Illness And The
Search For Meaning

An Interview with Jean Shinoda Bolen, M.D.
By Mary NurrieStearns


In this interview, we discuss the essence of Jean Shinoda Bolen's new book, Close to the Bone. Her compassionate work guides individuals and their loved ones through the realm of life-threatening illness. Jean offers hope and perspective for navigating through the "crisis of the soul" that accompanies serious illness.

Life threatening illness visits us all, either in our own lives or in the lives of dear ones. At some point, descending into the depths of the soul is inevitable.

Personal Transformation: Life threatening illness as a crisis for the soul is a central theme in your book. What does that mean?

Jean Shinoda Bolen: Life threatening illnesses are usually viewed as crisis. Crisis, in ancient Chinese language, is comprised of two elements, danger and opportunity. In medicine, it used to be that crisis occurred when a patient's temperature went up and up and up and then broke. Crisis was the place where one was in danger, and yet there was opportunity for major change. Life threatening illness has that effect on people. The focus often is entirely on the danger to the body, without awareness that the danger offers a major possibility of transformation of relationships and of the psyche, as well as the body.

PT: We are never the same after life threatening illness.

JSB: In hospitals and Doctors offices, often everything is ignored except the part of the body that has something wrong with it. People are discouraged from being conscious and expressing what is happening at a deep level, at the soul level. Patients get the message to be just the terrain or the body where the doctor and modern medicine will fight the illness.

PT: You use the term liminal time, meaning threshold. What is this threshold that life threatening illness takes us to?

JSB: When you are in between, you are in a threshold time, or a liminal time. When you are between the potential of life and death, you are in liminal time, on the threshold of crossing over from the visible material world to the invisible one. Life threatening illness puts you there because you know that your illness could result in your death. You are straddling the possibility of living or dying. During that in between time, different elements can tip the scales one direction or the other. You can be hexed by the people around you. If your doctor emphasizes the negative potential of what you have, and if you accept the message that this is going to kill you, the probability increases that it will. However, when you are in between, in that liminal place, it is also possible that you will deepen your connection with others who believe in the possibility that you can make it through. You can challenge authority, you can seek alternative possibilities to add to what modern medicine offers that can increase the possibility of surviving.

In my work, I often draw upon myth, because the language of myth touches the soul. The soul listens to metaphor, stories, poetic expression, and music. The soul is moved by emotion-laden expressions. In the myth of Persephone, she is burying flowers in a meadow and all is well one moment, and the next moment the earth opens up in front of her and Hades, the Lord of the underworld, comes and abducts her and she is pulled, terrified and screaming, into the underworld. Acute onset of a diagnosis or of symptoms can be like that. One moment you are fine, living ordinary everyday life in the upperworld, where the sun is shining. And then, the sudden onset of serious symptoms, the pain of a major heart attack, a test result that says you're HIV positive, or the appearance of cancer in the breast, requires much more definitive medicine, and you have to enter the hospital. The shift between everything being fine one moment, and you and the people who love you being in the underworld the next moment, is mythic. The myth helps express what your own experience is like. In the myth, Persephone is not given up on. Hermes, the messenger God, comes down to the underworld to bring her back. At that point, Persephone realizes that it is possible that she will not stay in the underworld forever. It is possible that she actually might return to life.

The story that you believe about the possibility of recovery goes into the depths of yourself. In your bones, there is a response that says, it is possible for me to recover. Then the equivalent of Hermes goes through your entire body in the form of neuropeptides and every cell of your body shifts from a depressed state to actively responding to the possibility of recovery. At that point, there is an infusion of a life force energy conveyed to your body. When that happens, in this liminal time, the potential of pointing towards life makes the tilt.

PT: This liminal time is also the time of soul questions. What are these soul questions?

JSB: We are spiritual beings essentially. We are spiritual beings on a human path, rather than human beings who may or may not be on a spiritual path. We know this in our bones. An illness that brings us close to the bone, brings us into the realm of soul, where we know things, not with our intellectual minds, but at a soul level. I think that we do know that we have a soul. When I say that we are spiritual beings on a human path, I don't have to prove it; this is not an intellectual debate. The words describe what we deeply know. As spiritual beings on a human path, we come into a material existence in our bodies, where suffering and limitation is essentially part of the human path. We cannot get through life without our particular encounter with suffering, in whatever form it may take. All of us are limited by our life spans. Life itself is a terminal condition.

