Body Language

January 1st, 2000

A Conversation with Marc Ian Barasch on Illness and Healing

When Marc Ian Barasch was thirty-five years old, he had a series of vivid and startlingly detailed dreams about cancer. Though he had no physical symptoms, he went to see a doctor, insisted on medical tests, and was diagnosed with thyroid cancer. At the time, Barasch was the editor of New Age Journal and thought himself “quite knowledgeable about the realms of healing.” But it was one thing to read and study and write about disease, and another thing to experience it.

In February 1985, he had conventional surgery. It was pronounced a success, although sorting through the spiritual, psychological, and social implications of the illness, the treatment, and its aftermath would take many years. Barasch says his life has been “affected unalterably by the singular event, both destructive and oddly ameliorative, of cancer and the titanic dreams that accompanied it.” At present, he remains “vigilant about health, attentive to the inner life, and persistent in my attempts to cultivate kindness.”

In part because of his long practice in Buddhism, Barasch found it essential to turn his relationship with cancer into something helpful to other people. This attitude motivated him to spend nearly fifteen years writing three books. The Healing Path: A Soul Approach to Illness (Penguin) is one of the finest books ever written about the mind-body connection. The best-selling Remarkable Recovery (Riverhead/Putnam) examines the commonalities among people who have spontaneously recovered from devastating illness. And the forthcoming Healing Dreams, due out this year from Riverhead/Putnam, explores life-changing dreams – what Carl Jung referred to as “numinous” dreams – and their implications for understanding human nature.

One of the things I like about Marc Barasch is his refusal to abide simplistic answers. He eloquently explores the role of the spirit in disease and healing, yet also demystifies the hocus-pocus of the “If your spirit is pure, no disease can touch you” line promoted by many in the new-age movement. The relationship, he says, is far more subtle, complex, and mysterious.

The complexity of Barasch’s thought is mirrored in his accomplishments. At New Age Journal, his emphasis on leading-edge coverage of environmental, political, and cultural issues garnered a National Magazine Award and a Washington Monthly award for investigative reporting. He has been a contributing editor at Psychology Today, editor-at-large for Natural Health, and has been short-listed twice for the PEN Literary Award.

Barasch was educated at Yale University, where he studied literature, psychology, anthropology, and film. A thirty-year practitioner of Tibetan Buddhism, he helped found the psychology department at Naropa University. He has several television projects in development, including The Millennium Dialogues with the Dalai Lama. He is currently producing a Hollywood feature film titled Disturbance. He is also an accomplished musician, and plays and records occasionally with a San Francisco-based “lit-rock” band that includes Stephen King, Amy Tan, and Roy Blount.

The trip to interview Marc Barasch last June was a return home for me. He lives just a few miles from where I grew up, in Boulder, Colorado; my first job, when I was about ten, was cleaning up the yard at a house not three blocks from his. Barasch’s own yard was overgrown with bushes – or, as he put it, “allowed to flourish unhampered.” When he asked me in, I wasn’t surprised to find the inside of his house comfortably cluttered. He was distracted and busy – I’d caught him in the middle of a book deadline – yet nonetheless warm. His hair, brown with a premature shock of white, was mussed and looked habitually so. As we talked, I was impressed by his intelligence. Whenever we hit upon an important point, I would see his mind leap; then he’d throw back a ladder of words so that I could follow him.

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Jensen: You’ve written two extraordinary books about a multidimensional approach to healing, have just finished a third, and have been through the cancer mill yourself. What do you think helps people heal?

Barasch: I’ve expressed this in different ways in the different books. In The Healing Path, I talked about people who had gotten well against the odds. They’d done everything from chemo to carrot juice. What they had in common was that they’d all decided to look upon their disease as unique, just as they were unique, and then find a path to healing that drew upon their own enthusiasms, beliefs, and coping mechanisms. Many of them found that they went back to earlier versions of themselves, from a time before they’d gone off on a life path that had stopped making sense. In a way, it’s only logical: if you treat illness as a personal journey, you’re more likely to marshal your own maximum resources, both inner and outer, in addition to finding an appropriate treatment regimen. But there was also another factor: a willingness to let the illness act as a catalyst for transformation, rather than following the usual model for cure, which is an attempt to get back to the old self and the status quo.

In Remarkable Recovery, we were researching “spontaneous remission” cases – and we did confirm that these were real cases with real medical records, many published in refereed journals. Once again, we didn’t find any common method or substance that people used to heal. But we did notice what we called “congruence”: a coming together of inner and outer. Independently, another researcher in Rotterdam also looking at remission cases came up with a similar description – he wrote of “a stronger congruence among emotions, cognitions, and behavior” – so that says to me that there must be something to it. If cancer can be understood as a form of entropy, or a growing disorder in a system, then you could say these people somehow came back into alignment with their core selves, body and soul.

