others the experience; writing reports, and case studies, etc. To shift to this new paradigm research requires three changes_:1
__________

1. John Heron. "Experiential Research Methodology" in Human Inquiry : A Sourcebook of New Paradigm Research. John Wiley & Sons, Chichester, 1981. pp. 153-166.

1. Participatory and holistic knowing : This self-directing ability is at least latent in all human beings, and includes the following processes and methods:

Using encounter which is tacit, intuitive, and holistic rather than surveys, questionnaires, and observation.
Planning research action together.
Practising and experiencing it.
Reflecting on the experience, revising, developing,discarding.
Finding the meaning of the data.
Communicating the findings.
Using participatory and holistic knowing in a caring way with mutual love and concern.

2. Critical subjectivity : This is a quality of awareness, an active knowing, where the mind is detached, objective, analytical and clinical. It goes beyond the split between subjective and objective. It honours individual experience and works to enhance that experience towards a critical subjectivity.

3. Knowledge is action : Education and social action may become fully integrated with the research process.
Thus we can see the vital role played in clinical research by a deep and meaningful healer/healee relationship. The second important aspect in healing is the spiritual realm.

THE SPIRITUAL REALM
Spiritual interventions we use in our Holistic Health Centre include:
Centering : Intensive Journal Method; Keeping a Spiritual Journal; Spiritual Direction; Meditation; Contemplative Prayer; Pain/Suffering; Creation Spirituality; finding the Meaning of Life; Enhancing faith and Hope; Healing of Memories; Nonviolent Action Retreat; Forgiveness and Letting Go; Laying on of Hands; Physical Fitness Programmes as a means of total experience; Relaxation and Guide Imagery; Enhancing awareness, and raising consciousness; Transformation; Psychosynthesis; Retreats; Finding the Meaning of Dreams; Support Groups: Death and Dying Yoga.
____________

1. Peter Reason (Ed.). Human Inquiry in Action. Sage Publications, London, 1988.

Roberto Assagioli’s Psychosynthesis₁ as a way of incorporating the spiritual dimension has been a part of our healing methodology from the 1970’s. He gives meaning central importance in life. Values, particularly the ethical, aesthetic, noetic, and religious are of great importance. The existence of a spiritual Self is the basis of psychosynthesis. Psychosynthesis includes psychosomatic medicine, the psychology of religion, the investigation of the superconscious, Eastern psychology (especially Indian), creative understanding, holistic approach, inter-individual and social psychology and the anthropological study of man, and active techniques for the treatment and development of the personality.
Jacquelyn Small₂ takes psychosynthesis a step further by giving a step by step approach to transformation. She says: "Essence is our soul--the authentic unifying centre behind our personality. It is the knowing self residing in a realm beyond concrete reality, which bases its choices on the essentials about us-our unique mission and purpose in life. Essence is the seat of our vision, our hope, creativity, intuition, spiritual yearnings and purposes, love, wisdom and all the other qualities that really give our lives meaning. Essence puts us in touch with the true powers of being human. This book fills in, what psychology has lacked, knowledge about Essence. This indwelling spiritual component of the Self is experienced as the urge toward wholeness and unites our lower self to our higher self. It carries on an active dialogue with our personality self. It speaks to us through symbols in dreams, visions, altered states of consciousness, and synchronistic events. These spiritual dispatches reveal spiritual directions. Establishing contact with it helps us change blind habits, unhelpful beliefs and addictions which lead to conflict in our lives. The goal of transformation or spiritual growth is an integrated completion of the Self with qualities of religion often attributed only to God; love, compassion, unity, wisdom, intuition, altruism, and truth." See also Chapter 4 on Psychosynthesis and Transformation.
The third important aspect in holistic healing is the use of symbols, myths, and metaphors.
________

1. Raberto Assagioli. Psychosynthesis. Penguin Books, England, 1965.
2. Jacquelyn Small. Transformers: The Therapists of the Future. DeVorss and Co. California, 1986.

SYMBOLS MYTHS AND METAPHORS: STORIES
All therapeutic approaches and systems make explicit and implicit use of metaphors. Metaphors are a way of talking about experience. Metaphors, in the form of fairytales, parables, and anecdotes, are consciously and unconsciously used by therapists in order to assist a client n making the changes he wants to make. The hope underlying this story-telling is that the experience of another in overcoming a problem which is similar to that of the client’s, will suggest to him directly or indirectly, ways in which he can deal with the situation. The use of metaphors helps us move beyond a positivist view of the world toward a world of multiple realities.
All knowledge is metaphorical. Metaphors are the organizing forms which serve as our perspectives on life. Mythical, symbolic life still is at the center of our lives and our sciences. The healing power of metaphors and cultural systems is the most powerful healing element in all cultures. Modern medicine
has rediscovered a small fraction of that which is labelled the mind/body connection. We must go far beyond into neuroimmunomodulaion and its healing effect which is triggered by healing metaphors in the social system. This points to the need to look at the healing potential of the social system at on all levels physical, spiritual, psychological, emotional - in the family, the group, the social system, and culture as a whole, including religion and medical ideologies.
In studying universal aspects of symbolic healing, James Dow₁ proposes the stages of symbolic healing in outline :

