1.1 Disease as creationIntroductionThere are many ways to look at diseases. Different ways to look at disease have advantages and disadvantages. The different views are mostly not contradictory, but more complementary to each other.
Iris’s caseThe case of a girl with severe acne will be used as an example. Her parents are constantly quarrelling. She has the fear that her parents will divorce and she will be abandoned. She is gloomy, depressed, retreats into herself, and disconnects from her friends. She gets outbursts of anger when everything gets too much.
Disease as a physical processThis is the first concept of disease, the way it is often used in ordinary medicine. A human being wears out, just like a machine. From time to time we need to replace the worn-out parts. This vision of disease as a wearing-out process fits in well with the mechanistic view of the world. This vision is not so strange. Everybody gets older, weaker, and eventually dies. But there are certain problems with this point of view. The human body is constantly being renewed and repaired, so it is not clear how and when the wearing-out process would prevail over the ability to repair. This dilemma is represented clearly in the following example. An elderly woman goes to the doctor with pain in her right knee. The doctor looks at it and says reassuringly: "Don’t worry, it is only a bit of wear and tear." Upon which the woman answers "It is all right for you to say that, but my left knee is just as old and there is nothing wrong with that one!"
In the case of Iris we can see her acne as a defective immune system that cannot overcome the acne bacteria anymore.
Disease as a threatOften the disease is seen as a threat. If something is not going well, death may even be looming. The disease is seen as something bad, as something coming from outside that has to be fought.
Bacteria and viruses have to be killed at any cost: it is either them or me.
This viewpoint has an analogy to the theory of evolution. In both visions, the central idea is that of fighting. The central idea is that one has to defend oneself against all negative influences from outside.
In the case of the girl with acne, the bacteria can be seen as a threat. Another threat is being abandoned by her parents, or not being attractive anymore to boys, and remaining alone.
Disease as temptationOne could also see disease as a temptation. It can be the temptation of knowing what one has which can overcome the fear of the unknown. Letting go of a state of being can induce feelings of insecurity. Diseases can have advantages in the form of avoiding tasks and responsibilities. One feels right to retire as one is wronged, or just tired. It can be the temptation of being right. Feeling right in one's state is a strong motive to stay there.
In the example case the girl can be tempted to remain in her state of being with the feeling of being wronged. It can have the advantage that she does not have to take up responsibilities or not getting rejected by boys.
Disease as protectionWe could see disease as protection in direct relation to disease as temptation. A certain attitude can keep a danger or a fear at bay and can therefore give a certain amount of protection. The disease can also serve as diversion tactic, as a compensation mechanism. By being intensively occupied with your work, for instance, you could push away or avoid a deeper problem, such as for instance troubles in your marriage.
In the example case, the girl is protecting herself by diverting the attention of her parents to her state, so that they have less time and energy for their own problems. Her acne can protect her against getting rejected by boys, by not engaging at all with them.
Disease as talent or strategyDiseases can be seen as survival strategies, as an art, or talent. They make it possible to manipulate the environment. You could also call it a strategy, a strategy that works excellently in certain situations in order to make the best of it. It is the positive side of diseases.
Going back to our example one could say that it is rather clever of this girl to make her parents stop fighting. When they see her so silent and gloomy they understand that they are hurting her and they stop quarrelling.
Disease as illusionAnother approach is to see disease as a delusion or illusion. Central in diseases is a certain idea about the world. Every personality has a central delusion, a central theme, something that the patient perceives incorrectly. The delusion is present in his philosophy of life. It is expressed as a conviction, very often generalised. This is expressed with terms like 'always, never, everybody, nobody, nothing'. Norms and values are a good representation of their delusions.
A nice illustration of the relationship between delusion and disease is written in the book by Bernie Siegel 'Love, Harmony and
Cure' (1989, page 36). A woman has ALS, a paralysing disease where the muscles waste away. She became conscious of the fact that her thoughts were always on her weight, that she always wanted to become slimmer because then her problems would probably disappear. Suddenly she wonders “Is it mere coincidence that I always wanted to have a thinner body and that ALS is now fulfilling this wish?”.
In Hawaii, shamans also have the concept of disease as a belief. King describes that the primary work of a Kahuna healer is to change the patient’s belief system, the rest of the rituals being a secondary matter. A feeling is an energy that is linked to and bound by a belief. King differentiates between three sorts of beliefs. First, there are opinions about which you can have discussions. Secondly, there are convictions. When people are confronted with the opposite of their convictions they become emotional, they start heated discussions and react with strong disapproval. And thirdly there are deeply rooted convictions. These are so deep that people hardly recognise them in themselves and their reaction to a confrontation is merely surprise. These last mentioned convictions are very difficult to bring to the foreground during a consultation.