Now, does this state contribute to remission, or is it just a byproduct of going through a life-changing healing journey? I don’t know. These were what are called “retrospective studies.” We weren’t observing the ongoing process but relying on people’s subjective testimony after the fact. Still, I think the patterns are striking. If they seem inconsistent, maybe that’s because the healing process took different forms according to people’s personalities. It definitely wasn’t a case of people becoming more serene and “spiritual.” Some people got nastier, more outrageous, very emotional. Others approached things very rationally.

Our main finding was that the people who healed tended to work at getting well on all fronts. They found social support, faith, and purpose, encountered deep emotion, did things they loved, and usually chose a more healthy lifestyle, including dietary changes – though not always; one just ate greasy cheeseburgers.

Jensen: I spent last evening talking to a friend’s step-father who has just been treated for cancer. Our conversation was centered around the mechanics of radiation therapy and the biochemistry of cancer. Similarly, with my own illness, Crohn’s disease, I’ve focused most of my attention on physical causes and cures. We seem always to leave out the psyche, or the soul, in these discussions, even though doctors now concede that it plays at least some role in disease and healing. But how big a role, and of what sort?

Barasch: Well, first we have to define what we mean by “soul,” which is not something that flits from your body like a winged heart when you die, but rather an integrative process, an authentic way of living that embraces all our polarities – intellect and emotion, body and mind, social and private. It involves intimacy with what Taoists call “the low, the dark, and the small,” and also openness to the big picture – what Zen practitioners call “big mind” – in which the ego and its needs aren’t running the show. In most cultures, the soul is understood to be multiple and variegated, not some eternal, fixed, singular thing. There’s a bush soul, an ancestral soul, a social soul, a soul that visits with the spirits.

And the soul and the imagination are intimately linked. The fact that images of the disease we are suffering – usually highly personal and fanciful images – show up so often in our dreams suggests that illness has some business with the soul. The places where an illness deeply affects us are where we need to go to heal. Being sick batters at our emotions and has a huge existential impact. The first response – Why me? – leads straight to philosophy and religion. It affects us as social beings, in our relationships, vocation, and communities. This paradigm is as old as the biblical story of Job.

But all of these dimensions have been shunted aside in so-called scientific medicine. So many things that are considered by medicine to be “epiphenomena” or “side effects” are really central, because healing has to address the questions disease raises. It has to be a full encounter.

This is why the new approaches to illness and healing have compound names – like so-called “biopsychosocial” medicine. And this is itself an echo of earlier medical models that still exist in tribal societies, where physical illness is viewed as part of a larger constellation of imbalance – a loss of harmony with the spiritual, social, ancestral, and natural realms. Still, there’s a lot of debate, especially between conventional and holistic practitioners, about just how much respective influence these different factors have.

Jensen: The spiritual factor seems to be the biggest bone of contention.

Barasch: And it should be, because it’s so easily misunderstood. On the one hand, the effects of the mind on the body can’t be refuted. I mean, we know this instinctively: When we get embarrassed, which is a purely psychosocial phenomenon, we blush, which is a purely physical function of blood flow. When we’re anxious, we feel it in our stomach, and when we’re in grief, we feel it in our throat; everything tightens and clenches up, and the flows of blood and neurohistamines are affected. Clearly, we’re orchestrating the pharmacology of the brain through the way we perceive and react to things, through the emotional resonances of everyday events. The hormones we’re marinating in cannot help but have an effect on the immune system, and thus possibly on specific disease processes, and logically on the healing process itself. It’s what’s generally called a “cofactor” – contributive rather than causative.

In general, the mind-body connection is not a direct causal relationship: emotion A creates disease B. The Freudians had a field day when ulcers were thought to be caused solely by stress, but now we’re finding that ulcers are more directly caused by a bacterium called campylobacter, and can be cured by a pill. On the other hand, maybe persistent anxiety creates the kind of physiological conditions in the gut that allow campylobacter to thrive. It certainly doesn’t hurt ulcer patients to look at the sources of stress in their everyday lives and try to reduce them, or to go deeper into the psyche and the social environment and see what’s causing all their stress. If the causes of a disease are many, then it stands to reason the disease should be treated with a multitude of approaches. We need an antidote to the old med-school dictum “One cause, one disease,” which has led to the magic-bullet approach. I mean, a magic bullet can be great, but not if it means just “fixing the machine” and returning it to the way of life that made it break down in the first place.

Jensen: The real trouble in this debate starts with the idea held by some that disease is a matter of “choice” – something we do to ourselves.

