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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and Narrative Medicine.
Sunday, September 13, 2015(1 comments)
Suicide Prevention -- Does it Work?
Are psychiatric services successful in preventing suicide or do we actually cause more suicides than would otherwise happen. We create a culture of helplessness in which people expect rescue and do not believe they are in control of their actions. They can attempt suicide thinking they will be saved, but can miscalculate and accidentally die. An Australian man stopped 160 suicides by giving people breakfast. Is this better?
Monday, September 7, 2015(1 comments)
The difficulty of practicing narrative medicine
I look at the stories that people hold about their lives that sometimes work against them. I tell the story of a driven man whom I warned 25 years earlier that he might drop dead if he didn't take a break, and discover that he did, in his fifties. I discuss the problems we face in medicine, how to help people change their stories that are leading them toward illness. This is one of the hallmarks of narrative medicine.
Monday, September 7, 2015(1 comments)
Working to Recover, or Adjusting to Illness?
Existing research is pessimistic about the value of our currently dominant biomedical paradigm for treating mental illness. Long-term antipsychotic use appears to make people worse rather than better. While the research continues to accumulate, practice does not change. Doctors continue to practice as if psychosis comes from lack of medication. People recover without medications. How do we reconcile these two models?
Sunday, February 22, 2015(2 comments)
Can We Reinvent Ourselves?
I ask the question, can we reinvent ourselves? I believe we can by becoming aware of the stories that we have absorbed which tell us how to live our lives. Through our interaction with others, we can modify those stories to become more effective and satisfying. We absorb stories through being born into a family, a place, a culture. We habitually perform those stories because we don't know better.
Sunday, January 18, 2015(1 comments)
Talking to Animals; what's the point?
We reflect on the winter buffalo hunt ceremonies of the Northern Plains and the ways in which humans communicated with animals, negotiating with them to cooperate in being hunted. This leads us to modern day attempts to communicate with animals, including studies from Northern Arizona University that decode the meaning of prairie dog chirps and efforts to talk to the great apes. We ask what is the point? What do learn?
Friday, December 19, 2014(2 comments)
Finding Magic in a Muggle World
What is magic in a muggle world? We recently conducted a workshop to explore that question. First, what arose was the idea our thoughts could influence the future to which we are headed. What if our visualizations could change the direction in which we are headed. What is really magic is the power we have to influence others. We have power to uplift. We have power to give hope when there is none. This is real magic.
Sunday, November 2, 2014(1 comments)
Defining Coyote Psychotherapy
In the recent meetings of the Institute for Psychiatric Services in San Francisco, Barbara Mainguy and I presented material on how we work with psychosis. We are exploring what it is that we do, and we know that it is inspired by indigenous elders, that it is centered on the body, which registers our traumas and stresses, that we are wedded to the idea of story occurring in a social context so that we are embedded with others.
Friday, October 10, 2014(1 comments)
Bringing Magic Back to a Muggle World
We need to bring magic back into our modern, materialistic world. While ultimately magic will have a scientific description, it will probably take place at the quantum level, which few of us can understand. Therefore, we are left to marvel at the way energy moves matter, at how our participation in each others electrical fields of our hearts creates coherence and even health and well-being. We are left to wonder and awe.
Tuesday, May 27, 2014(2 comments)
How we treat is more important than the treatment!
The way we relate to people is more important than what we do in both medicine and psychiatry. Randomized, clinical trials of the drug, citalopram, for geriatric depression, for example, showed that where a patient got treated mattered more than what drug they received. The response rate to citalopram varied from 16% to 82% among 15 hospitals. The time is nigh to improve the human elements in what we do be more helpful.
