It is said that all theory is a reflection of autobiography, and I am no exception. I am a physician by profession and a psychotherapist at heart. At the deepest level of my being, my calling is that of a healer. Being a healer, or more accurately a facilitator of healing within the realm of psychiatry, includes the skills of a physician and a psychotherapist but emanates from a different center of focus.

A physician’s task is to bring the physical, biological systems of the brain and body back into balance with each other, referred to as homeostasis. It requires knowledge of biology and treatments based on objective scientific principles. A psychotherapist, whether physician or not, primarily works at the subjective, psychological level of the mind. 

The task of a psychotherapist is to help people become aware of and understand their actions, beliefs, emotions and relationships in order to help them change what needs to be changed, mature what needs to be matured, and work through what needs to be resolved. Its focus is on helping the patient develop mindful self-awareness and assume self-responsibility. Its goal is personal growth and a commitment to living from a place of greater authenticity and wholeness. Whereas a physician can diagnose and treat an illness with little or no relationship to the patient, psychotherapy is built on establishing a therapeutic relationship founded on curiosity, respect, safety, and trust.

Being a healer includes the physical and psychological but extends the framework in which healing takes place. The words “heal,” “whole,” and “holy” all share a common root. This tells us something about the difference between fixing a problem, be it physical or psychological, and helping a person heal. The word itself implies that healing has to do with restoring wholeness within a sacred context. Images of healers range from the shamans of South America, shaking rattles and inducing trances while using plant medicines, to spiritual-minded practitioners of all stripes practicing laying on of hands, while focusing their own consciousness on a transcendent source of healing. Modern-day practitioners of healing arts are mostly found in the complementary and alternative medicine (CAM) world of hands-on energy healers, naturopaths, acupuncturists, massage therapists, herbalists, and yoga therapists, to name a few.

There is an underlying sense that the healing encounter is in fact a sacred mission of finding, connecting to, and liberating a human soul trapped within a complex weave of conditions and circumstances. It is about helping a person activate their innate, natural capacity to heal and develop. 

Allow me to introduce a modern-day version of a spiritual belief. There is a vital life force that is the foundation of all living things. It possesses information, energy, and intelligence. It has the innate capacity to animate, create, awaken, inspire, and heal wounds. Whether it is the body and brain automatically attending to a cut by sending blood containing all the components and intelligence necessary to seal and mend the skin, or a vision coming in a dream and resolving a problem in daily life, the life force is there to maintain life and promote growth.

As conscious human beings, we feel its presence in our bodies as vitality and its presence in our minds as awareness and intelligence. We feel its presence in relationships as love, nurturance, and the need to protect one another. We experience it as the will and strength necessary to overcome the challenges of life.

What happens when we are cut off from this life force, as in depression? What happens when we are caught in states of high anxiety, when the activation of our body and the energy of our thoughts are so chaotic and fear-dominated that all we get are obsessions and worries rendering us incapable of problem-solving? What happens when the heart is closed to love and only feels bitterness and despair?

Then we are in need of healing, being restored to our innate wholeness so that we can grow, thrive, work, create, and love.

Healing may involve the skills of a physician to diagnose and treat a biological obstacle to vitality, such as the need for higher brain levels of serotonin or noradrenaline. It may involve the skills of a psychotherapist to identify and help reduce excessive guilt or chronic shame that inhibits a person’s freedom to be themself and take necessary actions in the world. Freeing up the life force may involve lifestyle changes, addressing toxic relationships, or understanding and coping with the stress that socioeconomic instability brings. Restoring hope may be just as important and effective as restoring neurotransmitter balance with Prozac. 

The task of a healer is to diagnose and help provide what is necessary to achieve healing and growth. The focus of treatment may be physical, emotional, cognitive, social, or spiritual. 

I did not initially start my career with this orientation. My own inner yearning to feel whole, fully alive and to live a life of connection, meaning, and purpose propelled my search for a path of healing. 

My choice of psychiatry as a profession grew not only from a desire to help others. It also served as a path for me to discover knowledge and tools that would be beneficial for my own well-being. I, too, wanted a healthy body, a calm and peaceful mind, and an emotional life relatively free from the life-inhibiting emotions of chronic underlying fear, guilt, and shame. 