Barasch: Yes, as if nothing just befalls us. I call it “new-age Calvinism.” Calvinists, you remember, believed that if a person was prosperous, it was evidence that God loved him; and if someone was in penury, that person must be a sinner, because God, who was just and good, would never afflict a righteous person. I still see this attitude all over the place; I’ve even been on the receiving end of it. People have asked me, “Why do you want to have this disease?” and, “Why don’t you want to get well?” and, “What spiritual ignorance is causing your illness?”

No matter how fancy the wrapping on this doctrine, it too often turns into blaming the victim. I think it’s a way to distance ourselves from our common fragility and impermanence, which illness shoves right in our face. In the Bible, Job’s buddy Eliphaz complains that Job’s misfortunes are giving him nightmares; he’s afraid maybe this mess could happen to him, too. But then Eliphaz reassures himself that Job must have done something to deserve it and says to him, rather coyly, that no one is “blameless against his Maker.”

We have to be careful to try to chart a course, as psychiatrist and author David Spiegel so beautifully put it, between the “Scylla . . . [of] mindless materialism – viewing people as nothing more than the product of physical processes” and the “Charybdis . . . [of] disembodied spiritualism – the idea that if one fixes a problem in one’s mind, it is fixed in the body.” This whole idea of “taking personal responsibility for your disease” can get pernicious.

Jensen: For a long time after I was diagnosed with Crohn’s disease, all sorts of people told me, “You’ve got to learn to take responsibility for this.” I’d like to go back and point out to them that there’s a difference between being responsible for my disease, in terms of causing it, and being responsible to it, meaning being capable of responding to my body’s distress.

Barasch: Yes, that’s it exactly. Because we do have choices in how to respond to our condition. And not just treatment choices like chemotherapy or surgery – though these can be critical – but emotional, spiritual, and social choices. With regard to the latter, for instance: Do we go it alone, or join a support group? Do we reach out to friends and community, or just family? Or, looking at the psychological dimension, we might explore what Alfred Adler, Freud’s breakaway disciple (he had a lot of those), called “organ dialect”: What is your symptom saying – that is, what does it mean to you? How do you imagine it, dream it? How does it function in your life?

Simply examining and living with a disease can open some space for change, even if it’s only a change in how we relate to it, experience it, frame it, reframe it. And this is healing, in the root meaning of that word – becoming whole; joining body, mind, and spirit. But it doesn’t necessarily mean we’ve gotten rid of the symptom that ails us. We can be both ill and healed – whole within our affliction.

Jensen: I haven’t heard you use the word hope yet. Is hope not a part of the healing path? I have a friend who is HIV-positive, and soon after he was diagnosed he sent me a stack of AIDS literature. A sentence in one pamphlet grabbed me: “Eliminate false hope.” What that means to me is that one shouldn’t use hope as a shield against reality.

Barasch: Often, hope is an extrapolation of our usual strategies projected forward into some idealized future. And maybe if we weren’t so intent on this cherished fantasy, we’d find a fresh approach to illness – indeed, to life – right under our nose. Illness often means that we have to revise our expectations, let go of preconceptions.

The Buddhist ideal is to live “beyond hope and beyond fear.” Many people have trouble with that. They say, “Fear’s bad, sure, but hope’s good; I want to hang on to that.” But I’ve had teachers who are very ruthless on the subject. They say, “Hope and fear chase each other’s tails”: either you’re hoping because you’re afraid of what’s actually happening, or you’re afraid because you worry you won’t see your hopes realized. Meanwhile, that which demands your attention here and now, though it looks forbidding, may have something deeper to offer you. It’s worth exploring. If hope and fear are really two sides of the same coin, then maybe you need to balance that coin on its edge.

None of this is to say that you shouldn’t have a positive attitude. And there are certainly times when provisional hope – or whatever you want to call it – has been absolutely key to people’s healing journeys, allowing them to take that next step and behave “as if,” despite all evi-dence to the contrary.

Jensen: When I had my worst attack of Crohn’s, I was vomiting maybe twenty times a day from the pain. Had I believed I would get no better – had I not hoped the pain would subside – I might have just killed myself.

Barasch: I would say that chronic disease especially requires us to exhibit a deep kindness toward ourselves. It can be important to find a way to accept our pain – accept ourselves in pain – if we can’t eliminate it. I’m still haunted by a vivid dream I had when I was ill, one that seemed irritatingly irrelevant at the time, and that I just brushed aside. In it, a voice said, “The way out is the way in.” That’s a koan worth contemplating.

