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Addressing all Quadrants in a 'Standard' Consultation
8 March 2012
10:43 pm
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Mark Jack
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One of the things I have been wondering about is how to make herbal medicine address all four quadrants or whether it will be necessary to include other therapies. I think that in some ways herbal medicine is holistic as claimed, in others it still seems to be largely focused in upper-right or materialistic interventions. For example, the giving of Hypericum to help with depression or Melissa to help with anxiety: a physical substance (upper-right quadrant, UR) to treat an emotional (upper left, UL) issue. It could even be a series of physical substances to help the body work more smoothly and so help the emotional problem. (Compare this to using something like counselling or meditation which seems more like using an UL therapy for an UL problem). My experience during training and elsewhere is that although we aspire to more, sometimes it does come down to that.

So I would like to take a look at how herbal medicine is or can be holistic in the sense of addressing all four quadrants. I will give a few possible ideas, and I would be very happy to hear more thoughts on these and others.


Plants as More Than Just a Physical Substance

So one claim that could be made is that a plant is not just a physical substance and that a whole lot more gets transferred to the patient than just the chemical components; that part of the plant’s spirit, consciousness or essence also gets transferred. This would be a similar thing to the rational behind using plant essences.

 

Discussing Contributing Factors and Giving Advice

Often during consultations the patient’s lifestyle, sense of well-being and suchlike will be explored and advice will be given to the person about changes they could make. This certainly has its place and could have some value, but I am not so convinced that giving advice often ends up in a person changing. This process could perhaps be greatly improved by incorporating coaching techniques into a consultation, and have the patient lead on what kind of changes they would like or be able to make within a broader framework and with support provided by the practitioner. But then that is taking a step beyond normal herbal practice and would perhaps require more training and a separation of the consultation into two parts.

 

The Therapeutic Relationship

This I think is a big one. I just started reading the introduction to The Consultation in Phytotherapy by Peter Conway. There he mentions how disclosure (telling one’s story) and emotional release can have a positive impact upon the immune system (and ultimately a person’s well-being in general). So in this regard the consultation itself, if done well, can be therapeutic in the UL quadrant.

Obviously it is a relationship, and so there is stuff going on in the LL quadrant, the ‘we’ space. At the moment I don’t have a reference to back this up, but I believe that if you are in relationship with someone that is well balanced that that is shared in someway, that we can take on characteristics from others or perhaps even health in some kind of energetic way. I have a sense or a feeling that the later as well as the former may be true; that in seeing health we can more easily become healthy. I would be interested in anyone else’s thoughts on this

 

The Environment

A relaxed, beautiful clinic in a natural setting is one way the lower right quadrant could be brought into play. A healthy payment structure perhaps. A herbal practice that extends out into the community to help the community as a whole could address this in some ways. Being socially or politically active could too. What might be the role of a herbalist in this wider context?

When I have more time I may have more thoughts on this section (and the others), but for now I will just give a quote from David Abram’s The Spell of the Sensuous…

“Any healer, who was not simultaneously attending to the intertwined relation between the human community and the larger, more-than-human field, would likely dispel an illness from one person only to have the same problem arise (perhaps in a new guise) somewhere else in the community. Hence, the traditional magician or medicine person functions primarily as an intermediary between human and none human worlds, and only secondarily as a healer.”

 

How do you think herbal medicine is practiced in such a ways as to address all four quadrants; to be fully holistic?

 

All the best,

Mark

10 March 2012
12:01 pm
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owenokie
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I think this is a very productive angle to look into. Figuring out how herbal medicine addresses or could address each quadrant is a very important step. Lets us know what we are already doing (or could be doing with a little extra training). The second and vital step of this will be finding the correlating perspectives in each of the quadrants.