If we let this sink in, that we are spiritual beings on a human path, the questions are: What did we come to do? What did we come to learn? Who did we come to love? What did we come to hear? What are we here for? These are questions whose answers come from within, so that only we truly know when we are authentically living from our deepest self. When life threatening illness comes, a lot of what we are doing with our lives is revealed to us as being superficial or inauthentic. After realizing how precious life is and how potentially short it is, many people, especially women, become empowered by that knowledge to make major changes in their relationship life, and many men and women make changes in their work life.

PT: You discuss Procrustes' myth in your book. What are its implications for illness and recovery?

JSB: The myth is that if you were on the road to Athens, you had to pass Procrustes' bed. He would put you on his bed, and whatever part of you did not fit, he cut off. If you were too short for the bed, you were stretched, like on a medieval rack, until you fit. This story applies to us all. Every person has expectations placed on him or her as to what success means. It might be work success, or it might be to marry well. Your particular family expects its members to be a certain way. Whatever parts of who you really are don't fit expectations, or are unacceptable to the successful world you are expected to enter, you cut yourself off from. We lose that part of ourselves which stays buried in our underworld.

Facing the realization that life is limited is a mid-life issue. Life threatening illness raises all of the major questions of mid-life because mid-life, whenever that might be, is a state of mind when we understand how short life is. We have lived as many years as we have to that point, and life has gone by really fast. We have a sense of the limitations of time and of our active energies for life. An illness is an acute form of the crisis that many people have at mid-life, as they realize they may be wasting this experience, and become depressed. This might precipitate a crisis in relationship and work and life. When this happens, we are plunged into an underworld, where we find all of the human fears that none of us want to look at, but all of us have to.

When it is a life threatening illness, the fears are of death and dismemberment, of losing our essential womanhood or manhood, of pain, and also that we are going through something, and we will never be the same again. Going into the underworld also brings us into the realm of all the possibilities that we cut ourselves off from, our particular depths of talent and inclinations of joy that we stopped along the way. It is a time of remembering and reconnecting with that which we cut ourselves off from, as well.

PT: We often fear the underworld as this place of fear and vulnerability, yet if we are willing to, or are forced to descend there, we can discover great richness and the realm of the soul.

JSB: That's right. And that can make the experience a major turning point.

PT: How can illness be a turning point for us?

JSB: In psychological work, people make a descent, often precipitated by depression or anxiety. They begin to listen to their dreams and to connect with feelings that they have buried. In the underworld, there is a reconnecting with sources of mortality, and sources of meaning, and the potential of living authentically. Jung would describe it as, the potential of individuation, of following your own personal myth, of living from the inside out, rather than shaping yourself to meet or fulfill other people's expectations. When you descend into the psychological process, the turning point is when the potential of getting on a heart and soul track can grow.

I was very taken with the parallels between that which I do with depth analysis and Dr. Lawrence LaShan's work with terminal cancer patients. He initially found that even though people seemed to appreciate their sessions with him, they died at the same rate as people who were not doing psychotherapy. Then, he changed his focus in his work with apparently terminal people, and began to address what was right with these people. He has a wonderful series of questions which people were encouraged to find the answers to. They were questions such as: What would make you happy to get up in the morning, looking forward to what you would be doing during the day? What would you be doing if at the end of every day you would go to bed tired, but good tired? What would you be doing if your life were physically, spiritually, and emotionally in harmony? What would your life be like if you could imagine the world adjusting to you, rather that you adjusting to it?

His questions assumed that we have our own particular song to sing. Those are poetic ways of asking individuation questions. People found answers to these questions by going deep inside of themselves to remember and reconnect with their own sources of meaning and joy and service. He found that when people discovered what really would give their lives meaning, invariably, service to others was involved. People who were expected to die went into long term remissions. Half of the people he worked with lived on. Their cancers became a turning point in their lives.

PT: Recovery literally can be dependent upon this discovery.

JSB: Yes. Life threatening illness puts us on a soul path that may well lead to recovery on a physical level.

PT: Suffering and illness can be the pathway that brings into our awareness what our talents and purpose are. For some of us, this may be impossible to discover without suffering. In this sense, suffering has great meaning.

JSB: That's true. Our suffering and how we react to it has a possibility of really shaping and strengthening our purpose, or not. If people are able to grow through their experiences of suffering, the suffering is redeemed. They understand that their suffering was meaningful. One of my colleagues gave me Albert Schweitzer's description of "the fellowship of those who bear the mark of pain." Schweitzer had his health restored through a series of operations. After he went through those painful experiences and was restored to health, he knew suffering firsthand, and out of that, he responded to a need to help alleviate the suffering of others.

