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According to a brief but precise definition, in holistic medicine the physician treats the patient, not the disease. This certainly applies to the Gerson Therapy which heals by restoring the health of the whole body, rather than concentrate an a specific complaint. But its powerful effects extend to the patient's non-physical self as well. In order to make the Gerson program fully holistic, the psychological aspects of healing must also be considered.
Body and mind are two sides of one coin. They sicken together and must be healed together. Whatever affects the one will affect the other. Our task is to evoke the patient's self-healing potential and make sure that some disregarded psychological problem does not sabotage the therapeutic process.
There is now solid scientific evidence to prove that our moods, emotions and general outlook have a direct and measurable impact on our immune system. The proof comes from psycho-neuro-immunology (PNI), a new medical specialty which has been rapidly developing since the late seventies, thanks to a better understanding of brain chemistry and of the subtle connections that exist on the cellular level within the body. In a nutshell, the limbic system of the brain and the central nervous system release certain hormones that fit into receptor sites all over the body, causing them to release various secretions. The quality of the hormones and the secretion determines whether the immune system is boosted or weakened, switched on or off; and that quality, in turn, depends on our emotions, beliefs and prevailing psychological orientation.
A positive, hopeful, determined attitude strengthens immune competence, while despair negativity and fear weaken it. Lasting unhappiness or a traumatic event can overwhelm our cells. It is no exaggeration to claim that our every thought and emotion equals a biochemical act. In the words of neuroscientist Dr. Candace Pelt co-discoverer of endorphins, "Cells are conscious beings that communicate with each other, affecting our emotions and choices." It is equally true that our emotions and beliefs affect the activity of our cells.
Clearly, the patient's emotional health is of vital importance if we want to ensure that the Gerson Therapy brings optimum results.
Any cancer diagnosis equals a major trauma. It evokes powerful emotions: panic, fear, rage, or, at the opposite pole, resignation, numbness, despair. Either way, most patients experience a sense of isolation, of being cast out of normal life and deprived of a future. Harrowing memories of personally known cancer victims arise - contributing to a superstitious fear of the disease.
This fear springs from two sources. One is rational, based on the very real threat of suffering, disfigurement, drastic treatments with vile side efects, and probably no cure in the end. But there is a non-rational fear, too, which sees cancer as an intruder, an evil alien that has breached our defenses and may kill us. In their panic-stricken state very few patients realize that tumors don't come from outer space but from the faulty functioning of their own bodies. All these emotions are negative - heavy, distressing. And they are made worse by the average physician's response which is normally defensive and reserved, if not downright cold. (it was certainly cold in my experience when I presented with a secondary tumor and my previously friendly surgeon-oncologist suddenly turned icy, implying with his manner that by producing a lump in my groin I had somehow let the side down.)
If the patient then spends time in an average hospital, the additional handicap of dependence, loss of adult autonomy and privacy will make things even worse. The patient becomes a massive sufferer, with no say in what is being done to him or her. In the telling phrase of Ivan Illich, "Modern medicine turns the patient into a limp and mystified voyeur in the grip of bio-engineers."
These observations apply to cancer patients diagnosed and treated in an orthodox medical framework. But as almost all patients come to the Gerson Therapy from that system we must recognize their depressed, fearful or numb state and do something about it - fast. Ordinarily, humanity demands that we try to relieve their sense of isolation, fear and hopelessness, by giving them time, space and permission to unload their huge emotional burden.
But beside ordinary humanity, in the light of PNI's findings there are also sound medical reasons for urgently re-programming the patients' inner state from negative to positive. "No attempt should be made to cure the body without the soul", wrote the Greek philosopher Plato nearly 2400 years ago. In today's terms, even the brilliant Gerson program cannot do its best if something deep down in the patient's consciousness keeps saying "No" to life.
And that something may be a totally separate diagnosis. It may have to do with what Lawrence LeShan, pioneer researcher of the body-mind link in malignant disease, dubbed "the cancer-prone personality". Other researchers soon confirmed his observation that certain personality traits seemed to pre-dispose some people to cancer. In LeShan's formulation, these traits include low self-esteem, difficulty in expressing anger or aggression, a tendency to please others and ignore his/her own needs and feelings. In other words, the true self of such a person has disappeared behind a false self, developed probably in early childhood and maintained in adulthood, although no longer necessary.
Naturally, this personality profile is only a model and does not apply to all cancer patients, although in my work with sufferers over nearly fourteen years I have often come across these character traits. What matters is that - together or separately - they signal a negative outlook on life which a cancer diagnosis can turn into bleak despair; and PNI tells us clearly what that means in trends of reduced immune competence.
It is well known that cancer often appears 18 months or two years after some untoward life event, such as bereavement, divorce, career crisis, fiscal blow, and so on. Experience with clients has shown me that those events only represented the last straw that ultimately broke the camel's back; that, indeed, those people had long existed in what they had felt was a life trap, an impossible existential situation that apparently could neither be borne nor changed. LeShan and Carl Simonton, M.D., describe this life trap in detail. My own case material bears out its existence, and also the fact that those who feel unable to escape eventually reach a stage when they don't care whether they live or die. As many of them have told me, "Something snapped." I suspect it was the last strand of their will to live.