Sunday, September 1, 2013(1 comments)
Avatars and Hearing Voices Therapy
Recently we've learned about a computer assisted process for dialogue with disembodied, persecutory voices. In this process, developed by Dr. Julian Leff, a psychiatrist at University College, London, voice hearers pick a sound for their voice and a face which becomes an avatar on the computer screen. Then the facilitator helps them to dialogue with the avatar to oppose it. The results are very impressive. Series: Hearing Voices (1 Articles, 4653 views)
Monday, April 22, 2013 To Do and Not To Be
I reflect upon the importance of doing, what is called behavioral activation. In order to change, we need to do things differently, and not just think about doing things differently. Unfortunately, conventional medicine has supported a narrative which tells us that we do not have to make an effort to change our behavior, so people who are depressed or anxious don't believe they need to do anything. We need to change this.
Monday, March 18, 2013(1 comments)
Day 8 of Australia 2013: Bairnsdale
On the next to the last day of our Australian cross-cultural journey we visit our friend Wayne, who's now the Koorie Liaison Officer for AdvanceTAFE, an educational concern in Victoria. Our focus for the workshop that Wayne arranged for us was to consider how to better use culture to address problems in the community. The problems were the usual suspects -- drugs, alcohol, violence, gambling. What happens under colonization
Sunday, March 17, 2013(1 comments)
Day 7 of Australia 2013: Hearing Voices and Mind Mapping
Day 7 found us working with the Prahran Mission's Hearing Voices Victoria about indigenous and narrative approaches to voices. We demonstrated the use of what I call mind mapping with the various voices we hear inside our minds. This technique works for everyone, voice hearers or not, for we all hear talk inside our heads, the question being where we think it's coming from. In mind mapping we identify the talk and talkers.
Tuesday, March 12, 2013(2 comments)
Day 5 of Australia 2013: Indigenous Energy Healing 3
This third day of our presentations on North American energy medicine was all about energy. We practiced how to move energy through hands on the body, hands above the body, feather fanning, sucking, blowing smoke, drumming, rattling, placing rocks and crystals, and more. We had lunch and then we began our healing free for all. Rocky taught everyone a chant that we sang for three hours. All 49 people got doctored.
Tuesday, March 12, 2013 Day 6 of Australia 2013: Hearing Voices 1
Day 6 finds us in Melbourne and back from the bush. I include some pictures from the bush. In Melbourne we are doing a presentation with the Hearing Voices Group of Victoria about indigenous approaches to voices. We started the day by explaining our approach to voices which is to give them full ontological status and dialoging with them to learn why they have come and what they want. We did experiential exercises after.
Monday, March 11, 2013(1 comments)
Day 3 of Australia 2013: Indigenous Energy Medicine
On day 3 of our cross-cultural journey in Australia we are at a camp where we are sharing Native North American concepts of energy medicine, particularly Cherokee bodywork/osteopathy and energy medicine and psychology (aka "doctoring"). We discover again how similar these concepts and practices are to those of indigenous Australia and New Zealand and how all people heal through touching the body and its energy.
Monday, March 11, 2013(1 comments)
Day 4 of Australia 2013: Indigenous Energy Medicine 2
During the fourth day of our Australian cross-cultural journey we continued to present our form of indigenous (Cherokee) bodywork/osteopathy and energy medicine ("doctoring"). The second day focused on how anyone can feel energy differences in other people and within those areas of energy differences, can find points that need rubbing or holding. We showed how these intuitively discoverable points are the same as TCM.
Saturday, March 9, 2013(1 comments)
Day 1 of Australia 2013: The Autobiographical Narrative
Each year we make a cross-cultural tour to Australia, though one of our Coyote colleagues comes twice a year to make an impact on incorporating culture in health care for aboriginal people. This year we began with a lecture in a writing conference on the topic of the autobiography in which I describe my experience of writing Coyote Medicine. I finish with a description of what has been accomplished in five years of coming.
Saturday, March 9, 2013(1 comments)
Day 2 of Australia 2013: Story is Healing
Today we considered how story can save people's lives. When people are filled with negative stories about being inferior and worthy of humiliation and contempt, they respond accordingly often with substance misuse and violence. The traditional cultural stories of all of our peoples are antidotes to this negativity. By immersing ourselves in our cultural stories, we can turn victimization into recovery and transformation.