But if going in is too much for us, there’s nothing wrong with stepping away. So often we’re too harsh on ourselves. We expect ourselves to endure, achieve, overcome, and conquer. Being kind to ourselves in our weakness – which is really the only basis for healing – is not always the first thing we try in a crisis. Usually, we reach for the nearest blunt object and try to cudgel the problem into submission: the heroic ego to the rescue. And we usually wind up hitting ourselves in the head.

Jensen: Is there a relationship between forgiveness – however you might define it – and health or disease?

Barasch: I think the act of forgiveness can cut the endless cycle of action and reaction, what Buddhists would call karma. Mostly, I think forgiveness prevents you from reifying things. When you don’t forgive another, you objectify that person, hardening him or her into a particular mold. In order to nurse a grudge (wonderful phrase, that, as if you must keep your grudge on life support with round-the-clock care), you always have to think of the other person as “the one who injured me.” But that is only a portion of that person’s being. So long as you hold on to that frozen image of the other person, the two of you will continue to play out the same dynamic. Forgiveness renders the relationship fluid again, allowing you to see other aspects of that person. And you, too, are freed to exist more fully, not frozen into one posture.

Maybe you could say the same about disease – that an unforgiving attitude reifies the disease, forcing it to hold its negative place in your personal cosmology. Then you’re trapped in a fixed response, without flexibility of thought and feeling and action. But, in fact, disease and pain are never solid. The suffering is more intermittent than we think, and there can be unexpected changes. Even within the deepest pain there are moments of nonpain. In physics, light is understood to be a particle and a wave at the same time. The same is true in psychological reality.

In other words, the complexity of experience can never emerge when we’re holding tightly to one particular version of it, whether we’re in relationship with a person, a disease, or anything else. Of course, it’s scary to enter into the no man’s land of disease. We’re afraid to let it speak, afraid it will swallow us up if we let it open its mouth. It’s a matter of working with the shadow.

Jensen: Could you define “the shadow”?

Barasch: Purely psychologically – and I don’t want to apply this definition to disease in general, because it’s too facile – the shadow is the undeveloped and rejected parts of the self. In the course of ego development, certain things are pared away and put in the garbage heap. And they eventually start to stink. But, as with rotting vegetables or manure, there is a great fertility in this material. In a dream, for example, ugly or deformed or diseased personages may possess some disowned portion of the self. You see this in myths all the time – the troll who is the keeper of the treasure, but you have to answer his riddle to get it.

Again, I don’t want to romanticize illness, as if it were some wonderful path we should choose. But I have noticed that, among people who have suffered, who’ve had their intentions in life thwarted in some way, if they don’t become embittered they usually experience soul growth, because they now know for a fact that their ego is not the supreme ruler of all things. They’ve transmuted suffering into humility, into humanity. The hollowing out has made them deeper, more capacious.

In dreams, this is a function of the shadow, as well. When I had cancer, believe me, I had a lot of nightmares. I could say they were all about the disease, but it’s clear to me now that they were also about my spiritual and psychological blind spots. Basically, what happens in the dream is that you are forced into the same space with the devil, this thing that is utterly repellent to you. And the dream is a closed vessel. You can’t get out. So you’re forced to deal with it, listen to it, try to assimilate it. And in so doing, you are transformed; you receive some of the soul moisture that, before, was locked up in ice.

Illness, obviously, is one of those things that cracks open our idealized version of the world and of ourselves. A broken heart is another. It seems sad and harsh, but it can’t be helped. What, then, do we do with frailty and lack? How do we suffer honestly?

It can sometimes be extremely difficult to surrender to these situations, because we fear that if we do – if we even acknowledge what scares us – it is going to destroy us. So we are like the Little Engine That Could, puffing along with our positive thinking, always looking ahead, but afraid to look behind because something might be gaining on us. In fact, that something might not destroy but change us. The trouble is, the ego experiences change as death.

Jensen: When I was in the hospital for Crohn’s disease, there was a woman down the hall with the same disease who’d already had some thirty surgeries. The doctors wouldn’t let her out of the hospital because she gave clear indications that she would commit suicide. I would never be so arrogant as to suggest that her mental attitude was wrong or that her disease was a metaphor. I think it’s entirely possible that she just got the short end of the stick by developing an espe-cially voracious disease.

Barasch: You certainly can’t be glib and say, “Oh, disease is just shadow material, so deal with it.” God, no. It’s overwhelming, awful. The stakes are very high.

I once knew a cinematographer whose passion was making films about climbing major mountain peaks. When he developed early-stage multiple sclerosis, the thought that he wouldn’t be able to climb anymore was so intolerable that he killed himself. I was angry, because I thought he’d copped out. He couldn’t face the death of his fixed idea of himself: it was his current identity or nothing.

