This method is similar to the way we approach a car or machine: We first look the whole thing over and then narrow in on the broken part. But what works for machines doesn't work for people. In the treatment approach, the subjective and personal experience of an individual is considered "noise" and is ignored. Too often it is disregarded by the individual as well as the practitioner, both of whom learned this through culture and formal education. Marie's experience with asthma is a typical example. Asthma is exclusively seen as a disorder of the breathing tubes, which causes them to go into spasm inappropriately, interrupting the flow of air to the lungs. This disorder is seen a result of a biochemical instability that causes an excessive reactivity of the airways, particularly to airborne pollens and other such substances. The treatment is to diminish this reactivity with a variety of medications. The advice given to physicians by the famed internist Sir William Osler is instructive: He said, "It is better to know the person that has the disease, than the disease that has the person." As we can see in Marie's situation it would have greatly contributed to her healing to have "known the patient who has the disease" as well as "the disease that has the patient." This wisdom applies to Marie and her health professionals, both of whom knew much about asthma and its treatments but little about Marie.

Because Western medicine is the most frequently used form of treatment, let's use it as an example. Biomedicine has achieved its greatest success within very specific areas: anesthesia, surgery, immunization, and the antibiotic treatment of bacterial infections. Its expanding base of scientific knowledge has provided us with both an extensive, although narrowly focused, understanding of disease and extraordinary diagnostic and therapeutic strategies. New forms of treatment, improved public health, and increasing levels of affluence have resulted in an extension of the average life span from forty years at the onset of this century to a current seventy-five years.

However, the success of biomedicine has also exposed its severe limitations. Those successful treatments, public-health measures, rising levels of affluence, and urban lifestyles that are a consequence of the industrial revolution have also resulted in a dramatic shift in the kinds of illness we suffer from. Instead of epidemics of acute infectious disease, we now have epidemics of chronic, often stress-related, degenerative diseases whose causes are largely a result of harmful environments, changing lifestyles, personal attitudes, unhealthy relationships, and unresolved conflict. Biomedicine is well equipped to diagnose and treat degenerative diseases, but its therapies rarely result in cure because in general treatment fails to address the primary sources of these diseases, the unique web of circumstances within an individual's life that results in a disunity of mind, body, and spirit.

Much the same can be said about other treatments. It is currently fashionable to call many interventions and techniques holistic, suggesting that they aim at something beyond the goal of treatment. But the facts tell a different story. However well intentioned a practitioner may be, a practice strategy that involves one person (usually considered the expert) doing something to someone else most often falls under the treatment system as we know it. Although the intellectual intention of a practitioner and a client may lean toward holism, the practice and its impact may be quite different. The effort, regardless of the rhetoric, is usually directed toward repair and restoration of function, leaving the individual without further empowerment or enhanced personal skills and resources.

As with the homeostatic system, an understanding of the treatment system, its assets and limitations, demonstrates the need for an enhanced approach to healing. Exclusive use of a treatment system, by its very definition, is incapable of meaningfully including psychological and social aspects of our lives. These factors cannot be reduced to the level of biochemistry, cells, tissues, or organ systems without disregarding their meaning and significance to us. And while many practitioners are beginning to combine treatment with mind/body and spiritual approaches, this is still the exception, and many find it difficult to shift from being an "expert" in a particular practice to a shared practitioner-client relationship, a partnership that is an essential requirement of a broader-based approach to healing.

The Mind/Body Healing System
As we leave homeostasis and treatment to consider mind/body and spiritual healing we move from an automatic system that is inborn and a treatment system that is culturally imposed from without to systems of healing that rely on our consciousness and intention. Unlike the first two systems, mind/body and spiritual healing offer us the capacity for self-regulation and self-exploration, and in doing so give us the opportunity for a more direct and personal involvement in our health.

Unlike the physical context of the homeostatic and treatment systems, the Mind/Body and Spiritual Healing Systems evoke a very different view of the human condition. These systems call upon the capacities and qualities that characterize human life: consciousness, intention, will, creativity, faith, love, and compassion. In these systems we deal less with parts and increasingly focus on the wholes. The Mind/Body and Spiritual Healing Systems operate through "downward" causation, the process by which higher levels of human organization, the mind and spirit, effect changes in cells, tissues, and organ systems by reorganizing the whole. This is in contrast to the idea of "upward causation," with the parts determining the status of the whole. (I will cover these concepts more fully in the next chapter.) Both of these ideas of causation are valid, and it is important that a comprehensive healing system consider and incorporate both.