Thursday, January 24, 2013(1 comments)
NIMH and its Biologic Emphasis
I respond to Dr. Thomas Insel's blog about his views of the top ten advances for mental health for 2012. What saddens me is that all of these advances are heavily biological and that biological medicine hasn't really succeeded very well in improving our mental health. While these advances are very interesting, I argue that what we need is more understanding of how our social relationships form our brains and behavior.
Monday, December 10, 2012 Pain, Part 2
I continue to reflect upon chronic pain, beginning with some comments from my colleague, Peter Blum, who is a hypnotherapist and all around healer-guy in Woodstock, NY, and then leading into some brain science that shows that our brains are changed by the experience of pain and begin to link all kinds of unrelated experiences to that pain so that pain becomes multiply determined by more than just the sensations.
Monday, December 3, 2012 Chronic Pain and Opiates
I describe my struggle with prescribing opiates for people in chronic pain. My observation has been that my patients on opiates don't seem to be in any less pain than my patients not on opiates, and sometimes they are more grumpy. I explore the literature and learn that prolonged opiate use sensitizes people to feel more pain and that it can also act as a neurotoxin producing neuropathic-like pain, so perhaps not a good idea
Saturday, August 11, 2012 Healing Camp Day 1: Introduction to the Concept
In this article, I write about our invention -- Healing Camp. For the next seven days, I am going to describe what we do and how we do it so that others can (hopefully) replicate it. The concept is simple, that people from all levels of training and walks of life can come together and be healing for each other. We will be doing a similar but shorter event in Hartford, CT, the weekend of August 17th. Check Sukhasala website.
Wednesday, August 1, 2012 The Inflammatory Theory of Depression
In this article, I describe a way of thinking about depression that makes sense of how we collapse from too much stress and from unremitting anxiety and misery. In this theory, eventually life overwhelms our capacity to resist inflammation and it runs away. From August 16th through the 19th, catch me in Hartford, Connecticut, to further discuss these ideas. For details, see Monday, July 23, 2012 The High Cost of Medically Unexplained Symptoms
I write about how the search for the diagnosis for medically unexplained symptoms is an important aspect of what is bankrupting our health care system. We have to solve this problem for manage costs no matter what health care system we have. I acknowledge that some diseases are missed and that some diseases are yet to be found, but suggest that we are much better at findings serious and life threatening illnesses than before.
Thursday, July 12, 2012(1 comments)
Health Care Costs and Schizophrenia
I reflect on the cost of care for people who are diagnosed with schizophrenia. I muse about a moving lecture by Eleanor Longdon, PhD, who was once a schizophrenic and now is a clinical psychologist. She spoke about her own process at the Hearing Voices Conference in Melbourne, Australia. Eleanor echoed my observations, that the way we manage people who hear voices and suffer this kind of distress is costly and ineffective.
Sunday, May 20, 2012 Narrative Concepts
I attempt to say what a narrative is. It is a telling of something to someone by someone. It may reflect the basic means by which our brains work, the result of a co-evolution of brain and story to allow us to recall the myriad of details necessary for negotiating a social life with the 500 people whom we are capable of knowing. Its shortest form consists of two action clauses that can be sequenced and one orienting clause.
Sunday, May 20, 2012 More about Single Payer
In this article, I continue my musings about single-payer health systems. I share my experiences of working within the Canadian health care system as a physician (family medicine and psychiatry). I describe the back logs we did have and how we got around them, the lack of utilization review, how I could hospitalize anyone at anytime so long as there was a bed open, and how no one pushed me to discharge patients too early.
Monday, April 30, 2012 Single Payer Health
In this article, I look at possible difficulties of implementing single payer health care in the United States. We review studies that show that the difference in health care costs between the U.S. and Canada are due almost entirely to administrative costs. We look at the administrative inefficiencies that already exist in the U.S. and amply them to start a single-payer system, supporting local control of health care.
