Menpa’s Mirror

The first gift my Tibetan teacher, Dr. Wangmo, gave me was a small brass mirror. It was attached to a red thread and concave in nature. On the concave side was an engraved diagram of Tibetan divination. She said it was an amulet for protection that I should hang in my room. Remembering this gift today, I began reflecting on the mirror-like dynamics of the patient-practitioner relationship.

Practitioner’s must be very conscious not to project onto their patients. This is why it takes great human and spiritual maturity to be a practitioner. A practitioner has to take in the patient as a whole—what they are saying, how they are, their narrative, their symptoms, and the full range of their subtle energetic expressions. What tends to happen is that the patient as a whole is filtered through the mind, life-experience, and philosophical biases of the practitioner. In this case, the patient is neither truly seen nor heard, but interpreted. Interpretation is only a division of truth and not a complete picture. In this case, the practitioner will inevitably project his own orientations and biases onto the patient, onto the diagnosis, and onto the treatment plan. In contrast to all of this, the true role of the practitioner or healer is simply to be open and sensitive to the patient in the present moment. What is true now may not be true later. What is appropriate for the patient may not be appropriate for oneself or for another patient. What is needed in this moment for this person is unique and specific. Instead of interpreting and analyzing, we have to see as if into a mirror and then reflect within ourselves. What is the right thing for this person, given who and what they are in this moment, as a totality? It is the patient’s total sign that reflects what is the case. In this sense, as has been noted by others, there is very little utility to digging deep into the past in order to heal. What is evident on the surface is a reflection of what is in depth. What is interesting is that people are indeed so different. We should consider this not only on a personality or character or social level, but on all levels, especially on a karmic level. Much of what people suffer is, in fact, karmic in nature. In saying this, I am not intending the meaning of “justified” or “deserved”. By “karmic”, I mean to say “patterned”, “inherited”, and “accumulated” through lifetimes. Owing to this fact, everyone is in a completely different circumstance, in relationship to their karmic inheritances, karmic merits, karmic intentions, karmic possibilities, and impulse to transcendence. This reality poses many clinical difficulties if we are seeking for consistency, objectivity, and other empty aspirations. Such aspirations are like grasping the wind or trying to solidify water. The actual circumstance of the patient-practitioner interaction is a fluid landscape and not any kind of knowable or reliable terrain. It is a moving image upon which no target can be placed and no reliable reproduction can be made.

A patient will heal according to the laws of nature, as those laws manifest in their own case. What is natural for one is not natural for another. Some heal quickly, some heal slowly, even under the hand of the same practitioner and the same modality. This is why it is futile to seek for an objective standard of efficacy in the practice of traditional medicine. It eludes the very mind of standardization and herein is the evidence of its art. Healing is a matter of nourishing the soil so that a plant can optimally grow. Every plant has unique needs. Even two trees of the same species planted next to each other will grow different, flower at different times, and altogether show evidence of unique characteristics. The practitioner can only nourish the soil so that it holds the full vibrancy of life that is its natural potential. A thriving soil will in turn nourish the plant whose roots its holds. Who is to say how quickly the roots of a plant will uptake the available nutrients? How readily will it digest and absorb those nutrients? How soon will it grow, flower, and product fruit?

A multi-dimensional model of efficacy is what is needed. Efficacy does not exist objectively, or only in the form of outer signs. Healing moves from the inside out, from subtle to gross, from interior to exterior. While doing so, it naturally eliminates internal root (or systemic) imbalances. This means that the first signs of healing are often subtle in nature. In the modern world, we tend to seek physical evidence as a marker of efficacy. But physical evidence is among the last sign in both the healing process and the disease process. Everyone transforms at a different pace. For some, physical changes from treatment occur readily. These individuals typically possess enough constitutional yang to quickly utilize inputs in the system. The subtle shifts reach physical translations much faster in them. Others may heal on subtle levels for some time before the evidence is full on the physical level. Of course, treatment reaches all levels to some degree, but it saturates the system over time. The nutrients from the soil reach the roots first, then the trunk, then the branches, then the leaves.

This reality is also important to consider when patients appear healthy on the surface, even in their pulse, but are struggling with an imbalance that is difficult to ascertain either physically or energetically. In these patients, the plant still appears healthy, but the soil is depleted. It is only a matter of time before the depletion becomes evident on the surface. Similarly, a plant can be rooted in rich soil, thriving with life, and not show the evidence of it until much later.

Doubt is the great enemy of the patient and the practitioner. For the patient, it is doubt of the treatment, doubt of the practitioner, doubt of the modality. For the practitioner, it is doubt of the diagnosis, doubt of one’s own skills, doubt of the efficacy of treatment. These are the mind-forms which undermine the healing process and live like scum on a pond. To see clearly, we must wipe these adhesions away and cultivate a deeper sensitivity.

There are always those patients for whom nothing seems to work. These circumstances can reveal a number of things: a complex case, a person with significant energetic blocks that have not been addressed, lack of efficacious treatment, overtreatment or inappropriate treatment, practitioner’s misdiagnosis, lack of practitioner skill, and the patient’s own karma. Of these factors, it is the last which is least considered. Practitioners are usually quick to blame themselves for an apparent lack of result. But not all things are possible for everyone in the moment nor are all things appropriate for everyone in the moment. Some people may in fact be healing, but for whatever reason, require a longer path. Others may not be in a karmic situation to heal at the level that others are. In considering such things, we must be careful not to fall into the trap of judgement. Rather, we must use these insights to broaden our scope and vision, and better understand our patients and their response to treatment. Only in this way can we serve them optimally. Ultimately, it is this optimal service that is the true marker of efficacy and success. A practitioner who gives his or her highest self and very best to the patient is always effective and successful. Such a one has found peace within, even while encountering apparent disorder, chaos, and every kind of disturbance. A practitioner must cultivate a universal stand while appreciating every nuance of uniqueness in the great paradox of life.