My colleague, an exceptionally fine psychiatrist for very disturbed patients, went through a descent into the mental realm of suffering when she was a medical student, and spent some time on a locked psychiatric ward. That descent into mental suffering provided her with insights and awareness of what it is like to be there, and she has grown to be a guide for others.

Creative work also grows out of the suffering of life. The depths that music takes us to may echo the experience of the depth the composer lived. Our potential for poetic expression is tapped when we go through periods of anguish and suffering. Essentially, life happens with its potential for joy and suffering, and how we react to it is soul shaping. The person who insists on identifying with the victim may get stuck there, while the person who learns compassion for others as well as themselves may grow and find motivation for their work.

PT: Let's focus on healing and what helps. Begin by discussing the myth of Psyche and her two tools.

JSB: When you find yourself in the dark, and become aware that you are not conscious of the reality of your situation, you enter the realm of Psyche. In her myth, Psyche took a lamp and a knife to see the man who came to her every night. She wanted to know who her unseen bridegroom was. Was he a monster, which an earlier prediction seemed to indicate? She took the lamp and the knife and hid. In the darkness, after he went to sleep, she took the lamp to see who he was and the knife so that she could sever his head if he turned out to be a monster.

We need those symbols to look at what might be destructive in our lives. The lamp is a symbol of consciousness, of illumination. The knife is the symbol of discrimination and the power to sever the bonds with those people or addictions that, if we were to see clearly, we would know are bad for us. It is not enough to have some conscious awareness of a destructive situation, because without the capacity to sever the bond, the consciousness dims. Many people are in codependent relationships which are destructive to them. They need to be able to look at the situation holding both the lamp and the knife, so they have the power to sever those relationships or those addictions, if needed.

PT: Or those attitudes within ourselves that are destructive or negative.

JSB: I've heard women say that their diagnosis of cancer was both the worst thing and the best thing that happened to them, because for many, it allowed them to put themselves first or to take care of themselves. It's as if the cancer gave them permission to say no.

PT: What about the usefulness of rituals in healing?

JSB: Ritual is a deeply creative process that re-enacts and draws up qualities of participants into consciousness. Ritual brings elements of energy or power to life situations. For example, one of my friends wanted to gather her friends, to be with her on her journey, which was an encounter with chemotherapy for her recurrent cancer. She was told to expect that her hair would fall out in clumps. She heard about a women who cut her hair off before chemotherapy, and she decided to have a ritual in which we would witness her having her head shorn. It was a powerful experience to be present and to watch her go through this major change in front of us. Her hair was beautiful. It was a symbolic, as well as a real act, to have it cut and shaved. She was transformed physically before us. The courage it took to do that reflected the courage it took to go through the realm of cancer and treatment, which is a major heroic ordeal. That ritual was an archetypal experience.

Some rituals touch on patterns that humans have engaged in for thousands of years. Having your hair shaved is a major initiatory act from marine boot camp to the ordination of Buddhist priests. Women who marry in an orthodox Jewish tradition shave their heads, and Catholic nuns used to shave their heads as part of their initiatory experience. Another ritual that some women have done is to take either a symbol of or the actual pathology specimen that was surgically removed from them, and ritually bury it in the ground, as a symbol of returning to the earth. I recall a woman who buried the uterus that was removed from her, that it might become part of the earth, and then planted a tree that her uterus might contribute to new life.

PT: Let's move to the power of relationship. When we are in relationship with someone who is going through a life threatening illness, how can we help?

JSB: Companions on the journey make a tremendous difference. An I/thou experience with soul connection is essential, and often makes the difference as to whether or not a person comes through the underworld descent into which illness takes them. At a research level, participating in cancer support groups results in living twice as long and maybe even surviving a terminal prognosis. This finding contributes to the scientific validation of what we know at a soul level, which is that who and how others are with us influences whether or not we come through. People have extraordinary capacity to give support to each other. The support is partly emotional and spiritual, and partly energetic. A healthy person has an excess of life force, and through physical touch conveys energy to a person who is sick and may have a deficit of it. When you love the person that you are supporting through the journey, you might want to be a conduit for the energy of love and compassion, which are words that describe energy that is healing. The combination of energy and supportive belief helps significant others to endure and to come through. In most cases where unexpected remarkable recoveries or spontaneous recoveries have happened, a significant relationship has contributed. A connection between people is significant on a healing journey, and a relationship to the invisible world through prayer is significant.