In illness, you’re suddenly not yourself anymore. The question is: Are you going to cling in panic to some idealized self that no longer exists? Or are you going to cross the threshold and acknowledge that you’re on a journey, though you don’t know to where? You haven’t chosen it, but now you’re different in some way. This is one reason physical illness shows up as a turning point in so many spiritual biographies or as the catalyst of shamanic initiation. It’s a profound shock to the system. It dislodges you. You look in the mirror, and one of the unfortunate ill stares back. But in a way, you could say that disease also abrades away, painfully, all of these superficial ways in which we judge our worthiness, even life’s worthiness. Our worthiness, as in: “Am I strong, beautiful, competent, undamaged goods?” Or life’s worthiness, as in: “Life is good only when it makes me happy, or aggrandizes me, or favors my enterprise.” But who’s bigger, you or life? There’s a Rilke poem Robert Bly has translated: “This is how he grows – by being defeated, decisively, by ever greater beings.”

This attitude contrasts with that of the new-age movement, which supposes the mind can become sovereign over the body or “you make your own reality.” The belief is that your pure intentions will make life happen in a particular way, enable you to control things. Now, intentions can be powerful, but I wonder if this overemphasis isn’t fueled by a sense of outrage at the perceived injustice that we should be subject to the frailties of the flesh. If only we can make our spirits pure enough, our intellects bright enough, the new age seems to say, we shall never die. Death is perceived as an insult to our sense of ourselves as being a spirit or a mind.

We see the spread of this idea today in the immense popularity of people like Deepak Chopra, who has some valuable things to say, but is also a marvelous promulgator of the notion that if you just feel and think and live in a way that is absolutely congruent with God or spirit or whatever, then your obstacles, physiological or material, will vanish. And maybe they will, sometimes. But the greater challenge is to accept ourselves as we actually are and proceed from there.

Jensen: I tried to read one of Chopra’s books, but he seemed to regard death as the enemy.

Barasch: I think any exploration of our relationship with disease – and, in fact, of our relationship with life – has to start with the understanding that we are going to die, that we are vulnerable, and that there are many other organisms striving for autonomy and health and self-fulfillment that are antithetical to us. We must start with the fact that no one is going to live forever, and that most of us fear this terribly.

Once we have accepted this as our starting point, we can then move toward another realization that goes hand in hand with the first: that death, as well as being our companion for life, is also a fundamental spiritual metaphor and a fundamental spiritual experience. Almost every tradition says you have to be “twice-born,” and that death-and-rebirth pattern is not a single epiphanic event, but an ongoing process. To really live, you must die to your preconceptions. That’s a spiritual axiom with a very long, august tradition behind it.

Jensen: I recently had a dream in which anyone who had been severely burned was offered the opportunity to undergo an operation that would turn him or her into a seal. Some chose yes, some no. It’s clear to me that this dream was about conscious choice. Once you’ve been severely ill, you can never go back to being how you were. You can either stay in this state of being sick, or you can “become a seal,” which means to me that you can access depths previously denied to you.

Barasch: Yes, exactly. The language of dreams is a “both/and” language, the antidote for our waking, logical “either/or.” Taking dreams seriously means being able to exist in the depths and on the surface at the same time. In this realm, disease really does function as metaphor.

Jensen: My next book, A Language Older than Words, is about the language of the body. One of the means by which our bodies speak to us, I believe, is metaphor.

Barasch: So often we view metaphors as secondary or derivative. But in Tibetan Buddhism, there is an arcane tradition called the Mahamudra, which sees everything as metaphorical, but not in the sense of things standing in for other things. Rather, it is said, “Things symbolize themselves.” That is, the world is not your subjective fantasy, but it’s not what we understand as “purely objective” either.

Jensen: I see the world as a great dream, not unreal and immaterial, but alive and pregnant with meaning. To look at the world the way we look at our dreams, I think, would be to perceive it more as it really is.

Barasch: Yes. If you see a horse in a field, you might not even pay attention to it; it’s just another horse. But if you see a horse in a dream, you would likely ask yourself: What does that horse mean? Why is it here? The horse might have an incredible intensity or numinosity. It might even talk. Now, if we could bring that kind of perception to our waking existence, think of the richness of meaning that would greet us everywhere.

To get back to the relationship between the psyche and illness: What would happen if we perceived a symptom not just as an ache or pain to be avoided or alleviated, but as something that exists in meaningful relationship with us? I think that kind of a dialogue with symptoms is well worth the effort, and at the very least an attempt to engage with the world in a richer way.