As a young man, I desired a stronger positive sense of self and a meaningful life based on mindful awareness and conscious, thoughtful life decisions. I did not just want to live; I wanted to feel alive. I wanted my relationships solidly grounded in love and respect. I knew that achieving that required healing my own childhood wounds and maturing into the man whose potential I felt stirring inside. 

Formal training in psychiatry was just the beginning of my search. This book is an invitation to travel with me back in time as I discover extraordinary teachers, healers, wisdom traditions, theories of mind, and healing practices. While this personal search was ongoing, new and exciting developments were happening in the fields of neurobiology and the treatment of trauma. These discoveries allowed the ancient practices that I was studying, such as meditation, yoga, and hands-on healing, to be verified and grounded within a modern scientific framework. 

Over time my practice as a psychiatrist and psychotherapist and my experiences on my personal healing path began to form  themselves into ways of working with the people who came to me for help. 

The theories, practices, and experiences you will read about gradually integrated themselves into a way of practicing psychiatry. It is my own version of the new field known as integrative psychiatry, which will be explored in greater detail in subsequent chapters. My current philosophy of treatment looks to bring together elements of mind, brain, body, and inner personal self into a cohesive wholeness.

Psychiatry has been increasingly defined as the treatment of specific mental disorders. Most contemporary practitioners, fueled by scientific advances in understanding brain biology and the current cultural mindset of insurance companies and pharma interests, view psychiatry as primarily a medical specialty, whose principal tool is medicine or some other brain-based intervention. Psychotherapy has largely become the domain of nonmedical therapists.

Psychiatry indeed is a scientific medical specialty. However, that is not all it is. Attempting to fit all who come for treatment into that rubric does a disservice to many. The mainstream profession seems to have forgotten that the word “psychiatry” comes from the Greek word psyche, meaning soul or mind. I prefer to think of a psychiatrist as a healer of the soul and mind, not just of the brain. 

As I found new teachers and my self-understanding grew, I developed a greater curiosity about my patients. My focus was no longer limited to making a medical diagnosis or providing psychotherapy based on the limited psychoanalytic theory I learned as a resident. I wanted to understand who the person was who was being given a diagnosis. What factors were trapping them? Was it their biology, emotional life, thinking style, relationships, inner wounds, unprocessed trauma, or unexpressed longings of the soul? What combination of the above was at work and what would be the best way to approach treatment? I did not see myself treating a “case” of depression, but treating the person who had the depression. 

I remember when I began to do outpatient psychotherapy in the third year of my residency. I was working with a young college student, Henry, who came in after his girlfriend abruptly left him. He was heartbroken, practically inconsolable. It had happened three weeks prior to my first visit with him and he wasn’t sleeping, was crying nonstop, felt helpless and hopeless and at times had suicidal thoughts. He was twenty-two and I was twenty-eight. In spite of my education, and the few extra years I had on him, how much more did I really know about the heartbreaks of life and love? 

I listened, empathized, encouraged, and advised. I considered that perhaps his grief had triggered an underlying proclivity toward depression. I gave him some meds to help calm him, and improve his sleep and his mood. It helped to a degree. 

Then one day, a few weeks after I began to see him, he came in as a transformed young man. He was serene, he was beaming, he was relaxed. Quite honestly, he was in better shape than I was! I knew that this could not fully be attributed to medication and psychotherapy. How had this remarkable transformation taken place? 

He tossed down on my desk a book by Dr. Gerald Jampolsky, a psychiatrist. The title, Love is Letting Go of Fear, did not match anything I had been taught as a resident. It was an inspirational book about love, fear, courage, and letting go of judgments. It spoke about the human capacity for freedom and choice of beliefs and attitudes. It was about forgiveness and gratitude. The therapeutic effect it had on this young man was remarkable. 

Had I brought this book up with one of my psychotherapy supervisors, it would have been met with a shrug and seen as a way of helping my patient avoid dealing with “the real issues,” his underlying psychological makeup. It would not have been taken seriously. It would not have been included in the canon of psychological approaches deemed appropriate for a beginning psychiatrist. However, it strengthened my growing realization that people heal and transform through myriad approaches, most of which were being completely ignored by what I was learning in my residency.

I was interested in the underlying ingredients that facilitated the fundamental core shift of being that I witnessed in this young man. He seemed to be onto something that I could personally use and that would be useful to my patients as well. 