Monday, April 9, 2012 The Debate Over Obamacare
I offer my views on health care financing. I suggest that we have reached a point as a society in which we are not willing to let people die in hospital waiting rooms who do not have insurance. We even have laws that require hospitals to care for whoever appears regardless of ability to pay even if we do not have any means to remunerate those hospitals. It's time to wake up to the reality that this kind of reality costs.
Monday, March 26, 2012 Problem Based Learning
Problem-based learning has become the norm for much of medical education, yet other disciplines are slower to adopt it. I muse about how to integrate PBL (as if is called) into the on-line psychology teaching environment and consider student objections. This essay was prompted by the comments of two students who were strongly opposed to PBL and gave me the opportunity to reflect upon its strengths and weaknesses.
Tuesday, March 6, 2012 Day 14 of the Australian Journey 2012
Today is the end of the Australian cross cultural adventure. I fly back to the U.S. today and resume ordinary life. I write about the people I met whom I appreciate and what I learned and where we might go next.
Sunday, March 4, 2012 Day 11 of the Australian Journey 2012
Today is Day 11 of the Australian cultural exchange adventure for 2012. We interacted with Mission Australia in Sydney and were deeply impressed with their services for young people and for homeless adults. They have managed to integrate shelter with education and skills training so that homeless people become able to transition into the work force. One person told us, "I came here a prostitute, and I left an artist."
Sunday, March 4, 2012 Day 12 of the Australian Journey
Day 12 of the Australian cross cultural exchange journey consisted in our leading an inipi ceremony (sweat lodge) for people associated with Mission Australia. We also learned much about some very exciting projects being conducted by Mission Australia, including the Michael Project, which is an intensive effort to assist homeless people in Sydney, and the Catalyst-Clemente Project, which provides education for disadvantaged.
Sunday, March 4, 2012 Day 13 of the Australian Journey 2012
Today is Day 13 of the Australian Cultural Exchange Journey for 2012. After a quick morning run, we went to Mission Australia's Youth Forum 2012. We met Nancy Ingram, an elder from the area who attended Harvard University and knew about Vermont. I have a talk about the importance of heroism for adolescents and finding ways for them to be heroic or to save face when they feel they have not been heroic.
Friday, March 2, 2012 Day 10 of the Australian Journey 2012
Today was Day 10 of the journey and was a day for reflection and preparation for the Sydney portion of our trip. We reflected upon what culture camp had meant for people and confirmed that we would come again next year. Then we flew to Sydney and ate a marvelous fish dinner.
Wednesday, February 29, 2012 Day 7 of the Australian Journey 2012
Today is Day 7 of the Australian journey 2012. We are on Boole Poole in the Lake District of Gippsland. Our sweat lodge ceremony had been rained out the day before, so we prepared to do the ceremony as soon as the rain stopped which happened around 8am. I've written about sweat lodge before, as have others, most notably Bucko, author of The Lakota Sweat Lodge. It was a wonderful experience and then we hear crocodile tales.
Wednesday, February 29, 2012 Day 8 of the Australian Journey 2012
This is Day 8 of the Australian cross cultural adventure. Today we went to the heart of the community where the elders from the Northern Territories demonstrated some of their ceremonies and procedures to the community. That included the burning ceremony for healing pain, the smoking ceremony for purification, and spear throwing. On the way back to the island, I interviewed a patient advocate from Western Australia.
Wednesday, February 29, 2012 Day 9 of the Australian Journey 2012
Today is Day 9 of the Australian Cultural Exchange Journey for 2012. Related to the constant, driving rain, we mostly talked today We talked about the health care system to which we wished to move and how to get there, especially through changing the socialization of students and giving them new stories about what to expect from others.