In my case, I’ve had cancer in my thyroid. On the one hand, it’s just a disease. On the other hand, it contains various levels of meaning. The latest research indicates that thyroid cancer is a civilizational disease. Atomic testing and excessive exposure to X-rays are among the only known causes. Kids growing up when I did, in the fifties, drank radioactive-iodine-contaminated milk, and in a certain percentage of us, this has turned into so many internalized mini-Chernobyls. So there’s social meaning.

Now, there are people who drank milk at the same table as I did who didn’t get thyroid cancer. So although there’s a direct cause – an etiology – there may also be other meaningful factors, such as the way I’ve lived my life, my habitual emotions and their repercussions in my body, and my attitudes and how they might have led to disease-promoting activities. And the organ itself and its location and function suggest issues surrounding voice, perhaps a sense of not feeling I could speak in my true voice. Or, since the thyroid produces the basic hormone that runs the entire metabolism, it may have had to do with how I use my energy. Certain patterns of living that came out of certain inner conflicts could have exacerbated my condition.

But we can also turn this idea on its head. Yes, I came to this disease with a preexisting set of psychological and spiritual habits. But instead of – or, better, in addition to – asking whether any of these habits exacerbated the disease, I could have asked what I might have learned from this disease about these habits, and about my life, and even about life in general. I could have communicated with this new partner, this other to which I was now chained, like in an old movie where two escaped convicts are chained together: you may think you can knock the other guy into a river without getting dragged in yourself, but you can’t. In the movies, the outcome is always that the convicts wind up talking to and learning from each other. Having exhausted all other options, they actually discover who the other is. Perhaps I needed to listen to my disease, and to the organ itself. Like most people, however, I found the whole situation confusing, and I kept trying to look at my condition as nothing other than an organic dysfunction.

Jensen: A straight mechanistic approach.

Barasch: Yes, even though a straight mechanistic approach conflicted directly with what, for example, my dreams were telling me.

Jensen: When what you are told in dreams goes against what you are told elsewhere, how do you know what to believe?

Barasch: It can be very difficult. The doctors said, for example, that the thyroid is a thermostat. (They often use mechanical metaphors.) But in my dreams, it was a starfish. I found that to affirm my own vision against the machine model created tremendous cognitive dissonance for me. Of course, there’s no reason both metaphors can’t work, but there was something deeper at stake.

In the dream, there was a sacred, intelligent starfish that represented – that was – my thyroid. That was the exact language of the dream: “sacred, intelligent starfish.” And in the way that these healing dreams – sometimes called “big” or “numinous” dreams – seem to work, this one had a dimension of synchronicity with waking reality: The next day, on the spur of the moment, I went with my daughter to the Boston Science Museum, where I’d never been before. They happened to have an exhibit on starfish, and someone there put a starfish in my hand and said to me, “They can regenerate.”

This spoke directly to the issue I was wrestling with at the time: was it necessary to excise this organ? The conventional treatment was surgical removal, but I was asking if there was some way for it to heal. One message was coming from my dreams, the other from the world of medicine. I’m not sure, by the way, that even now I would blindly follow the advice of dreams, or recommend that anyone else do so, either: dreams can be very tricky. But here, at least, was this other country heard from, this countervailing attitude.

After that, I began to study my dreams intensively. I started keeping records, because these dreams were all so titanic and unprecedented in my own experience. For probably five years, I spent an enormous amount of time going over them as if they were some kind of apocrypha I needed to understand. I found in my reading that many traditional cultures view the body’s organs as living creatures having their own intelligences, their own voices. I started to see the body as a community of intelligent entities – which means, among other things, that I started to see it far less hierarchically. We normally see our conscious mind as the sole subject, and the body as an object. Therefore, we don’t allow for any two-way communication.

But if we look more deeply into metaphor, we see that such two-way communication unquestionably happens through it. Metaphor is how the body and the psyche talk to the conscious mind. It’s how the parts of the body – often through dreams – bring themselves into conscious awareness.

Jensen: Where do dreams come from?

Barasch: The medieval Hasidic commentator Amoli distinguished between the “Dreamweaver” and the “Master of Dreams.” The Dreamweaver produces ordinary dreams, which are a rehash of waking life, what Freud called Tagereste, “the residues of the day.” The Dreamweaver is probably close to our conscious mind, or just below it, in the subconscious.

But the Master of Dreams is another story. The more you look into what Jung called “big” or “numinous” dreams – dreams in which the dreamer is being spoken to – the more you find them infused with great wisdom. These dreams tend to be very vivid, with bright color and intense sounds. You get the sense you’ve been somewhere else. They’re called “clear dreams” in some traditions, “true dreams” or “talking dreams” in others.