In our example, the girl lives with the delusion that quarrelling is threatening and that she will be abandoned.
Disease as a sign or symbolIn this view a complaint is seen as a symbolic expression of a psychological problem. Many expressions in our language confirm this viewpoint: 'This is a load on my shoulders', 'This is heavy on my stomach'. It is possible to see all diseases as symbolic. Dethlefsen describes this view extensively in his book 'The Meaning of Illness'.
In our example of the girl one can see the acne as a distortion of her face, her image to others. She feels less beautiful and attractive.
Disease as cultural phenomenonIt is also possible to see disease as a cultural phenomenon. Every culture has its own norms and values. When these norms and values are one-sided, they become illusions or delusions. These norms can lead to complaints in individuals in that culture. In
Western culture, it is 'not done' to show sadness. You don’t suddenly cry, and definitely not in public. Even at the funeral of a well-loved person you are supposed to remain composed. This is in contrast to other cultures where the wailing can be heard from far away. The pattern to keep your grief inside is a cultural disease. Different cultures have different types of psychoses; there are many different types of psychoses in Europe and Japan, and different illnesses. For instance, breast cancer is very common in western culture, whereas stomach cancer is more common in Japan.
Disease as myth or fairy taleMyths and fairy tales are expressions of cultures. If somebody recognises his own problem in a fairy tale it can touch him deeply. Patients can express a cultural problem. Via the myth one is connected to the whole of humanity. Often the myth also offers the solution to the problem and can thus be a real help. Joseph Campbell expresses this as: “If you can find out where someone is blocked, it must be possible to find the mythological key to unlock this door”.
On the other hand you could say that by solving his own problems, someone could help humanity to solve its mythological problems. It has become apparent that the best help with a certain problem can be given by those people who themselves have had and solved that same type of problem. They are best able to feel the essence of the problem and to know where solutions are to be found and where only temporary solutions will fail. “Alcoholics Anonymous” is a good example of this.
Disease as creationFinally there is the view of disease as a creation. One can call disease 'spirito-somatic', analogous to the term psychosomatic. Human beings create a certain state within themselves and then look for a fitting situation around that. The circumstances are not the cause of disease, but instead, man is the cause of his disease and the creator of his circumstances. In this viewpoint, the responsibility comes back to oneself. Dethlefsen describes this in his book “
Disease is a Path to Perfection”.
Within the ability to create diseases lies the ability to find a solution. Human beings then have the ability to change, let go of old problems, and to create new possibilities. From this viewpoint of disease as creation, terms like good and bad are not applicable anymore. One simply has a whole range of states, creations with experiences belonging to them.
Disease becomes a learning process.
Campbell gives a nice example of this viewpoint. A woman with a lot of pain told Campbell: "God has done this to me". He answered her "No, you did this to yourself. God is inside you. You are your own creator. When you discover inside yourself the place where you created this, you will be able to confirm this and live with it, perhaps even enjoy it, as being your life." The woman instantly felt a very deep change taking place and her complaints diminished considerably.
If we look at our own example in this way, then only the girl herself is responsible for her situation. That applies to her state of depression and apathy as well as all the other circumstances which she is in.
A comparison of the different points of view
These different viewpoints can exist next to each other. They are different angles from which to view a problem. It depends on the point of view whether we see man as an observer of his own life drama, or as an actor, producer, or writer. You could also say that man plays all the parts at once. The differences in points of view are then merely the consequence of a restricted way of looking at the whole.
One can even find a sort of hierarchy in the viewpoints, a hierarchy in the level of looking at causes outside yourself or inside. If we see disease as a process of wearing out, then there is nothing that can be done about it. You are a complete victim of that, "you’ll have to learn to live with it." At the other extreme, with disease as creation, man is completely his own cause. Psychological, social, or physical circumstances don’t have any influence on the situation, because they are a part of his own creation.
Perhaps it is useful to mention that not everybody will accept every point of view as being true. It can be difficult to accept a particular point of view. This could be because many things happen at a subconscious level. Some viewpoints are also quite paradoxical and that could make it difficult to gain an insight.
Another important factor is feelings of guilt. Many people react very emotionally to the suggestion that disease could be a creation. The idea that they themselves are responsible creates so many feelings of guilt that they cannot accept this. But in the vision of disease as creation, the concept of guilt cannot exist. This misunderstanding is caused by confusion about something else, 'the I and the
Self'. The 'I' can be guilty of something, but the '
Self' can only be itself, create, and express itself.