Tuesday, February 28, 2012 Day 6 of the Australian Journey 2012
Today is Day 6 of the 2012 Cultural Exchange Adventure in Australia. It was also the first day of culture camp at Boole Poole with the aboriginal coop. The driving rain prevented our crew from Northern Australia from doing much outside. We had planned a sweat lodge ceremony but that was cancelled also due to the rain. So instead, while we tried to stay dry, I interviewed the new doctor at the Coop.
Monday, February 27, 2012 Day 5 of the Australian Journey 2012
I describe the fifth day of our journey for cross-cultural exchange. Today was primarily a day of our teaching. The days vary from receiving mostly to giving mostly. We focused on the importance for everyone, regardless of ethnicity or indigenous status to participate in ceremony in such a way as to feel closer to the spiritual dimension and to celebrate what's good and positive about one's life instead of tales of misdeeds.
Sunday, February 26, 2012 Day 1: Australia 2012
This article begins my 2012 Australian journey. I briefly describe my presentation for the day and then go to the meat of what I learned, which is about aboriginal health and disparity statistics in Australia today. Generally, as anyone can imagine, aboriginal people are in terrible shape in Australia -- to my surprise, worse than their counterparts in the USA and Canada. We know the sad state of Indians in the US.
Sunday, February 26, 2012 Day 2 of the Australian Journey 2012
Day 2 of the Australian Journey for 2012 finds me in Melbourne at the International Hearing Voices conference, attended by aboriginal and non-aboriginal people alike. I present the highlights of the conference including aspects of my keynote address. The conference is unique in that it is organized hy voice hearers and not professionals who treat voice hearers. It is also unique in being upbeat, positive, and full of hope.
Sunday, February 26, 2012 Day 3 of the Australian Journey 2012
This is Day 3 of the Australian Journey. It's also the second day of the Hearing Voices International Conference in Melbourne in which aboriginal elders and their wisdom for managing voices (and giving the voices full ontological status as potential beings) were showcased. I write about some of the techniques I demonstrated in my workshop for managing voices including guided imagery, dialogue, and theatre.
Sunday, February 26, 2012 Day 4 of the Australian Journey 2012
Day 4 of the Australian Journey finds us in Warburton with Auntie Jennie, an aboriginal elder from Queensland. I discuss the workshop we did together and explore further the concepts that integrate indigenous theories of mind and mental health with the Hearing Voices movement, showing that its founders were thinking indigenously as they approached voices, which appears much more effective than the biomedical approach.
Thursday, February 23, 2012 Medical Writing: the Healing Power of Narrative
This article represents the start of my annual trek to Australia to work with an aboriginal cooperative in Southeastern Australia. The goal is to help them to incorporate their culture into their health care and other human services through cultural exchange with aboriginal North Americans, aboriginal people from the North of Australia where culture is less disrupted, and others from the area. More to come of my 2 weeks!
Thursday, February 2, 2012 On the Nature of Afflictions
In this article I wonder about what illness has to offer us. What is the nature of affliction. Is it a thing or is it a doorway, an invitation to make meaning. All illnesses offer us this opportunity.
Monday, January 9, 2012 Reflections after a Hypnosis Workshop
I describe some reflections after co-teaching a hypnosis workshop. Particularly, we look at a person whose story is too large, as big even as the whole United States. How do we work with someone whose story is that large. I describe ways to extract smaller stories, short stories from the large novel, stories that can work within an hour time frame, the usual length of time for mental health or hypnosis encounters.
Friday, January 6, 2012 Mind, body, and unexplained symptoms
I describe a woman with a "mystery illness" who has defied the efforts of conventional physicians to diagnose her. She has also been unsuccessful at gaining help from alternative medical practitioners. I show how inflammation is an integrative process which can affect a variety of organs and can be provoked by stress, including the stress of worrying too much. We we can change the underlying process, we can reduce it.