The Mind/Body Healing System relies on personal responsibility and self-motivated effort. It requires the development and use of personal skills and capacities-physical, psychological, and psychosocial-that can help us connect mind, body, and spirit, and the development of the capacity for self-regulation. In contrast to homeostasis, which operates automatically, and the various forms of treatment, which are applied in response to the appearance of disease, mind/body healing is proactive and intentional. Its focus is on personal attitudes and lifestyles, and the skills that are necessary for healthy relationships, conflict resolution, and personal growth and development, the critical components of a health-promotion program.

The Mind/Body Healing system is activated through personal choice and initiative. The expansion of consciousness, access to a more comprehensive self-understanding, and the development of new skills and resources lead to a progressive capacity for self-regulation.

The full potential of this system is developed over time as a result of our choices and our efforts. It is neither automatic, like the homeostatic system, nor culturally imposed, like the treatment system. We have a choice, to develop its potential or not. It is a person-centered system rather than a disease centered one. Mind/body healing is concerned with psychological development, personal transformation, and mastery, to the extent possible, over the activities of the mind and body.

This aspect of healing bases its scientific legitimacy on the emerging research in the field of psychoneuroimmunology. The discovery that the interconnectedness of our thoughts, feelings, images, and biochemistry is mediated through a mobile neuropeptide messenger system, a series of natural chemicals that transfer information between the mind and body, has provided us with an understanding of the biochemical pathways that link the mind and the body. To the extent that our emotions and chemistry are linked, how we develop psychologically influences the physiology of our bodies. Research is now demonstrating the relationship between certain feeling states, attitudes, and perspectives and their effect on our biochemistry, for example, how feelings can suppress the immune system. Further, we are becoming increasingly aware, as we'll see later, of how our attitudes and actions can enhance our resistance to the detrimental effects of excessive stress. In short, we are learning how to evoke health.

The change in focus from diagnostic categories to issues of personal attitudes, lifestyles, and psychological development alters the relationship of the health practitioner to his patient. This interaction becomes more of a partnership, in contrast to the hierarchical relationship that characterizes the treatment system. The focus is long-term, and treatment, which can more accurately be termed "self-regulation," is more internal than external. The intent of the mind/body system is more educational than therapeutic, and a health practitioner serves more as an educator and coach. The skills required are very different from those taught in conventional practitioner training programs. They include expanded psychological skills, communication skills, and an awareness of the practices that serve as resources for this aspect of healing. It is at this level of healing that we most profoundly see the shift from outer aids to inner resources.

To maximize the effectiveness of the homeostatic healing system we need only to adhere to some basic health practices. In the case of the treatment system we need only comply with the directions of the practitioner. When it comes to mind/body healing, however, we need some instruction. The first part of the mind/body curriculum is learning a variety of practices that develop the skills, resources, and capacities for self-regulation. There are many to choose from including: meditation, Yoga, breathing techniques, Tai Chi, Aikido, imagery, biofeedback, art, dance, writing, and journaling. Each of these practices, and many others, is something we can do for ourselves in contrast to something that is done to us. We become our own healers, applying intention, will, commitment, and persistence to our efforts to develop our healing system fully. In this manner we discover that when we pay attention to our lives, many of our most potent sources of healing can be found in the routine activities of our day-to-day lives.

The second aspect of mind/body healing is learning how to more deeply observe and understand our individual lives. In particular, we can learn new ways of approaching health and disease, relationships, communication, conflict, and career choices. The expansion of self-knowledge will provide us with an understanding of the workings of the mind, an expansion of consciousness, and a deeper and richer sense of a very different self. There are many techniques that offer help in the expansion of self-understanding. These include meditation, psychotherapy, twelve-step programs, self-help groups, reading, seminars, and, of most importance, an ongoing process of self-inquiry.

Just as the focus of mind/body healing differs from that of homeostasis and treatment, their goals also differ. Homeostasis defines health as the maintenance of a steady state, and treatment aims at restoring normal function. Mind/body healing incorporates these aspects of health, but extends them to include the expansion of consciousness and self-knowledge, and the acquisition of new skills and resources, an adventure that continues throughout a lifetime. As we shall see in the following chapters, at this level our definition of health slowly shifts from preoccupation with sporadic episodes of illness toward a concern with the more creative and personal act of designing a healthy life.