Thomas Lavin, a Zurich-trained Jungian analyst, holds PhD’s in clinical psychology and theology. He was chief clinical psychologist for the US Army in Europe, where he was in charge of drug and alcohol addiction programs. He is a founding member of the C G Jung Institute in Chicago. His private practice is in Wilmette, Illinois, and he consults internationally on typology, spirituality and addictions.

Addiction is not a simple thing. We can have positive addictions and negative addictions, but in the process of addiction we are giving over our freedom. We are making choices. So to the idea of, “Well, it’s a disease, it’s not my fault”, I say no. It is my fault. I’m making choices. I can choose to move from one addiction to another addiction. I can be free. Freedom is relative, but as long as I’m human I can still say yes to the creative spirit within myself.

To be addicted comes from the Latin word addicere, to give my voice over to. Someone who is addicted has no voice. Linda Leonard wrote a wonderful book called Witness to the Fire: Creativity and The Veil of Addiction in which she talks about the word “addiction”: What does it mean? Where does it come from? Ad means to or toward. Dicere means to speak. I give my voice to or toward some person, place, thing, or even a process. Process addictions are rigid attitudinal ways of approaching the world.

Addiction need not be limited to alcohol or drugs. I can give myself over—hand over my voice—to anything. In fact, the original meaning of “addictus” was spiritual, in the sense of someone dedicated to the gods, one whose voice was given over to the Divine (e.g. AA’s third step). Thus, inherent in the meaning of addiction is the sense of dedication, or bearing witness to creative energies. Among the Romans, addiction also signified the making over of goods to another by a legal sale. A slave was even known as an addictus, someone who had no voice, who was a slave to a master. Addiction is the act of giving oneself over to something as one’s master.

In this century, people like Carol Gilligan have discovered how important it is for women and men to come to voice, to get their voice back. The process of sobriety is a process of getting my voice back, of finding my voice, awakening my voice, so that I can respond to the presence of the Divine, wherever I find her, him, or it. It is a dedication—a rededication—in a pristine sense.

I can be addicted negatively; I can be addicted positively. We have to understand that addiction is Janus-headed. Almost everything psychological has two faces or sides to it. In our dreams, we regard snakes as something terrible, but then what do we see on the healing wand of Asclepius, what do we see in the caduceus? Snakes. A symbol also of the resurrected Christ in the catacombs of Rome, the snake sheds its skin, representing rebirth.

Not only symbols but also diseases that happen in our lives are Janus-headed. Addiction is terrible, it’s true, but addiction can be transformed. How can the addict get her or his voice back, so that they can respond when they’re called? My hypothesis, having worked for 30 some years with alcoholics and addicts, is that within every addiction there is a vocation, a calling. Addiction is not the end of the line. Someone is addicted. Until I come to voice, I can’t respond. Like Samuel in the night, how do I respond if I don’t have a voice? Samuel went to his guru and said, “I think I hear my name called.” And he’s told by the Prophet Eli, “Say ‘Here I am.’” Saying yes is part of dealing with addiction. The spiritual part of addiction—getting my spirit back, getting my voice back—is to be able to say yes to all of life. No one, no thing, is excluded, precluded, left out. In dealing with addiction, we have to see it as one side. It might be a sad story, maybe generations of sad stories, but we can’t talk about addiction, whether positive or negative, without pain, because people who get their spirit back have to deal with the pain of staying with their own creative spirit.

Anyone who follows her or his creative spirit has to leave the collective, leave the mediocrity of the collective. It’s Eliade’s myth of the eternal return: you leave the collective, you go out into your own desert and have your own religious experience, and then you come back to the collective with something. Each and every addict, each and every alcoholic has something to give to the community. Anyone coming from alcoholic or addicted homes has something to give back to the community. We may not know it yet or, even if we know it, maybe we haven’t come to voice yet, to ask the questions: Where am I a slave? Where have I given up my voice? Where am I mute to the life-force of Creation?

We can lose our spirits in different ways. Very often the models that are given of addiction are male. This is a problem in our culture, because the female addict is left out and not given a paradigm. Apropos of this, an article in AA Grapevine, February 19, 1996, was given the title “No Secondhand Gods”. The writer says:

I came into Alcoholics Anonymous beaten down by gin and depression, barely clinging to a thin and unhappy belief in God, and trying desperately to talk myself back into my childhood faith. It wasn’t working. I was an ex-nun whose faith had fallen apart in the convent, partly because the order’s strict policy on alcohol prevented me for the first sustained period in my adult life from drinking away troublesome doubts and questions. The first thing people in AA told me about spirituality stopped me cold. They told me if I wanted to live, I needed an honest relationship with an honestly envisioned higher power. Ill fitting secondhand gods need not apply.

I found this both liberating and terrifying. Terrifying, because I’d been taught to hang on under my religion like grim death, whether I felt honest doing it or not. Liberating, once I discovered I was genuinely more afraid of drinking again than I was of going to hell for disbelief. The ensuing years were an incredible revelation. My sponsor has an interest in comparative religion, and some of her books introduced me to a marvelous new faith, one that made me exclaim, “So that’s what I’ve been all my life.” I became a practitioner, and eventually a clergywoman of this faith, and it has given me the sort of relationship with my deeper power that I could have only dreamt of.

Nevertheless I have a solid granite derrière on the subject of keeping religion per se out of AA. So I’ve never gone to meetings and tried to preach my religion to anyone. I’ve seen the damage that that can do to groups, the confusion and pain it can cause to newcomers. But I do try to be honest about my deeper power. It isn’t easy. You see, I envision that power as female, and I call her “Goddess”, not “God”, and in some AA meetings you’d think I’d thrown a stink bomb into the circle every time I refer to my deeper power in this way. I was careful where I began saying it. For the most part my home group didn’t mind the new phrasing, so I tried it out at another meeting where I heard various people’s powers referred to as God, Allah, the Tao, the Great Maybe, and Eddy. All had gotten reasonable respect, even Eddy. So I was totally unprepared for the roar of derisive laughter that greeted me when I spoke one evening of the Goddess as I understand her. I was thunderstruck. Tears came to my eyes. I nearly died trying to find a power I could believe in, I told them. I would never laugh at yours. Please don’t laugh at mine. I tried it again at other meetings.