Saturday, December 31, 2011 The Narrative Paradigm and the New Year
I write about my enthusiasm for the narrative paradigm for psychotherapy as we enter into 2012. Within this paradigm, we understand that we don't necessarily know the reasons for our actions, but rather we look for the stories that create the roles that guide us to do what we do. We find that people mostly know what needs to change in their lives but have stories that stop them from making those changes.
Sunday, December 4, 2011 Reflections on Teaching Statistics Again
I have the role of being the statistics teacher for a graduate psychology program in which students don't like statistics. I discover my hidden assumptions about students which may be relevant to life and to psychotherapy also. I reflect upon our attitudes toward math in North America and how different that is from Asian cultures. I reflect upon some students' resistance to problem-based learning and what that means.
Sunday, October 2, 2011 Excerpt from Coyote Wisdom Chapter 10
This excerpt tells the story of my work with Tiffany, a young woman with cancer who was from the Christian faith and how we used Meister Eckhart as a way to bridge my Native American philosophies with Christianity to create a healing dialogue throughout the course of her cancer. this seems like an important story to me because it shows how we can create healing (meaning and purpose) even when the patient dies.
Wednesday, September 7, 2011(1 comments)
Reflections upon transitioning to private practice
Just over 2 months ago I left the public mental health sector in New York to transition into private practice in Vermont. This article reflects upon those two months of changes and wonders what we can learn from the type of care available in Vermont compared to New York and from New York's apparent discrimination against paying private practitioners in favor of community mental health centers.
Sunday, September 4, 2011(1 comments)
Sundance No. 2, 2011
Barbara and I write this following our second sundance of the season. In this article we contemplate the idea of the sundance as an embodied metaphorical struggle in which the suffering and deprivation encountered are physical metaphors for the suffering of life. The mindset we use to embrace uncertainty matters in everyday life. We do best when we abandon the idea that we can know what is going to happen next.
Sunday, September 4, 2011(1 comments)
This essay is about accountability. In the community mental health center where I have been working, most of the patients lack any sense of self-agency or accountability. Most see themselves as helpless victims of diseases over which they have no influence. They expect me to provide them with a drug that will regulate their moods and emotions and make them feel normal again. What does it take to restore a sense of agency?
Tuesday, July 5, 2011(1 comments)
Thoughts after Sundance 2011
I reflect upon Sundance 2011 and what I have learned. I realize that Sundance is about love and compassion and following this red road that leads to these directions. Sundance gives us an opportunity to rise to become spiritual warriors, to find all the benefits and none of the detriments of battle, to create a community of fellow warriors within which we can feel strong, and to transcend our natural limits to become more.
Sunday, April 24, 2011 Sweat Lodge, Prayer, and Community
Prayer and community have been stripped away from contemporary health care. Both are sorely needed. I talk about the sweat lodge ceremony as being a laboratory for exposing mainstream healthcare practitioners to the perspective on health and the world of Native American people and show how it produces the kind of connectedness and sense of belonging that we desperately need and which is associated with greater health.
Monday, April 4, 2011 Adolescent Addictions and Las Vegas
This weekend I attended an addictions and mental health conference focused upon adolescents in Las Vegas, Nevada. What an appropriate venue! I spoke about narrative practices in relation to addictions -- how we have to counter the dominant stories about magical potions and find other heroic stories that work equally well.
Wednesday, March 30, 2011 Nanglyala Mental Health Center
I write about the composite mental health center I have created in previous essays which comes from my and others' experiences working in mental health in New York State. I call it Nanglyala Mental Health Center, in honor of the Russian word for Valhalla, which one can't use, for it actually exists. I propose a thought experiment in changing the culture at NMHC, which I hope someone somewhere will be inspired to do.
Wednesday, March 23, 2011 Narrative and Science: Day 13 of the Australian Journey
Today was our last full day in Australia and the occasion for a lecture and series of discussions at the University of Melbourne's Center for International Mental Health and School of Population Health. We explored the bridges between science and the indigenous world view of narrative. Particularly we were impressed with how neuroscience is completely supporting indigenous knowledge about narrative and its importance!