People's prayers make a major difference in recovery. We know this at a soul level, and research studies verify the effectiveness of prayer. I quote the study done at San Francisco General Hospital on patients who were in the cardiac care unit. One half of them were prayed for and the other half were not, in a research project in which no one knew who was being prayed for, and who was not prayed for. The results were dramatic. The prayed for group did much better. Studies like this help us, for we can minimize that which we know on a soul level, until the scientific feedback confirms that what we innately want to do is right. Healing touch, prayer, or other alternative or complimentary choices, such as affirmations or rituals, aid healing. Without scientific backing, there is a tendency to not want to appear foolish or do something that others might say is silly. What we innately know to do, that which arises in the moment, is right to do. Outside authority, especially skeptics and cynical people, are toxic to healing processes.

PT: In healing, it is important for us to turn to people and to stories that give hope and that nourish us deep inside.

JSB: It is so important, for example, if you are expected to go through chemotherapy that has serious and difficult side effects, and you have a disinterested, impersonal oncologist who says, "This is what I am prescribing for you; it has a forty percent chance of helping you," and you already feel bad; you will think the odds are against you. As you get weak and throw up and feel awful, when you receive this treatment, chances are that your psyche is depressed and has little hope that this experience is going to result in something good. On the other hand, you might have an oncologist who says, "I've chosen this particular chemotherapy because I think that it will help you. It has a forty percent record for your particular kind of cancer, but I've chosen it feeling that it is going to help." Next, you talk to somebody who was helped by chemotherapy, who describes its positive effect. As you take chemotherapy, your belief is "this is an ordeal, and it's making me sick now, but it's going to help me." The messages from the doctor and from the anecdotal story, the witness who says it helped her, have the effect of giving every cell in the body the message "this is going to help." The body is much more likely to respond to that belief system and to the chemotherapy.

PT: How does life threatening illness impact relationships?

JSB: When there is a life threatening illness, especially if the person who has it is a woman, her relationships are tested, and some of them don't make it. If the people in the woman's life are self-absorbed and draining of her, and she has been co-dependent to them prior to this, she may need to and finally be empowered to sever those relationships. With her primary relationship, the husband may grow in his capacity to be a loving person, and find inside himself the ability to be a caretaker at a level that he never knew was in him. The woman and the man discover their barriers to emotional intimacy, and take down what has been erected. The potential of death makes both risk loving more. Others do the opposite. The risk of losing this person makes them draw away. It is a true test of relationships. When you come through such an ordeal, the people who helped you through the descent are the ones that you then proceed on with. With AIDS, it is remarkable seeing men who were, up until then, living an eternal youthful side of themselves be able to be caretakers at a profound level for their significant other.

PT: In closing, if you were to give a statement of hope to someone with a life threatening illness, what would you offer?

JSB: Wherever we are, on the journey that is our particular life, encounter with a life threatening illness is a major time of transformation. It is part of the great adventure that is life. Remembering that we are spiritual beings on a human path, how we react to this illness is critical and crucial. It is at a soul level that the journey is significant. The quality of the life we have remaining, and our capacity to recover from whatever it is that we are suffering from is enhanced when we act as if what we do can make all the difference, while at the same time knowing that there is a great mystery. When it is our time to go, it is our time to go. We need the capacity to hold both in consciousness. It is a paradox, holding the opposites, and yet to live with both is to live a very meaningful life. My observation is that when we are ready to go, and many life threatening illnesses provide a preparation time to go inside and to come to some deep understanding about who we are, that however much we have struggled, when we approach death and there is a sense that we are now ready to go, a sense of serenity and peace is usually present at the moment that we do go.

PT: Fear subsides

JSB: I think that soul makes the transition out of the body when we die, and that is a major moment. My realization of the soul being in the body and going on after the body is no longer was the great lesson of being present when my father's soul left his body. I saw his face light up with joy at that moment, then saw an instant later the body that he was no longer in was worn and discarded; clothes no longer needed to be worn. That experience helped me profoundly know that we are spiritual beings, who for a time come into the material body, go through a life that has potential for suffering and potential for joy. We make choices as to how we respond to the unchosen circumstances that are part of all of our lives. There is something soul shaping about experiencing and reacting to what happens to us in life. That is what the journey is about.