At about the third of the meetings, I got either ridicule, or after the meeting, conversion pitches. I wondered if it was just my area that was unusually closed to the idea, until I began to hear stories from other women of my faith on the Internet. All confirmed my impression that female deity language is the one kind that routinely elicits laughter or hostility at AA meetings. For a while, I tried dancing around the issue with terms like “Creator” and the “Divine”. I didn’t wear my religion symbol around my neck at meetings, even though some Christians and Jews often wore theirs. Eventually, I stopped dancing. That’s one tango not required of the more mainstream believers in our ranks. And I truly don’t understand why it should be required of anyone.

I’ve watched for years now as this problem has driven desperately ill newcomers away from the program. They’ve had to fight the prevailing society so hard for a faith that fits, and it is so hard for them to face being laughed at or scorned for it in what is supposed to be a place of safety when they’re barely out of detox. Please, next time you’re tempted to have a contemptuous, and audible, reaction to somebody else’s deity, think. If it’s what’s keeping her alive, do you really want to knock it down?

Openness to spirit means openness to all forms of spirit. There are many stories of coming to voice, stories of getting one’s spirit back. Our stories are different. Both introverts and extraverts can be drunks and addicts, but we do it in different ways. A subtle but important part of understanding the dry drunk is understanding psychic energy. When we’re in a dry drunk, if we’re extraverts we think we’re introverts. And if we’re introverted, we think we can be the life of the party and tell jokes and do things just like extraverts do. It’s strange but true. Some introverted people, when using mind-altering chemicals, will often extravert, extremely inadequately but extravert nevertheless.

Now 100 introverts don’t make one extravert. I was at a party once in Chicago with a group of Jungian analysts, all introverted. It was Jung’s birthday, June 6, and nobody knew what the hell to do. One person started singing “Happy Birthday, CG”, and I thought: Here I am with all these introverts, I can’t stand it, but that’s how things are. In the same way, people who are introverted, and who are with extraverts, look at them and say, “Will anyone in this room ever sit down and shut-up?” Introverts bug the hell out of extraverts, extraverts bug the hell out of introverts (and of course they marry one another!). There are stories of people who become addicted by going up, by going higher. There are some who become addicted by going down deeper. The extravert has to come back down to the ground, and the introvert has to come up to becoming normal. Both wind up in the same place, but the path, the journey, is different. Treatment programs often ignore typology. We tend to typologically tyrannize people in treatment. You hear stories of people saying, “I got sober, but I wasn’t authenticated. Because they wanted to make me a goddamn extravert or introvert.”

I have this wonderful patient who’s a PhD in theology, and she comes into my consultation room once a week, and she sits down, and I look at her and say, “How do you feel?” And she says, “Damn you.” If I asked her what she thought about Luke’s Gospel, she knows. She thinks very well. That’s why I ask her every week, “How do you feel?” “Sonofabitch. Let me think about it,” she says. “Let me think about it”!

We need to understand that there are different paths to losing our spirit and that there are different paths by which the spirit returns. This is as subtle as understanding that someone has a preference for a deeper power. Jung says extraverts are basically people who flee the center, centrum fugere, are centrifugally energized. Some people get addicted and get intoxicated in order to flee the core, to get away, to get high, to get above it. But you don’t need to drink to get high. You don’t need substances to get high. You don’t need to go shopping to get high. There are other ways of fleeing the wasteland, or the fact that your life is so banal. Other people get high so that they can go underneath the surface and find solace in the center they know they won’t find at home, so they drink in a solitary way, seeking the center, centrum petere. They are centripetally energized. We have to teach these people in treatment, in our homes, wherever we find them, that they don’t need substances to go deeply within. This is why it’s important for us to look at the typology of addiction.

Extraverts can get high without mind-altering chemicals, and they don’t have to become introverts in the process, doomed to a life of staying at home reading books. Introverts need not be condemned to an endless round of AA meetings with people they otherwise wouldn’t talk to. There’s a tremendous difference, and we need a fingertip feeling for the subtleties of introversion and extroversion in the healing process.

The Grimm fairytale, “Spirit in the Bottle”, gives us many insights into the relationship between addiction and spirit.

Once upon a time, according to the Brothers Grimm, there was a poor woodcutter who had only one son. He saved up a little money, and he sent the son to the university. After a semester or two, the son had to come back, because like many of us he ran out of money while studying. He came home to his father and said, “Father, I’ll help you. I’ll go out with you and chop wood.” But the father said, “With those hands you’re going to chop wood? And besides we don’t have an ax.” The son pleaded, “I want to do something. I just can’t sit here. Let’s borrow our neighbor’s ax.” And indeed they were able to do that, and duly set out.

After about four hours of chopping, the father said, “Let’s sit down, have our bread and water, and rest. It’ll go twice as well for us afterwards.” The son said, “Father I’m not tired. I’d like to take a little walk in the woods and look for bird’s nests.” “Don’t be a fool,” retorts the father, “Afterwards you’ll be too tired, and you won’t be able to chop wood.”

The son goes off anyway, looking for birds. Nearing a big oak tree, he hears a sound, a voice screaming, “Let me out, Let me out!” The student looks down at the base of the tree, and there is a bottle, and in the bottle he sees a little man, jumping up and down, screaming, “Let me out! Let me out!” The student pulls the cork, and out comes this little man, who then, like a genie, gets bigger and bigger and bigger, until he’s as big as the oak tree itself. The genie looks down, and says to the student, “Now I’m going to have to break your neck. That will be your reward.” “You should’ve told me that before,” said the student, “I’d have left you in the bottle. But I’ll keep my head on my shoulders all the same. You’ll have a to consult a few more people before I let you tamper with my neck.” The genie says, “I am the mighty spirit Mercurius. I have been shut up for centuries, and when I’m freed it’s my duty to break the neck of the person that frees me.” “Not so fast,” says the student. “First I need to know it was really you in the bottle.” The spirit thinks, fin and goes back in the bottle. The student then puts the cork back on and recaptures Mercurius.