Yes, in my experience its VERY easy to get caught up into the symptom A = plant/substance/supplement X equation which is so limiting and epidemic in medicine (including acupuncture when used under the medical model). And I think in acute and first aid situations this is appropriate enough (heroic medicine). However it doesn’t seem to get to the roots of the puzzles presented to us by our clients. I would suggest that this is an important factor in modern medicines failures (chronic conditions being treated symptomatically or simplistically as if they have only one cause).These puzzles need to be explored by the client and the herbalist/therapist (whatever modality) and using the 4 quadrants to provide some sense of organization may be very fruitful. 

 

Plant spirit. I think there are few herbalists out there that would not agree with this…the hard part is going to be to find Right UR and LR quadrants for this. Use of fresh plant medicines vs dry is part of the equation here. Rutland biodynamics has their interesting take on fresh plant tinctures (with some research behind it). The LL has plenty of correlates with ceremonial usage of plants (incense, sage, ayauasca, kava, etc)…The herbal traditions of Ayurveda, China, Tibet and the Eclectics with their specific indications and the homeopaths do have important contributions to make on this front of linking plants to the UL experience of individuals.

 

One of the things that drew me into Buddhist Psychology was seeing in clinic that compliance and change were the biggest challenges. I don’t just mean taking herbs, but I mean people already virtually knowing what they need (even if not specifically) and yet not doing it. Whether its clients coming in for a better “diet” or agreeing to exercise or so forth…what stands in a clients way when it comes to making a positive life change? So this begins to overlap with the therapeutic role. Whats interesting for me is that the Buddhist Psychotherapy I’m studying is non-prescriptive in its approach so integrating this with Herbal medicine will be very interesting. Certainly ti seems to be most effective when the client comes up with much of their plan with minimal guidance and information from you as opposed to a prescriptive approach…The Conway book looks great, its been sitting on my shelf waiting for me to read it!

An environmental and ecological context is powerful place to start…creating some contact between a client and their medicines/foods…growing their own food or getting it from local producers, seeing pictures of the plants in their formulas or even gathering them themselves. Herb walks and medicine making classes. Some herbalists do family consults, much cheaper, the whole family comes in and works on things together with dietary change a large part of the focus. The community role of the herbalist may be partially about raising the question of health into a broader context than the simply physiological (to the emotional and spiritual as well as to the family, community, and environment/habitat). What is a clients habitat and what is their niche within it? What are their resources? This is touching on a evolutionary perspective.

16 March 2012
11:02 am
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owenokie
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Yesterday I tried a sample interactive lesson from core integral. They have two sample lessons you can download, about 90 minutes long. Some of it will certainly be review…however they went over a method for applying the quadrants to personal or professional situations which they call Quadrivial Analysis, and I found it helpful applying it to the development of my herbal practice. I think we may find it useful for our work here. 

 

https://www.coreintegral.com/programs/courses

 

Owen

16 March 2012
10:29 pm
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Mark Jack
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What do you mean by “finding the correlating perspectives in each of the quadrants.”?

 

The ritual use of plants in addressing the LL is a really good one, and interesting one (thinking here of its use in gatherings rather than individual vision quests or suchlike). That makes me think of how actually going to a doctor does affect things in the LL in the sense that you get cultural recognition of the illness you have and can take on a different role in some cases. At the moment in the west I don’t think that herbalists have much recognition, no where near as much as doctors have (you can’t get a sick note from a herbalist!), and so unfortunately a herbalist suggesting a person have some convalescence would not generally be enough for our culture to gather around and support that. In a smaller community perhaps through developing a reputation, being well known and doing a fair bit of education perhaps a herbalist could affect the culture enough to be able to contribute to LL support in that way. I wonder how ritual could be used in a way that appeals to a community of people that would have people in it from all levels of development. 