1. A generalised cultural mythic world is established by universalising the experiences of healers, initiates, or prophets, or by otherwise generalising emotional experience.
2. A healer persuades the client that it is possible to define the client’s relationship to a particularised part of the mythic world, and makes the definition.
3. The healer attaches the client’s emotions to transactional symbols in this particularised mythic world.
4. The healer manipulates the transactional symbols to assist the transaction of emotion.
   __________

1. Jame Dow. "Universal aspects of Symbolic Healing : A Theoretical Synthesis" in American Anthropologist, 8 (1986) pp. 56-69.

All symbolic healing methods involve an ontological shift for the client into a particularised mythic world. Symbolic healing becomes possible when a particularised mythic world exists for both the therapist and the client and when the client accepts the power of the therapist to define the client’s relationship to it. The therapist then attaches the client’s emotions to transactional symbols and manipulates these symbols.
Once we have chosen and established a metaphorical perspective on our world, lived with it and given it some life, we can begin to establish dialogue, new world-views may emerge. The use of metaphor encourages us to live equally with two or more world-views. Thus we can explore ways of developing high-quality awareness, right action, and use of metaphor. This is closely linked to the spiritual realm discussed above- developing mindfulness through the disciplines of Buddhist meditation, using psychodrama, a yoga of participation, confronting distress to heal old hurts and patterns. From this we learn to act from our center rightly in our lives and in our world. The forth important aspect in holistic health is the mind/body connection.

MIND/BODY CONNECTION
"The labyrinthine puzzle of unconscious-conscious awareness intercourse that makes our social life so complex is, in fact," says Barbara Brown₁, "the crucial substructure of all mind and body control. It is so delicate, so observing, so responsive, that this lacy, elusive organisation of mind can be shown to respond subconsciously even to the mistakes of science. After all, the mind does depend upon information to make its conclusion and direct its activities, and when the information is sanctioned by authority, the mind muses it. This explains why so may volunteers for psycho-physiological experiments so often produce the results researchers want; and why placebos can relieve real physical problems. The ingrained belief in authority by conscious awareness can indeed overrule the innate intelligence of the unconscious mind."
The most important and totally unique characteristic of stress as a cause of illness, according to Brown, is that it is the "only cause of illness that requires activation and energising by mental processes. If unconscious worry can distress mind and body, is it not possible that the unconscious mind may also function actively to ensure well being ? This leads us into the whole realm of beliefs and their effect on illness."
_________

1. Barbara B. Brown. Super-Mind. harper and Row, New York, 1980. pp. 70-72.

Biofeedback has shown us the prowess of the mind to move electrochemical underpinning of the body with such precision that we can not help but appreciate the extraordinary powers of mind to control body processes.
In Healing From Within, Jaffe₁ observes that " the medical community does not accept or is unaware of the impact that psychological processes have on the self-restorative capacity of the body. Many doctors assume that spontaneous remissions occur merely by chance and hence could not be introduced systematically into the treatment process. But what if research could prove that these cures are attributable to specific psychological process? If that were the case, couldn’t physicians incorporate them into their therapeutic program? Wouldn’t beliefs then become an important aspect of treatment , and make `miracles’ routine and explainable?" Much of medicine, both past and present, consists largely of magic and suggestion. In most medical research, the power of belief systems are considered a distraction that interferes with the study of the actual physical mechanism of drug action. In our research we take the opposite position, we see their importance and incorporate them in the research methodology.
"Physicians have just begun to speculate about what physical mechanisms in the brain might initiate physical changes as a result of mental suggestion. The placebo effect may be activated in part by naturally occurring substances in the brain called endorphins. These molecules are the body’s own pain -relieving materials; they allow the nervous system to turn off pain when it is appropriate to do so. In essence, the brain can release its own narcotic. Endorphins were first identified in 1975, and scientists are still not certain precisely how they work. But early studies already indicate that they have a chemical structure identical to morphine. And when secreted by the brain, they may maximise the body’s ability to respond to a variety of healing techniques."₂ The connection between the level of trust of the patient in the doctor which again hinges on the importance of the doctor-patient relationship covered above is the basis of the mind/body connection. But it is necessary to go far beyond endorphins and hypnosis and extend the placebo effect into the whole area of neuroimmunomodulation. We see the effect of beliefs, values, and attitudes on health and the importance of positive imagery in strengthening the immune system.
________