The spirit says, “I’ll be good, let me out.” But the student says, “Uh-uh, sorry, you had your chance.” “No, honestly, I’ll be good, please let me out. I’ll make it worth your while. You’ll have all the riches you want.” “I don’t know,” says the student.

Then he thought about it: he had outsmarted the spirit the first time, so maybe he could outsmart him again. And he said to himself, I’ll take a chance. Maybe he’ll keep his word and, besides, he can’t hurt me. So he pulled the cork, and the spirit came out as he had the first time. He stretched and spread until he was as big as a giant. He handed the student a piece of cloth, very much like a poultice, and said, “This is your reward. With one end, if you rub anything that is broken or wounded it will be healed. And if you rub steel or iron with the other end, it will turn to silver.” “I’ll have to try that,” said the student. He went over to a tree, gnashed the tree with his ax, rubbed the poultice on it, and the tree was healed. He wiped the ax off, and the ax instantly turned to silver. He thanked the genie, and said, “Thank you for the reward. Now we can part.” The spirit said “Thank you for setting me free.” The student went back to his father.

Cutting the story short a bit, the father berates the son and says he’s a blockhead. But the son tells his father the story, and thereafter the student takes care of his parents, who never again want for anything. With the rest of his money, he returns to the university and goes on studying. And seeing that he was able to heal all kinds of wounds with his poultice, he became the most famous doctor in the whole world. He who almost had his spirit strangled out of him, he who was wounded by negative Mercurius, becomes the wounded-healer. Woundedness becomes the foundation for healing.

The idea of venturing forth, “opening up the bottle”, getting in touch with the dangerous spirit that could strangle the life out of you and outsmarting it, outwitting it, is fundamental to staying sober. The daily journey to sobriety must be a risk, an adventure. I remember being at a physicians’ AA group where there was a new physician present, and in the discussion afterwards, this doctor said, “I don’t get it, did someone just say alcohol was cunning, baffling, and powerful? That doesn’t sound like ethyl alcohol to me. I mean, you’re personifying a chemical.” And we all said, “Harry, you’re getting warmer.”

It’s hard to believe—Alcohol: cunning, baffling, powerful? Nietzsche wrote that Christianity has dragged Eros through the mud. I think Christianity has also dragged the virtue of cunning through the mud. We have to be cunning, wise as serpents, like the student with the genie, if we’re to remain sober. We have to be tricksters to stay sober, and if we’re working with people in treatment, we have to be artful dodgers to help them stay sober. There isn’t a damn thing wrong with being a trickster. The question is, who does the trickster energy serve—the drunk/addict or the healer?

It’s the question of the Grail King—who does the grail serve? To be able to go back after you’ve almost lost your life, after you’ve almost been strangled to death, to be able to go back and open the bottle again, to deal with the spirit in another form, and make that which was your downfall bring new life and new meaning to your life and the life of those around you—sounds like a paradox, one of many paradoxes in understanding the multidimensional aspect of spirit and its role in addiction. As human beings we cannot live without breath, and we cannot live without spirit either. In the Grimms’s tale, told in the middle of the last century at the beginning of the process of the industrialization of Europe, there was a loss of spirit. And who comes out? Old Mercurius, Mercury, Hermes, the god of transformations. Is there a goddess of transformations?

Linda Leonard, in Witness to the Fire, recounts the ancient Sumerian myth of Inanna. Inanna was the goddess of heaven and earth, whose sister Ereshkigal was Queen of the Underworld. Ereshkigal’s husband died, and Inanna decided to go down into the Underworld to offer sympathy to her dark sister. She’s met by a gatekeeper, who tells her that she can’t go down into the Underworld, just because she wants to, and now she has to pay the price. There are seven levels in the Underworld, and Inanna is stripped naked, piece by piece, at each of the seven levels—stripped of her crown, stripped of her jewelry, stripped of everything that gave her identity as a queen, until she is naked. Inanna was then judged, and Ereshkigal, staring at her with eyes of death, hung her corpse on a peg until it became a piece of rotting meat.

When Inanna did not return after three days, her aides sought help from the father gods. But most of the father gods were angry that Inana had craved the power of the underworld, and they refused to help her: “She who goes into the dark city stays there.” Only Enki, Lord of the Waters, responded. From the dirt under his fingernails, he created two small asexual creatures who slipped into the Underworld unnoticed and grieved with Ereshkigal, who was moaning with the cries of a woman about to give birth. Ereshkigal was grateful for the empathy and gave them Inanna’s corpse, which they revived with food and the water of life given to them by Enki.

Inanna was told that no one ascends from the Underworld unmarked. Demons from the Underworld clung to her sides, and she was required to send back a substitute to take her place. Refusing to send her faithful feminine aide, she chose instead her husband, Dumuzi, who had been feasting instead of mourning for her. Dumuzi tried to escape the demons but they found him and beat him and stripped him naked and finally took him to the Underworld. The myth ends when Dumuzi’s sister Geshtinanna agrees to share his fate, each spending half the year in the Underworld and the other half above with the living.

In our patriarchal culture, the need, especially for women, to act out our shadow side is often denied. A 12-year-old girl, for example, whose hormones were beginning to kick in, comes downstairs in a bad mood one morning, and her mother says, “Uh, uh, no way. Go back upstairs now and come back down as Suzy Sunshine, or Daddy will be mad.” So down she comes as Suzy Sunshine until she winds up in the hospital with all sorts of psychological problems as a teenager. Such is the price she’ll pay for refusing the call to the underworld. That hospitalized teenager became the famous healer, Dr Christiane Northrup.

All of us in our culture have to go down into our darkness, into our own underworld. For some of us, that’s going to be through alcohol and drugs. We’re going to be bad little boys and bad little girls. And how long do we stay down there? Maybe until we’re stripped naked of our identity. And then the water of life, the life force, will bring us back up to the surface, sadder but wiser.

There are all sorts of books coming out now in Jungian psychology, about “meeting the shadow”, “romancing the shadow”, “dealing with darkness”, “uncursing the darkness”, and so on. People are catching on that individuation is not a Pollyanna trip—it’s not all lightness and archetypal warmth and light. It’s also dealing with the darkness and the cold. So is the journey into sobriety and discovery.