I wanted to understand the mysterious alchemy that led to the profound shift and change in consciousness that I witnessed in Henry. Were there practitioners who were able to facilitate that with their patients? Who were they? I wanted to find people to work with myself and learn methods or philosophies that provided transformative, life-changing experiences for my patients. Yes, I was young; yes, I was naïve; and yes, I appreciated the reality that most change occurs slowly, incrementally, without the help of magic. But that did not deter me from my quest.

At that time, I had no way of knowing just how intertwined my personal and professional path would eventually become, allowing me to establish a treatment approach that resonated both for my patients and myself. 

That path would lead me to experiences that included silent meditation retreats, extensive hypnotherapy, Eye Movement Desensitization and Reprocessing (EMDR) work, Buddhist psychology, vision quests, sweat lodges, wilderness camping and even the far-flung metaphysical realms of the Kabbalah, the foundation of the Jewish mystical tradition. 

On this journey, I would have the privilege of in-depth training with exceptional teachers of hypnotherapy, Buddhist psychology, meditation, self-relations psychotherapy and application of the wisdom of Kabbalah through mind-body, non-verbal, energetic healings. 

You will be meeting some of those teachers in the pages of this book and read about what I understand to be the basics of their teachings. In addition to my personal quest, I continued to pay attention to Western medicine and the advances in the biological treatment of psychiatric conditions along with the evolution of new forms of psychotherapy. These included several generations of cognitive work and EMDR for trauma, as well as Dialectic Behavioral Therapy (DBT) Acceptance and Commitment Therapy (ACT), both of which use principles from Eastern philosophy and mindfulness meditation practice.

I began to collect ways of working that I could integrate with each other, allowing me to address each person more fully according to his or her own needs, whether through medicine, talk, hypnosis, trauma treatment, or meditative contemplation.

Medicine, behavioral change, and words have their limits. Such approaches rooted in biology and psychology do not always put the pieces back together when someone is falling apart. They do not always provide a sense of wholeness to those who have suffered from trauma and subsequently experience themselves as internally fragmented and unable to feel safe in a world they feel they do not belong in and cannot survive in. 

In my years of exploration and advanced training, I witnessed the way a handful of talented clinicians were able to facilitate the healing process by reaching in and establishing a level of authentic human-to-human contact with the person  seeking help. Along with that connection came a palpable transformation and the emergence of energy, clarity, emotion, and motivation in the person being helped. This was not as a result of standard modes of psychotherapy. Whether it was hypnosis, imagery, EMDR, energy healing, dance, chanting, or the focused, loving attention of a group, there was something that created an altered state of consciousness, activated the life force and allowed a shift in body, mind, and sense of self. 

I often sat amazed wondering, “What just happened? How were they able to do that? Could I learn to do that?” 

Turning to the text, the reader will see that many years of training would go into studying the work of those exceptional clinicians and healers who were able to effect change in this way. Many years went into studying the theoretical foundations of the approach and ways to apply the method. 

The first part of this book, titled “Exploration,” reflects my own search for healing and transformation. This section contains elements of personal memoir, covering events from my early family life that fueled this search. There, you will meet the talented therapists and teachers who helped me, like Nancy Napier, Steven Gilligan, and Diane Shainberg. I describe, to the best of my understanding, the theories and philosophies upon which they base their work. I will share my experiences at retreat centers and workshops, and other transformational journeys that were crucial to my personal path. 

In the second part of the book, “Education,” I discuss the discoveries of mind-body medicine, neurobiological correlates of interpersonal healing, and advances in the treatment of trauma, such as EMDR and Somatic Experiencing. 

The third part of the book, “Integration,” lays out a vision of a practice of psychiatry that pays equal attention to mind, body, brain, and inner self, all in the context of a therapeutic healing relationship.

In the final part of the book, “Application,” I bring these modalities into my office and apply them to actual treatments. Identities have been disguised and some patient histories have been condensed into composites. However, all the stories derive from actual cases and the application of integrative work. If you are a therapist reading this book, I hope to inspire you to pursue your own journey of healing to the maximum and to incorporate your discoveries into your work alongside the standard approaches of your field. If you are not a therapist, it is my hope that the book will illuminate your path of healing and help you find a direction that speaks to you.