The question of factoring in the plant spirit into practice is an interesting one. When I have made some tinctures in the past I have spent time being with the plants and feeling into them so to speak. I have then asked their permission and asked them to help me. If they have a spirit this emotional connection to them would make sense, and it does feel nice to take this approach. But how does one validate such a practice and find out what the best practices are? The answer one might get is ‘ask the plants and they will tell you’. But that just pushes the question back to how does one best ask the plant to get a good in-depth and accurate answer that isn’t just ones inner talk saying what it thinks? Stephen Buhner has written some good stuff on connecting with plants, and I have spent some time on such techniques. It certainly feel nice to emotionally feel into plants, but so far I haven’t been able to dedicate the necessary years it takes to fully connect!

Considering, as you put it, “What is a clients habitat and what is their niche within it?” seems like a very crucial question.  One aspect of it that occurs to me is how is a disease an adaptive response for helping a client maintain their niche, because if the disease is playing an important role for them just trying to get rid of it may not work. Or another aspect might be around what behaviors are required or encouraged by their setting, and that there needs to be awareness of such things and perhaps working with the setting to bring about change. I think this may not have been exactly what you meant, so I would be happy for you to clarify it more (or maybe I should consider it further when less tired)!

 

Regarding the Core Integral courses, the house where I am living we are starting a small integral / evolutionary community, and we have just this week started to work through ‘Essential Integral’ together, and I was intending to apply as much as possible to the ideas of Integral Herbalism. I very strongly feel the need to both improve my understanding of integral and to raise the level I operate at to be able to play my part in developing Integral Herbalism!

18 March 2012
11:57 am
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owenokie
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by “finding the correlating perspectives in each of the quadrants.”? by this I mean simply how some given datum/piece of information in one quadrant correlates with other quadrants…for example states or relaxed and calm alertness (UL) correlate with synchronous alpha-brain wave patterns in the UR.

 

Connecting with plants is a tough one…there is certainly a methodology that is repeatable for experiencing (subjectively) a communication with a plant. (As there is with the rigorous methodologies of many meditative traditions). There maybe some research with EM photography of plant auras and so on that can provide some beginning of understanding mechanisms for plant-human communication. There are some rational frame-works. Co-evolution, phytochemicals, aromatic compounds, and so forth…entrainment of energy fields (as demonstrated by work with EEG and ECG) possibly occuring between plants and people and so on….It is however dangerous ground from an orthodox UR perspective! Having done some energy work I do have an sensory experience of the energy fields of plants and different trees and plants feel differently on my hands however such experience is difficult to validate from a scientific perspective.

 

Bringing community into the picture is important I think as are your ideas around ritual. The ways of working with LL and LR will be important to investigate. Ritual, group therapy, support groups, classes, herb and nature walks, community gardening, and so on…

 

Yes, I think asking how is a given response adaptive (and possibly now maladaptive) is an important question. Is the clients pattern something that served them 30 years ago and is now just a habit-pattern (samskara in Buddhist terms)? How detrimental is this pattern today? How does holding onto it serve them today? How do we open a client up to seeing and changing a maladaptive behavior? To seeing other possibilities?

25 March 2012
11:05 pm
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Mark Jack
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So there does seem some rich ground for the connecting with plants thing. Buhner’s books looks at some of the science as well as giving a methodology. I think it does also mention a bit about what others have done in developing their connections with nature. I would like to see further comparison and integration of different approaches to connecting with plants, and how it connects with research done in different fields and it is something I might look into when I have more time. For the moment though I will just continue to feel into plants and develop some connection through presence with these other living beings. It is my hope that on some deeper level I get a feeling for how the plants work, as it were, and thence be able to alter slightly what I do to take this into account.

So what is the energy work you have done and what is the perception you gain of plants this way? 

 

I am wondering if at some point it might be good to branch off from these general discussions and start topics dedicated to the individual areas such as connection to plants through UL practices (or LL – as it might be the ‘we’ space created in communion through which we learn about the plants). It also reminds me of the need for a larger community of people working on these things, one could spend several years just on working with this one subject!

7 April 2012
7:01 pm
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Mark Jack
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I think we have already touched on this issue, that of the context of treatment, but for me this quote touched on part of it quite eloquently.