Some of us are going to journey too high. We’re going to get the hell out of Iowa and join the Army and see the world and get to drink like “my father the minister” won’t let me. And then we’ll wind up somewhere like the heroin ward that I directed, in a US Army hospital in Germany, where in the 1970s I had 85 beds for 125 people who were coming down from bad heroin trips. A day never went by that there wasn’t heroin in the ward. It was a locked ward. There were bars on the windows. Two people had the key. But there was always heroin in the ward. Of course, we know that “addicts have no willpower”. No willpower? Then how the hell do you get heroin into a locked ward on the fifth floor where everything is behind bars? These people were truly cunning, baffling, and powerful.

Addiction is a detour on the journey but also a mission—and a driven mission—nevertheless. If we don’t see the spiritual aspects of this disease of addiction, we’re missing it. Jung’s idea of “spiritus contra spiritum” was, if you can help a person to understand the context of their addiction as really a search for the divine in whatever image or form, then you’ve gone about half way in terms of helping a person take what’s available within herself or himself to transform the disease and themselves.

Addiction is a diamond. What needs to be done is to find a new setting for it. As Jung says about spirit: “Do we know, for all of our familiarity with the verbal concept, what spirit really is? Are we sure that when we use this word we all mean the same thing? Is not the word spirit a most perplexing, ambiguous term? The same verbal sign spirit is used for an inexpressible transcendental idea of all-embracing significance, the spirit of the time, for instance. In a more commonplace sense, it’s synonymous with mind. Be of the same spirit: that means mind. Second, it may connote courage, liveliness, or wit, or it may mean a ghost. It can also represent an unconscious complex that causes spiritualistic phenomena, like table-turning or automatic writing. In a metaphorical sense it may refer to the dominant attitude in a particular social group, the spirit that prevails there. Finally, in a material sense, as spirits of wine, spirits of ammonia, spirituous liquors in general, (and this is not just a bad joke) it’s part of the venerable heritage of our language.”

So spirit can mean mind, spirit can mean divine force, spirit can mean ethyl alcohol or spirits of something, and it can mean spiritualistic. Jung says, when I utter the word spirit—no matter how accurately I may define the meaning I intend to convey—the aura of its other meanings cannot be wholly excluded. When we talk about spirit we’re talking about all of these realities.

My hypothesis, my experience—personal as well as professional—is that we are experiencing the subtle return of the spirit in our culture, in our treatment rooms, in our hospitals. Hopefully, we’ll have the courage to let go of what we have to let go of, and welcome this new manifestation of the spirit in our time and in our persons with a whole heart.

J.P. Harpignies is a contributing editor at Lapis, and was the organizer of the alternative medicine conference from which these excerpts are taken. He is also co-producer of the annual Seeds of Change Conference in San Francisco and the author of Double Helix Hubris: Against Designer Genes.

These are extraordinary times for "alternative" medicine. After over a century of marginalization, suppression and bitter struggle with the allopathic establishment, acceptance and some sort of integration seem to be at hand at last. Medical schools are racing to include alternative modalities in their curricula, hospitals to offer complementary care. Even the Journal of the AMA has, for the first time, devoted an entire (fairly even-handed!) issue to the topic.

These breakthroughs are a testament to the power of a remarkably broad based grassroots movement. From executives meditating to relieve stress, to truckers getting acupuncture for tendino-muscular injuries, to urban Hispanics visiting a santero for herbs and counseling, millions of Americans from all walks of life have voted decisively with their feet and wallets for more personal and cultural autonomy in their healthcare choices. And they've done it despite decades of, until recently, almost universally negative propaganda from the mainstream media and virtually no insurance coverage for alternatives.

Though they are neglected by "serious" cultural observers, this dynamic social trend and related impulses for natural, untainted food and environmental restoration are, in their own way, arguably as significant as the Civil Rights and Women's Movements. Clearly, most who turn to "unconventional" treatments are seeking efficacious and affordable remedies for their ailments and more sensitive, respectful practitioners. But many of them are also, consciously or unconsciously, searching for a medicine that honors the body/mind/spirit continuum and that acknowledges the relationship between human health and the larger social and ecological matrix. This is a profound challenge to the authority of technocratic elites obsessed with military metaphors of "wars" on disease, purely reductionist science and techno-utopian attempts to subjugate and redesign the natural world. It is, in that sense, the most culturally and politically successful mass movement embodying holistic principles to have emerged in the modern West.

Of course, as heartening as these recent breakthroughs in mainstream acceptance may be, success invariably brings new sets of problems. First, the battles are not over, as recent anti-alternative pieces in the New England Journal of Medicine indicate. Entrenched opponents can become even more reactive when they sense they're losing the ideological conflict. Also, opportunism and turf wars — licensing disputes and power struggles of all types — are bound to increase since there's now more at stake. Another real risk is that integrative medicine could become largely a niche market for the affluent and fail to tackle the crucial socio-environmental dimensions of health, though obviously issues of affordability, corporate control, pollution, etc. reflect larger social contradictions.

The alternative therapy landscape offers a dizzying array of techniques and theories ranging from archaic lore to high tech experiment, the sophisticated to the half-baked. It is not realistic to expect a systematic reconciling of all these practices or of the worldviews of reductionist biochemistry and ancient, vitalist, spiritually-based medical traditions anytime soon. Instead we are seeing a de facto coexistence of radically different medical paradigms, and while that is a very exciting, typically postmodern situation ripe with creative potential, it also presents tremendous challenges. Government regulators, researchers and patients will all at times get very confused as they try, respectively, to write appropriate rules, design intelligent tests and clinical trials, and seek the most effective treatments for specific conditions. For example, how will Western researchers, accustomed to studying single "active ingredients," attempt to test Chinese herbal formulas with dozens of synergistic components? And then, speaking only of herbs, there are the more concrete problems of ascertaining the authenticity and purity of ingredients and of avoiding the ecological damage now being caused by over-aggressive wildcrafting.

