Our Work Continues in the Face of the Pandemic

a man and woman wearing medical masks talk in an office

Dear Friends of the Institute,

I am deeply grateful. Around the world, first responders, doctors, nurses, and family members are putting their lives on the line every day. Researchers are working around the clock to find new ways to treat the sick and find a vaccine. For many, life has been put on hold. Paychecks have stopped arriving, and in these hard times neighbors are reaching out to help neighbors, businesses are bringing food to emergency rooms, and hotels are opening their doors to exhausted doctors and nurses, who are afraid of bringing the virus home.

In the face of a global pandemic, my work continues. Our work continues.

I have spent my life seeking to transform medicine. It has led me to examine our healthcare system’s overriding focus on treating disease rather than promoting wellness. We started the Institute for Integrative Health in Baltimore searching for people who were prepared to ask questions that would challenge conventional thinking about healing and society – looking for science-based answers that would shift the global conversation from the status quo and all that encompasses, to creating and maintaining health. These are revolutionary ideas.

While seeking to create an epidemic of health we have been answering some of the questions that are now finally at the forefront of international conversations centering around the pandemic. Who is most at risk and why? How can we change that? How can we build more resilience? How do we move forward? When western medicine doesn’t have all of the answers, what does integrative medicine have to offer?

Our Scholars, Fellows, Visiting Visionaries and forums are shining a light on how primary care is crucial and yet undervalued in this country, how the arts can support well-being and resilience, and the critical importance of seeing the whole person and understanding the context of their lives when envisioning a world where health is for everyone, not just those who can afford it. We are partnering with members of our community, evaluating the impact of urban gardens and “wild” nature in hospital settingsteaching kids about nutrition who live in food deserts, and we are working with medical school students, giving them the essential tools of how to cook, what to cook, and how food fuels the body, so that they can go on to lead patients toward healthier nutritional choices.

It sounds so easy, and so normal when you think about it. If kids understand how to turn raw food grown in their garden into delicious meals, they will have a better life outcome. If medical students understand that it’s possible to easily cook nutritious food that is also delicious, they can better inform their patients, and everyone will be healthier. If people understand the value of nature in supporting resilience and wellness, humans and the planet will thrive. These are just some of the ways our thinkers are changing the world. There is more, so much more.

At the Institute, ours is not the work of finding a vaccine. Every day, we are working with our partners around the globe to catalyze a new paradigm, actively bringing substantial and lasting change to the way that wellness is valued and supported in all our communities.

At this moment in time, the world is facing tectonic shifts. It is a moment that allows for the possibility of real transformation, a moment that asks for the best from all of us. We must be nimble, dedicated to change, and ready with new ideas. Here at the Institute, we are.

Wishing you and your loved ones health and wellness,

Brian M. Berman, MD
President
The Institute for Integrative Health
Professor Emeritus Family and Community Medicine
University of Maryland School of Medicine

Developing safety, persistence, trust

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Acquiring Resources

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

Helping Relationships

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) “When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.

Suffering

Suffering is the ongoing pain from wounding. There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. “The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”