‘the encounter between the therapist and the patient could have been therapeutic without any meaningful contribution from the treatment itself. Or the patient could have had high expectations in the treatment that prompted a powerful placebo response. Or the patient self-administered some other treatments concomitantly that caused the improvements. In other words, it is not the effect of the remedy per se, but the non-specific effect of the context in which it is given that benefits the patient.’

It was actually in an article at http://www.guardian.co.uk/science/blog/2012/apr/03/homeopathy-why-i-changed-my-mind by Edzard Ernst about why Homeopathy still helps even though the studies show the pills act as nothing more than a placebo.

I am interested in how the encounter helps shape the context, for example, what about it makes the patient do other helpful things of their own volition that contribute to the effect (if indeed they do). It seems like a potentially really rich area for exploration and raises many questions. Does seeing a therapist help focus someone? Does it help them believe in themselves? How would we shape the context more to help them into this healing way of being?

7 April 2012
9:21 pm
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owenokie
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Yes, that is a large topic in and of itself.

In my buddhist therapy course we’ve done some exploration of what makes a “good” therapist, and usually it has little to do with technique or perspective and a lot to do with presence, which is of course a very subjective thing. Though I would postulate that if you interviewed a whole number of people they’d probably tend to point to the same person as having a good “presence.” Subjective,  maybe, but probably fairly consistent.

 

At my school Tai Sophia, one of the founders, Bog Duggan (an acupuncturist), says its not about the needle. A word or an herb or a pill or a gesture are all needles. We’re really just in the business of making more effective placebos. A bit tongue in cheek but there’s something important there. Hazrat Inayat Khan, the Sufi, also speaks about the doctors presence being more important than the physical medicine. So we’re exploring something here about therapeutic relationship and how that relationship catalyzes healing or self-healing within the client.

 

Yes, the impetus to change is all important! And this will play a huge role in developing an Integral Herbalism.

7 April 2012
9:35 pm
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Mark Jack
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So it is the practitioner in all four quadrants meeting the client in all four quadrants!

Here we are talking about presence which may be classed as UL affecting the UL of the client, but in fact probably it is a whole lot more than that, and I can see that perhaps all four quadrants of the practitioner could be influencing all four quadrants of the client.

I like the quote ‘We’re really just in the business of making more effective placebos’! But I guess here placebo means ‘everything that is not the physical remedy’ as I guess perhaps it does when people say homeopathy works by the placebo effect, which in that context could be more a word of praise for harnessing all these other factors rather than derogatory! Of course more effective medicines is also a large part of the picture, but I guess without the placebo effect they are half dead (because of the nocebo effect if nothing more).

 

Presence, presence, presence, always presence!

9 April 2012
9:01 am
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owenokie
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“So it is the practitioner in all four quadrants meeting the client in all four quadrants!”

 

I think this is a helpful perspective.

 

We’ll yes, we’ve been speaking in UL terms, however there is a clear LL: which is the herbalist/client relationship. Which of course has been studied from a UR and LR perspective. Also there are some important UR studies that begin to bring scientific investigation of “presence.” Heartmath speaks to this as does some of the work on entrainment. Specifically the studies showing how the brain-wave patterns of interviewees entrain with the ECG of the interviewer. Some of this studies can be downloaded from the Heartmath website. So we have presence, as mediated by the EM field of the interviewer, being responded to (or not) by the interviewee as measured by their EEG. I’m sure other factors have been studied, but this is a start. They have some research on what factors in both individuals had an effect upon this phenomena, which could point towards UR explanations of what makes for a “healing” presence in the treatment room.

4 July 2012
9:24 am
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Mark Jack
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This article on Integral Medicine gives a really detailed overview of how one could address all quadrants: http://www.kenwilber.com/blog/show/513. (I have also posted it in the resources section, but thought it good to post it here as well as it is such a good article and I didn’t want it missed)

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