The above are only a few of the vexing conundrums we will have to face. Many of these complex issues will not be resolved in the near future. We, patients and practitioners alike, will have to learn to combine open mindedness, nimble intellectual rigor, compassion and political savvy to navigate this maze. Nonetheless, all this is a small price to pay because it is undeniable we are entering a new era of vastly expanded healing possibilities, a far more vital, diverse medical ecosystem. And nowhere has the spirit of this new emerging holistic healthcare universe been more evident than at a recent New-York Open Center conference. This unusual conclave brought together pioneering doctors and nurses who have led the way in the integration of alternatives into mainstream institutions with renowned representatives of many of the great ancestral healing traditions — Ayurvedic, Chinese, Tibetan, and Native American.

There was Dr. Jim Gordon, the first chair of the Advisory Council to the NIH's Office of Alternative Medicine on the same stage as the Dalai Lama's physician Yeshi Dhonden; the president of the North American Society of Homeopaths, Miranda Castro and Mohawk midwife Katsi Cook sharing cases of dire birth emergencies resolved by combining the wonders of high-tech hospital neo-natal ICU equipment with their respective healing arts; Taoist priest and teacher of classical Chinese medicine Jeffrey Yuen, passionate Tibetan Buddhist scholar Robert Thurman and the inspiring, intense Ayurvedic educator Bri Maya Tiwari "jamming" with Dr. Rudolph Ballentine; Jery Whitworth, the director and initiator (with heart surgeon Mehmet Oz) of the groundbreaking Columbia Presbyterian Hospital Complementary Care Center, honestly sharing the joys and the problems of that daring venture; natural foods pioneer Annemarie Colbin exploring biochemical individuality; Dr. Leo Galland explaining how the black plague contributed to undermining traditional views of illness; cancer educator par excellence Ralph Moss analyzing the new politics of cancer and the relative merits of many treatments.

From master herbalists Donald Yance and David Winston, to leading holistic nurses such as Jeanne Anselmo, to pioneering women's health activist and clinician Virginia Reath, to the dynamo Maria Josepher, co-founder of the Arrive program that brings holistic health modalities to thousands of drug addicts and ex-offenders, to several leading Tibetan doctors from as far away as the mountains of Ladakh, to eminent psychoneuroimmunologists and medical anthropologists who have done cutting edge research on the physiology of meditative states, a remarkably diverse array of clinicians, teachers and scholars compared notes and shared their hopes and concerns. As the weekend progressed one could sense a deepening respect and appreciation between many of these very different practitioners, and a growing excitement in the audience, especially among the many medical students in attendance. Abstract ideas about cross-disciplinary cooperation were becoming more embodied and palpable; the realization of how far we really had come was sinking in, and visions of a genuinely holistic medicine that only recently would have seemed utopian, now seemed attainable. For many of these leading-edge practitioners who have been in the trenches for so long, it is hard not to be wary and skeptical, but this gathering really gave even some of these battle-scarred veterans of the medical paradigm wars the sense that a new "big tent" of healthcare was being born — one that allows the profound mind/body/spirit sophistication of our species' ancient wisdom traditions to coexist fruitfully with the best tools of contemporary science.

Dr. Andrew Weil has been a leader in alternative and integrative medicine for over 30 years. After receiving his MD from Harvard Medical School in 1968, he wrote Natural Mind, the first of seven influential books he has authored. During his distinguished career he has traveled the globe researching alternative healing and has been a pioneer in integrating natural and preventive approaches to treatment into mainstream medicine. He has appeared on numerous television and radio programs, and through his efforts almost single-handedly increased the number of courses on nutrition and preventive medicine in medical school curricula throughout the US.

A true pioneer and visionary, Dr. Weil now serves as Director of the Program in Interactive Medicine of the College of Medicine at the University of Arizona, the first program of its kind, which he founded in 1994. Dr. Weil has been instrumental in helping the New York Open Center design its forthcoming training programs for healthcare practitioners, and we were grateful to have the opportunity to honor him. The following excerpts are from his acceptance speech at the Open Center's annual gala.

Thank you Open Center for honoring me. Just before I came up here, I was speaking with a young woman who said she was here because she was interested in this field. And I said to her, "What exactly is 'this field'?" She said that it had to do with contemplative studies. I would say actually that this field has to do with consciousness. And a number of the speakers tonight referred to consciousness and the need for transformations in consciousness. I think the Open Center has been very instrumental in that.

It is almost dogmatic in mainstream Western science that consciousness is an epiphenomenon. It is something that simply arises out of chance connections, neurons or biochemical reactions. That it is secondary to material processes in the brain. There is a minority of thoughtful scientists who have tried to develop new models in which consciousness is primary. But we are a very long way from seeing that become dominant and influence the thinking of scientists.

My work in medicine has been aimed at trying to bring about a transformation of consciousness in medicine and in healthcare, which I think is absolutely necessary. And I feel that this is one area in which this field has made very substantial progress.

Integrative medicine is really on the verge of becoming a mainstream phenomenon in this country, and I think eventually in other countries. It is not there yet. It is poised to become that.

I'd like to talk to you a little bit about my perspective of how it's gotten to this point and where it's likely to go from now on. But before I do I think you also have to recognize that we still have a long way to go. There are still no nutrition courses in medical schools in this country, amazingly enough. And most of those schools that offer integrative training offer it as an elective study, not as a required study. But I think this is coming, and it's interesting to look at how it's coming and why.

I have been writing and saying the same things about health and medicine for over 30 years. And calling for a need to rethink how we think about health and illness, the origins of it, and the ways we treat it. For most of that time, I was completely ignored by my colleagues. Throughout the 1970's, I began to get a following in the general public. This was a period in this country where we saw something called the 'holistic medical movement' get started. Holistic medicine emphasized the fact that human beings were more than just physical bodies, that we were also mental and emotional beings and spiritual entities. The essence of that movement was that we were minds, bodies and spirits.

I remember very well being in Tuscon during the 70's and helping organize holistic medical conferences, and what was most striking about them was that the people that attended were laypeople, social workers, and nurses — lots of nurses. But never any physicians. None.

The medical world couldn't have cared less that this was going on out there in the world of the general public and consumers. They saw it as a fad that had no relevance to what they were doing in their medical institutions.

Well, it wasn't a fad. It didn't go away. And that consumer movement has now reached a point where it really is a mainstream phenomenon in this country. For some years now, consumers in America have been spending more money on visits to alternative practitioners than on visits to primary care physicians. So this is a very powerful market force.