When I was trying to sort out my own big dreams, I would tell people, “It was a dream, but it wasn’t a dream.” I had no language to describe it. But then I studied Jung and looked at other cultures and discovered they all talk about it. Most commonly, they make a distinction between true dreams and ordinary dreams, or big dreams and little dreams. And the big dreams, the true dreams – whatever you want to call them – seem to come from a Master of Dreams, a source outside ourselves, which appears to be the basis for our idea of God.

Jensen: So did the starfish dream come from the thyroid speaking to the dream master?

Barasch: Well, we know the body and the brain talk to each other via neuropeptides and their receptors. But that is just a corner of a much larger picture. It seems to be a field effect – what Hinduism calls Indra’s Web – where everything is somehow connected to everything else. We could say it’s Rupert Sheldrake’s “morphogenetic field,” or Jung’s collective unconscious.

Jensen: The first interview I ever did was with Joseph Campbell. I asked him where archetypes come from, and he said, “Oh, obviously, the archetypes come from the organs.” I was twenty-two at the time, and I thought he must have been losing his mind. It took me years to decide I agreed with him.

Barasch: There’s a great Jung quote to the effect that, although people think the archetypes are airy and spiritual, they’re actually closely related to the instincts.

Jensen: We still haven’t answered the question of how dreams work.

Barasch: [Laughing] I don’t think we can.

Jensen: I wonder if we could discuss the shadow a little more. It’s so underrepresented in discussions of holistic health and spirituality.

Barasch: Well, OK, if you promise you won’t think I’m being too negative. I’m usually unbearably cheerful, but we’re in the realm of the unspoken here, a kind of forbidden zone.

Basically, we identify disease with outright evil and so believe it must be walled off, quarantined, carpet-bombed, not touched or thought about: “See no evil, hear no evil, speak no evil.”

It’s like after a nightmare: you wake up feeling horror and revulsion, not wanting even to acknowledge that you had this awful dream. You try to forget it, certainly not to look at it. These dreams become the things you cannot look at, like the gaze of Shiva, which burned off the head of Ganesh in Hindu lore. But then Shiva put an elephant’s head on Ganesh, and he became one of the most beloved gods in the Hindu pantheon, a sort of wounded-healer figure.

Until some blast from Shiva comes along, we tend to operate according to the ego, which of course forms the surface of our entire social, cultural life. Suffering can crack that surface wide open, with unpredictable consequences. We’re suddenly forced to live from the inside out.

Lately I’ve found myself drawn to the mystic Saint John. What I get from him is the idea that, until you are like Job on the dung heap, God will not speak to you. Some people see this idea as religious masochism, but I think what Saint John was getting at is the fact that only when you’ve suffered do you realize that your ego isn’t running the show; and only then can this life force that is much larger than our conscious stratagems find a point of entry. It shows itself in those moments when we’ve been forced – or sometimes have chosen through spiritual practice – to forsake the distorted pseudoself that usually gets us through life.

Jensen: I agree with everything you’re saying, except I would say it’s not that God won’t speak to us until we’re naked on the dung heap; that’s just the only time we will listen.

Barasch: Yes, because God is always speaking. Illness or suffering can melt all that waxy buildup in our ears. Buddhists emphasize the active quality of ignorance: it’s not that we don’t know the truth; we do know it, but we actively push it away or ignore it. Both capital-T and small-t truth are coming at us constantly. It’s just that we have effective antiballistic-missile systems to knock each particle of unwelcome truth out of the air before it even gets close to us. It’s subliminal. This eternal vigilance costs us our freedom.

An Australian shaman once said to me that this voice – truth, knowledge, God, whatever you want to call it – is soft, like a butterfly on your finger; you could flick it off with an absent motion and lose it, just like that. We wish truth would grab us by the lapels, but we have to come to it, sometimes through voluntary attunement, a moral decision, but usually it’s good old Shiva.

Jensen: So disease, such as your thyroid cancer, can transform us personally. What about as a society?

Barasch: The social aspect of disease is actually the one that interests me most. In traditional cultures, if one is sick, all are sick. But in the Western nations, we consistently ignore the collective nature – and collective cause – of disease. In fact, we don’t recognize the cause at all. We live in this amazing consensual delusion, with people dropping like flies all around us – everybody knows somebody who is dying of cancer – yet we refuse to acknowledge that we are in the midst of a pandemic.

I spent a year trying to answer just one question: how do we identify causes and cures of cancer – or of anything else? For me, the cause of cancer ultimately comes down to industrial civilization and the desire machine that runs it. Cancer is a civilizational plague that arises directly from the way we live, the things we consume, the patterns that are imposed on us, or that we accede to, and that bear us along like a cultural conveyor belt. The machine that is late-industrial civilization is grinding people up limb by limb.