1. Dennis T. Jaffe. Healing From Within. Alfred A. Knopf, New York, 1980.pp. 52-63.
2. Jaffe, op. cit., p. 55.

This is done by examining the expectations and beliefs, and helping the person to change those that seem to hinder the treatment process. Healer and healee must work determinedly to alter negative mental patterns into positive, health-enhancing patterns. The person must be guided towards discovering the healing power that lies within. Accurate information about the body’s potential can counter their fears and pessimism. Information is healing. It brings a sense of hope and the belief that they may be able to effect change in their condition.
According to Daniel Moerman₁, "There are substantial pathway which link physiological and cognitive states and these pathways are the stage on which metaphoric concepts of performance may `be effective’, that is influence biological processes." He analysis the placebo effect, traditionally considered to exist on this mind-body boundary and often used to explain the effectiveness of the shaman’s technique. The patient’s expectant faith produces what to biomedicine is known as the placebo effect.
In her Imagery in Healing<sub>2</sub> Jeanne Achterberg says, "when the imagination is considered as the ultimate healer, aspects of what has become known as `placebo effect’ are being addressed....The placebo effect comes about because of the imagination; but it isn’t synonymous with the imagination itself. Its tenacious presence in clinical studies of drugs and surgery provides ample proof for the effect of the mind on body chemistry ..... Every thought is accompanied by electrochemical change. So if you take a pill, and you feel that it’s going to cure you, the pill is metabolized in a very different environment than if you think the pill is Poisson. That’s crude way of summarising the very exciting research that is now going on regarding the biochemical aspects of imagination. Placebos like imagery, hypnosis, and biofeedback, surely must have direct effect on the immune system, but the components are yet to be carefully researched. The imagination can incorporate and translate into wondrous biochemical changes that are as yet beyond the comprehension of the finest scientific minds. The wise doctor within each of us knows how to make pain disappear, and tumors melt. It knows whether to call forth T-cells or histamines or endorphins - all in the proper order and combination. The mind/body connection only triggers the process . . . . Hopes and fears, previous experiences, archetypal belief systems, and especially expectancy, all form the basis for
________

1. Daniel E. Moerman. "anthropology of symbolic Healing" in Current Anthropology, Vol. 20,1, March 1979. pp. 59-66.
2. Jeanne achterberg. Imagery in Healing. New Science Library, Shambhala, Boston and London, 1985. pp. 84-87.

the basis for the quality and degree of the response. The effectiveness varies depending on how much the patient expects to benefit....Even the active properties of drugs can be overcome by the imagination".
Much is written and recognised throughout recorded history of the shamans’ work in the realm of imagination. Jeanne Achterberg 1 links this same power to the scientist. The shamans use a primitive form of medical and psychological aid designed to pacify the ignorant natives. The shaman is the world’s oldest professional from whom both the modern doctor and priest descend. The shaman is characterised by practices of ecstasy or altered states of consciousness. A shaman has guardian spirits from whom power and knowledge is gained to heal others. Shamanism is the oldest and most widespread method of healing with the imagi-nation. There is archeological evidence suggesting that the techniques of the shaman are at least 20,000 years old. Their practices are consistent throughout the world.
Jerome Frank in his Persuasion and Healing2 concludes that "any effectiveness of shamanic healing is a function of heightened expectancy on the part of the sick and injured, and that the true benefit of the primitive techniques is to provide emotional relief and a sense of community. Shamanic rituals and symbols provide one of the more fascinating sagas of how human being attempt to relate to the supernatural in order to create a condition of health. shamans of all genres do not distinguish between body, mind, and spirit, a person is treated as a total unity. We can trace the healing use of imagery as the golden thread throughout the history of medicine from Hippocrates, Aesculapius, Aristotle, Galen to the present time" The use of imagery in modern medicine has taken us to the edge of a new era of healing - neuro-immunomodulation-which bridges the whole of shaman and science in going ahead with the golden thread of healing.
Norman Cousins has the last word on mind/body connection (placebos): "What is most significant about placebos is not so much the verdict they supply on the efficacy of new drugs as the clear proof that what passes through the mind can produce alternations in the body’s chemistry. These facts also indicate that the same pathways and connections that come into play through the use of placebos can be activated without placebos.
________

1. Ibid.
2. Jerome Frank. Persuasion and Healing. John Hopkins University Press, Baltimore and London, 1974.

The main ingredient is the human belief system. Confidence in the ability to mobilise one’s resources is a prodigious force in itself. The text great advance in human evolution may well be represented by the ability of human, working with a new understanding of brain chemistry, to preside over their own beings".1 This is in line with the thinking and research of the authors. This new era of healing, incorporating the use of imagery in healing has been described in Volume 1, Chapter 2 of The Banyan Tree series, pages 87 to 144.
________

1. Norman Cousins. Human Options. W.W. Norton and Company, New York, 1981. See also : Norman Cousins. Head First :The Biology of Hope. E.P. Dutton, New York, 1989.

[index]