It was still possible for people in mainstream medicine to ignore it all and to pretend that it didn't exist until very recently. Really, I'd say, only in the past five years did this begin to happen. It's really only in that period that my colleagues have taken me seriously, and I've really begun to be invited to talk at medical schools and to talk with deans at medical schools and the people who are planning curriculums.

So what's changed? I haven't changed what I have been saying. What's changed is the economics of medicine and healthcare. And it's only as we have begun the precipitous slide into what will eventually be total collapse of the healthcare system in this country that medical institutions have begun to pay attention to what consumers have been demanding.

They are demanding a type of treatment that is fundamentally different from what they have been receiving. They are demanding something different than giving a single molecule as a pharmaceutical treatment. In other areas of science, there is a tremendous rise of interest in complexity. Models based on complexity are very successful. Medicine has been completely oblivious of these developments going on in physics and in mathematics.

Holistic medicine has the potential to completely change the way that we give medicines to the human organism. Incorporating models based on complexity would be a shift away from reductionism, which I think is one of the stifling paradigms in conventional science and medicine. If we can show that a mind-body intervention produces a positive outcome, and there is a great deal of data lying around supporting that, this would be a major challenge to the paradigm of materialism, which ultimately, is where the idea that consciousness is an epiphenomenon comes from. There is a potential to change the idea that brain biochemistry is primary and consciousness is secondary.

Beyond that, I would say that there are many other potential effects that would ripple through society if these changes begin to come about in medicine and healthcare. When I was doing a lot of my fieldwork in the 1970's in shamanistic cultures in South America and in other parts of the world, I was always struck by the fact that the way that Native Americans in North and South America used the word 'medicine' is very different from our use of the word 'medicine.' When they talk about 'medicine men' and 'medicine women' and 'medicine places' and 'medicine songs,' this has a different import than the way we use medicine, which is often a synonym for drugs or treatment.

I'm tempted to call that Medicine with a capital 'M.' It embraces concepts, that in our society, are quite separate from medicine — in particular, all of religion and all of magic. These all come under the term 'Medicine with a capital 'M.' I think our society desperately needs Medicine with a capital 'M.'

And in many ways, our culture is sick and it needs this larger vision of medicine. I think integrated medicine has the promise of offering that to us. I think it ultimately comes down to a transformation of consciousness, but I think it's actually going to be the mechanics of economics that are going to make this possible. And I think it's inevitable that things have to go in this direction. So, thank you.

Kenny Ausubel is an award-winning writer, filmmaker and social entrepreneur specializing in health and environment. He founded and produces the Bioneers Conference, an annual gathering of biological pioneers, and co-founded Seeds of Change, a leading biodiversity seed company.

From When Healing Becomes a Crime, The Amazing Story of the Hoxsey Cancer Clinics and the Return of Alternative Therapies by Kenny Ausubel, published by Inner Traditions International, One Park Street, Rochester, VT 05767. (c) 2000 by Kenny Ausubel.

"My fight against cancer includes chemotherapy, Swedish massage, and relaxing to the muffled rhythms of Tibetan drums." This advertising tag line, floating above the close-up of a smiling middle-aged woman wearing an artsy bandana to hide her hair loss, looks at first glance like a feel-good promotion for a holistic California clinic. Expensively placed in the New York Times, instead it heralds the opening of the new Integrative Medicine Center at Memorial Sloan-Kettering Cancer Center, the bulwark of the cancer establishment that has historically abhorred such alternative influences — until 1999, that is.

Although this shift appears sudden, it actually marks the surprising reversal in a centuries-long power struggle, a bitter medical civil war between conventional and alternative approaches. After a long exile, these alternative therapies are now ascendant, thriving in a crest of popular demand, scientific validation, and commercial promise. Actually, the tide is just starting to turn, and the face of cancer treatment will soon become almost unrecognizable as valuable alternative therapies permeate mainstream practice.

If Harry Hoxsey had lived to witness this apparent sea change in medicine, he would likely feel very mixed emotions. He would heartily cheer the grass-roots surge propelling the movement, the same kind that once carried his Hoxsey cancer clinics to unmatched heights of popularity and validation. He would be exhilarated by the philosophical conversion of his enemies. But he would also be cynical, suspicious that a clinging monopoly was fighting to save face and above all keep its corner on the cancer market. But then, Hoxsey survived decades of being "hunted like a wild beast" only to see his clinics padlocked. He died a broken man, anguished over the future he felt was robbed from him and his patients. The Hoxsey treatment did live on, an underground legend still attracting more patients today than any of the other banished therapies, irrepressible after all.

The astonishing saga of the rise and fall and rebirth of the Hoxsey Cancer Clinics provides a classic case history of the corrosive medical politics that have long prevented the fair investigation of promising alternative cancer therapies, practices whose ultimate acceptance now seems inevitable. When the government's Office of Alternative Medicine, part of the National Institutes of Health, recently commissioned a preliminary scientific review of Hoxsey, it signaled a radical departure, a seeming cease-fire in organized medicine's nearly seventy-five-year crusade against this reputed "cancer quackery." The government was giving a state nod to what is arguably the most notorious alternative cancer therapy in American history.

Often called the wildest story in medical history, Hoxsey is worth the telling sheerly as a great yarn. Beginning with the treatment's reputed discovery by a horse, it is a chestnut of Americana that might have sprung from the pen of Mark Twain. Were it presented as fiction, no one would believe it.

For over thirty-five years, Harry Hoxsey doggedly sought a scientific test of his herbal cancer remedies while organized medicine systematically blocked him. Though largely forgotten today, Hoxsey's quest ignited a cancer war that blazed across the national stage from the 1920s through the 1950s. Against all odds, he won a formidable series of victories, especially against his medical nemesis: AMA chief Dr. Morris Fishbein, the "Voice of American Medicine" for twenty-five years. These two figures came to personify the acrimonious schism dividing medicine.

In the McCarthyite wake of the 1950s, Hoxsey ultimately lost the war when the treatment was forced out of the country to Tijuana, Mexico. It was the first alternative clinic to set up shop south of the border. Hoxsey's successor, nurse Mildred Nelson, has quietly treated patients there ever since. Like Hoxsey, she has continued to claim a success rate as high as eighty percent, but her contention is unverifiable since the treatment has yet to be rigorously tested.