Jensen: Or organ by organ.

Barasch: And we keep seeing cancer as something that “just happened” to poor Aunt Gracie because of bad luck, or because she had that cancer gene. But we’ve had the same genes for maybe fifty thousand years, and there hasn’t been a cancer crisis before the modern era. Sure, cancer’s always been around: they’ve found it in Egyptian mummies and the roots of it in primitive organisms. And it’s more prevalent now in part because we’re living longer, and the likelihood of cancer increases with age. But there’s never before been a pandemic like the one we see around us.

Albert Schweitzer was astonished when he went to Africa and found that the people there didn’t have cancer. Today there would be genetic studies done on those tribes to determine what grants them this amazing immunity to cancer. But it’s not a matter of immunity. These so-called cancer genes emerge under duress, with too many stressors to the organism and its immune system. That’s a biological fact that gets left out of all the accounts of the salvation that genetic engineering will supposedly bring.

Jensen: If cancer is a civilizational disease, then what’s the cure?

Barasch: Well, it’s not just genetic fixes. If we want to sustain our collective life, spiritual and physical, on this planet, we need to transform our society, which employs so many people to produce toxicity in exchange for tawdry consumer baubles. It’s as though we live in a world where the most profitable industries manufacture an invisible poison gas, and people are dying left and right, and whole medical specialties are devoted to finding antidotes to the poison gas, yet no one asks, “Why don’t we stop manufacturing the gas?” Instead, someone is made a hero for inventing a better gas mask. The ultimate cure isn’t technological inventions; it’s stopping the problem at its source.

My town of Boulder, Colorado, is a nuclear-free zone. I’ve thought a lot about the idea of creating “cancer-free zones.” Why couldn’t we do whatever it takes to rid our towns of cancer? What would that take? What would it mean in terms of individual lives and the collective life of a community? To begin with, it would mean examining what it is we’re doing and desiring that is fueling this threshing engine.

If the causes of the cancer pandemic are collective social factors, then the cure must be collective and social. In tribal cultures, they try to heal not just the sick person but the family, the society, the ancestors, the relationship to the gods – most of which are identified with the natural world. Even to begin to think about this is a step toward building a stronger bridge between health practitioners and the environmental movement – one that goes beyond temporary alliances around “cancer clusters” near toxic-waste sites and the like.

Ultimately, the cancer crisis is a crisis of love: love in the deepest, non-narcotic sense; love as ineluctable connectedness, as sensitivity to the nuances of the other and tenderness toward all living things.

Jensen: Do you think we’ll ever see a large-scale transformation of society?

Barasch: The underlying paradigm is the hardest thing to change. You can nibble away at it here and there, but even your nibbling can be used to fuel the desire machine. Hence, the trend toward fast-food, one-stop-shopping spirituality, which is just one more frantic attempt to escape, one more instance of mistaking the finger pointing at the moon for the moon. This “spirituality” might open a door, but in the end it may do little more than provide analgesic comfort amid the existing pattern of narcissistic consumerism: “Be a happy, enlightened consumer.”

As in individual healing journeys, I don’t see us changing our way of being until the current pattern stops working – though many of us think it already has – and things become worse. You have to shudder to think what worse might look like. Many people, of course, have their eyes open to how dire the situation has become, and are starting to find effective ways of channeling that awareness.

In my own case, at least, I marvel at the possibility of looking at our existing condition as the raw material of enlightenment. It’s like the old Buddhist saying “In the poison is the medicine.” There is tremendous magic just in relinquishing category. A lot of the talk is about building a better you, whether as individuals or as a society, but I think so often when we go that route – even with the best intentions -we end up erecting some new monuments that are going to topple over. We try to decorate them, shore them up, gild them, when what we really need to do is pull them down, or even just let them fall apart, and see what green and living shoots, what new organic models emerge.

Jensen: One of my favorite phrases is “Under the pavement, grass.”

Barasch: These forces of light and life are inexorable and ever present, but we struggle so hard to ignore them and maintain the status quo. Much of the civilization in which we live is the result of a refusal to see, or to listen: to the imagination, to our fellow beings, to the woundedness we all feel, which could change the world if we just acknowledged it. It’s as if we’ve created this whole deafening way of living just to make sure we can’t hear this thing that can be so quiet, as quiet as a butterfly. Our defense industries and goodies factories, and light-speed lifestyle and media oversaturation are all arrayed to cover up this gentle, quiet sound. But all the din and clatter of the world can never drown it out. It is always there, as close as our own breath.

Originally published in the January 2000 issue of The Sun

Filed in Interviews by Derrick Jensen