Harry Hoxsey was either a fabulist of epic dimensions leading credulous cancer patients to a certain death, or an effective healer persecuted by a medical trust. His powerful arch enemy, the American Medical Association, had previously crystallized the medical establishment's sentiments in its supremely influential Journal of the American Medical Association (JAMA). "It is fair to observe that the American Medical Association, or any other association or individual, has no need to go beyond the Hoxsey label to be convinced. Any such person who would seriously contend that scientific medicine is under any obligation to investigate such a mixture or its promoter is either stupid or dishonest."

Paradoxically, this long-standing denunciation has not been based on the objective scientific evidence that is supposed to determine the acceptance or rejection of medical therapies. Rather, the cavalier dismissal typifies the kind of prefactual conclusion that has characterized "scientific" medicine's century-long pattern of condemnation without investigation.

Today, substantial laboratory data indicates that the Hoxsey herbal tonic could have genuine value against cancer. Thousands of patients believe it saved their lives. There is no dispute that the Hoxsey remedies for external cancer are effective. Over the course of this century, numerous prominent figures including senators, congressmen, judges, and even doctors have affirmed Hoxsey's reputed cures and repeatedly called for an investigation. Why then has it taken so long?

The answer is buried in medical politics. It revolves around a fierce trade war fought over money as well as a fundamental conflict of medical opinion. Its consequence has been the exclusion and outright suppression of Hoxsey as well as numerous other promising cancer therapies.

In fact, that war is subsiding at the precise moment when yesterday's "quackery" is repeatedly emerging as tomorrow's medicine. As the preeminent herbal cancer therapy, Hoxsey is now revisiting a therapeutic terrain dramatically expanding to embrace botanical and natural medicine. Its reemergence symbolizes a much larger social transformation.

By exploring the unorthodox careers of renegade healers Harry Hoxsey and Mildred Nelson, we hold a mirror to the turbulent social and economic forces shaping medicine across the rich arc of the twentieth century. The story provides a perfect miniature of modem cancer politics as well as unearthing its ancient roots. It helps decode the arcane legacy of retrograde public policies still haunting us today while illuminating the emerging path to a future that is meaningfully inclusive of natural medicine.

This journey through the shadow side of medicine does raise very disturbing questions. If there were effective "unorthodox" treatments for cancer, would doctors even know about them? By refusing to investigate, has organized medicine denied countless people access to potentially lifesaving therapies? And who has the ultimate right to determine the healthcare choices of patients, especially people facing life-threatening illnesses for which conventional medicine has little to offer?

I began my odyssey into the Hoxsey story as a filmmaker and journalist in 1983, launching my own personal investigation into the treatment and its amazing history. Collaborating with public health nurse Catherine Salveson, I produced a documentary film on Hoxsey, and we both subsequently stepped through the lens to become players in the upside-down world of cancer politics during an era of dramatic flux.

Catherine and I bore witness to the creation of the Office of Alternative Medicine (OAM) in 1991, which grew directly from years of extreme public pressure mobilized by the large, highly organized alternative medicine community. In particular, the effort was led by the ardent constituency demanding the fair evaluation of unconventional cancer treatments. Congress firmly set the OAM's mission: to "investigate and validate" alternative therapies, with a priority on cancer. As early as 1987, national polls showed Congress that over half the American public favored the complete legalization of alternative cancer treatments.

The tacit reason for such widespread and passionate popular interest in alternatives is glaringly obvious: the medical establishment has largely lost its celebrated "War on Cancer" using surgery, radiation, and chemotherapy. But what has remained hidden from most people is the existence of another cancer war: the zealous campaign against unconventional cancer treatments and their practitioners. Over the course of the twentieth century, innovators such as Harry Hoxsey advanced over one hundred alternative approaches, at least several of which seem to show significant promise. Yet rather than inviting interest and investigation from mainstream medicine, their champions have been ridiculed, threatened with the loss of professional licenses, harassed, prosecuted, or driven out of the country.

The facts clearly reveal that a consortium of interests has repeatedly condemned these treatments without investigation: The American Medical Association (AMA), Food and Drug Administration (FDA), National Cancer Institute (NCI), and American Cancer Society (ACS), as well as certain large corporations which profit from the cancer industry. It is important to emphasize that this confederation of interests known as organized medicine consists principally of medical politicians, not practicing doctors. Physicians themselves have often objected to the unscientific rejection of alternative therapies and to restrictions on their own freedom to research or administer them.

The news blackout muffling this scandal has been so effective that most people do not happen into the underground of "disappeared" therapies until the fateful moment when they or their friends or relations are diagnosed with the dread disease. It is usually while fighting for their lives that patients discover the plethora of alternative cancer therapies claiming to offer hope and benefit, though with little if any scientific evidence to support their assertions.

The campaign against unconventional cancer therapies has continued to boil, and the story of Hoxsey remains acutely relevant because it vividly illustrates how this struggle is nothing new. Where just a hundred years ago medicine was a rich grove teeming with diverse practices, it has been supplanted over the course of the twentieth century by a medical monoculture. How did this happen?

What radically tipped the balance of power was the arranged marriage between organized medicine and big business. Only since 1900 has medicine transformed itself into a vastly lucrative industry. Intent on eliminating economic competition, this medical-industrial complex has ballooned into today's $1 trillion medical-corporate state, within which cancer treatment is very big business. It has often been profitability that has driven the adoption of official therapeutics, and, as we shall see, organized medicine has been far more successful at controlling the cancer industry than at controlling cancer itself.

Along with economic competition, at the heart of the conflict is also a pronounced polarity of medical philosophies. In truth, both traditions, known as the allopathic and empiric schools, have made important contributions. Yet patients facing a life-threatening illness often poorly treated by conventional means have been denied access to all but the allopathic brand of cancer treatment.

Medical politics aside, Hoxsey may well represent a valuable cancer therapy. The underground of cancer patients who appear to have recovered using Hoxsey's "snake oil" bespeaks the contemporary renewal and validation of herbal and folk medicine. It marks the return to a rich materia medica empirically gleaned by keen clinical observers and intuitive healers throughout the ages.

Ironically, actual snake oil, the favorite archetype of medical charlatanism, seems to have gotten a bad rap after all. Contemporary research has found it to have important therapeutic value, possibly even against cancer. It contains the same omega-3 essential fatty acids which have elevated fish oil to a highly prized therapeutic agent. Recent studies have demonstrated that natural compounds in these same fish oils increase immune response and prolong survival among cancer patients. Snake oil has a long history of medical usage which continues today in China, where it is successfully employed to treat arthritis and skin disorders. How did Chinese healers know? How is it that folk-medicine traditions have consistently prefigured and predated innumerable scientific "discoveries?"

Empiricism is a way of knowing based on direct observation and experience. Outcomes are its first measure of success, emphasizing pragmatic results over theory or understanding. To the contrary, allopathic rationalism has asserted that practice must be the application of preexisting theory, not of therapeutic experience. The heritage of this conflict between allopathic and empiric philosophy is sharply expressed in Webster's definition of empiric: "One who enters a practice without a professional education and the proper experience; a quack."

In 1927 Dr. Morris Fishbein, whose overarching influence would guide orthodox medicine for the rest of the century, wrote, "Obviously a system of therapeutics that depends on ancient empiricism in its use of drugs cannot hope to be permanent in the present system of scientific medicine." Clearly he never got to Chinatown, much less to China.

When all the tangled politics are cut away, Hoxsey is really about plant medicine. Herbal medicine is today enjoying a boisterous renaissance and the Hoxsey tonic epitomizes the bountiful botanical legacy that is the cornerstone of modern pharmacy. The very word drug derives from the Dutch term droog, which means "to dry," since people have historically dried plants to make medicinal preparations. Whether the Hoxsey herbal tonic does successfully treat cancer remains an open question, but it is well proven that many botanicals possess powerful anticancer properties. Several major chemotherapy drugs derive from plants, as do numerous primary pharmaceuticals.
The tragedy framing this story is that cancer has reached epidemic proportions. Cancer incidence in the United States has risen by sixty percent just since 1950, and by twenty-seven times since 1900. Each year, a staggering 1.2 million Americans — one in two men and one in three women — develop some form of internal cancer.

The cancer death rate has also climbed precipitously. Where in 1899 the disease killed 30,000 people, in 1999 over 560,000 died, a fifteen-fold increase in one century. Cancer is poised to become the top killer in the United States, making cancer treatment the "dominant specialty" of American medicine. This most feared affliction has become the very emblem of modern civilization.

Yet outside a small handful of success stories, the cure rate using conventional cancer treatments has hardly improved since the 1950s. Then as now, despite $30 billion spent on the "War on Cancer" since 1971, over half of cancer patients die — every year, more than twice as many Americans as were killed in all of World War ll. As we shall see, credible critics say that even these poor success rates may be doctored to appear more favorable than they really are.

Although organized medicine has summarily rejected unconventional therapies as unproven, we shall see that conventional cancer treatments are themselves largely unproven according to standard scientific protocols or the treatments' disappointing results. There are few major breakthroughs on the horizon, and even respected mainstream oncologists are calling for new directions. A shockingly high proportion of cancer is preventable, which is not a medical problem but a political one.

The bottom line is that ever growing numbers of patients are turning to unconventional therapies, with or without the approval of their physicians. Varying estimates suggest that as many as sixty four percent of cancer patients are now using alternatives, a shocking figure suggesting the depth of desperation. Their footprints are easily tracked to places like Tijuana, the Bahamas, and Europe. Patients are seeking alternative options despite organized medicine's opposition, the lack of insurance coverage, and the fact that most doctors can provide little or no information about them.

This runaway popular demand is triggering tectonic shifts in the orientations of medical practice, government policy, insurance coverage, and the mass media. Alternative cancer therapies are gaining dramatically heightened prominence and some are already starting to enter the repertoire of mainstream medicine.

Yet even now, terminally ill cancer patients whose doctors have given them up to die are compelled to cross international borders in search of potentially life-saving therapies. These basic human rights issues are echoing loudly through the halls of Congress, where a relentless movement of cancer patients and activists seeking medical civil rights is steadily influencing public policy to allow more options for both patients and doctors.

What we may be witnessing at last is a rapprochement between these polarized camps, a long-overdue truce in the cancer wars. Conventional medicine is approaching alternatives with a tentative handshake, though only time will tell whether the gesture is sincere or just a temporary concession in the winner-take-all game that has dominated U.S. medical politics for so long.

But what we are unequivocally witnessing is a marked increase in formal research on alternative cancer therapies. The government's creation of the Office of Alternative Medicine inaugurated a new openness, giving society permission to probe these taboo treatments through unbiased research and discussion. The OAM has recently been elevated to the National Center for Complementary and Alternative Medicine with increased funding, and other federal agencies including the National Cancer Institute are expanding their research into alternatives. Among the participants are top mainstream medical institutions, universities including Harvard, Columbia, and Stanford, as well as elite cancer centers such as Memorial Sloan-Kettering and MD Anderson.

Because some of these alternative therapies could represent the cutting edge of cancer treatment, a gold rush mentality is kicking in. Corporate medicine sees a sizable market and large companies are taking a stake. Ironically, the underlying commercial motive which has long worked against the acceptance of alternative medicine is now spurring its rapid growth. This economic imperative is accelerating its legitimization and relaxing the political polarization.

There is a profound healing taking place within medicine. This mending embodies a reintegration of the tragic split that has cleaved it in two, separating allopath from empiric, doctor from patient, technology from nature, mind from body, body from spirit. That healing is beginning to knit together the fractures of what in the end is one body that would do well to have all its parts joined.

There are many questions and challenges ahead, and the sorry history of the cancer wars gives ample pause to remain circumspect. We are balanced on the cusp of a transformation in medicine, a tenuous bridge to what could be one of the most vibrant and fertile eras in the history of medical discovery.

Ending the medical civil war is bound to result in a greater menu of choices for patients, and what is best for the patient surely ought to be the first consideration. We have the unique opportunity to create an authentically collaborative medicine embracing the best from all worlds. How many treatments can we explore? How many lives can we save?