And, as the well-known saying has it, "Cancer is a socially acceptable form of suicide."
What we are dealing with here is the mysterious interaction of biochemist and emotions, a vast new area of body-mind medicine which we are only beginning to explore. But there is already enough orthodox clinical, as opposed to anecdotal, evidence to prove that inner attitudes can make a big difference to survival.
In a now classical study, British researcher Stephen Greer interviewed a group of women three months after they had undergone mastectomies, to find out how they were coping. He found four distinct types among them who showed, respectively, fighting spirit, denial, stoic acceptance, and hopelessness. After 5 and 10 years, 80% of the fighters, but only 20% of the hopeless had survived. These rates had nothing to do with medical prognoses.
In the U.S., David Spiegel, M.D., of Stanford, invited a group of 56 women with metastasized breast cancer to attend weekly meetings for a year, where they could share worries and sorrows, encourage each ether, and change their mental attitude. A control group of 50 women attended no such meetings. Spiegel only wanted to discover whether the group activity enhanced the members' quality of life, which it certainly did. But, to his amazement, he found that they also lived twice as long as those that did not attend.
These studies, as well as my own case histories suggest that the fighters, unlike the despondent patients, give positive non-verbal messages to their bodies which boost their immune system, and get results accordingly. Not always. Humanity's mortality rate remains obstinately 100%, but we don't all have to go at once.
Still, on the orthodox side, an interesting insight comes from U.S. oncologist-surgeon Bernie Siegal, M.D., author of several best-selling books which have helped to extend public understanding of the body-mind link in health and sickness. He claims that 15-20% of cancer patients unconsciously or consciously want to die, no doubt to get out of a bad life trap. 60-70% wish to get well but are passive and expect the doctor to do all the work. 15-20%, however, are exceptional: they refuse to play victim, they research their disease, don't obey the doctor automatically but ask questions, demand control and make informed choices. In Bernie Siegel's words, "Difficult or uncooperative patients are most likely to get well." Apparently they have more killer T-cells than docile patients. I suspect that many Gerson patients would qualify for membership in Bernie Siegel's groups of Exceptional Cancer Patients.
So how do we go about promoting a positive outlook and a fighting spirit in the patient?
The best I can offer is what I have learned and practiced over the years. The following steps refer to all patients with cancer or other chronic degenerative diseases; the specific needs of Gerson patients will be discussed afterwards. The first step is to de-mystify the disease, discuss it openly, in a natural voice, without euphemisms or technical jargon. This helps to provide a safe space where the patient can find emotional release, encouraged by being listened to with total, non-judgmental attention.
I always ask the initial question, "Do you want to live?" If the answer is yes, I ask, "Do you want to live unconditionally?" Another firm "yes" settles that matter. But often a "yes, but ..." reply identifies an undecided individual, and the need for further exploration.
It is important to build a therapeutic partnership with the patient and give him or her responsibility and an active role to play. We must be totally honest, have the courage to say "I don't know" when we don't refuse any kind of prognosis. If a patient tells us that 85% of people with his condition die within three years, we invite him to join the 15% who don't. (I recall with joy and admiration the fragile little lady riddled with cancer who, when told that she had six months to live, brightly replied, "Oh good, I have six months to get well." And get well she did, on the Gerson Therapy ...)
The 18-24 months of the patient's life prior to the diagnosis can yield valuable clues. Did some major stress drive the patient to drink, drugs or other destructive habits which caused significant liver damage? Gentle questioning often allows us to identify some life trap; the next task is to show that there is a way out, other than dying.
To flush out the inner saboteur, we need to help the patient recognize and release self-defeating patterns, old unfinished business, and resentment - especially resentment, since the repeated reliving of old hurts, rage or pain puts the autonomic nervous system into distress mode, which is the last thing the patient needs.
Reprogramming means shifting the emphasis from negative to positive. To quote LeShan once again, his basic question is "What's right with you? What are your special ways of being, relating, creating? What is blocking their expression? What do you need to fulfill yourself? Above all, what do YOU want to do with your life?"
I agree with LeShan's claim that under the circumstances it is permissible to ask questions which one would avoid otherwise. Questions like: If you had another thirty years to live, would you remarry your spouse? or stay with your partner? or remain in your present career?
Once these important basics have been clarified, it is time to switch from the passive to the active mode and point out the enormous potential open to the patient, if only he or she will act, not just react, and start making personal decisions. After all, there is nothing to lose.
If possible, the family dynamics should also be explored. A toxic relationship - to a spouse, an over-demanding parent or antagonistic children - may contribute to the disease. Without recognizing the situation there is no way to ease it.
A great deal can be achieved in a short time. The main tool of the physician or therapist is his or her personality and calm, reliable presence. Often this presence is the only solid support to the patient's confused, chaotic world. Other tools, such as teaching relaxation techniques, simple meditation, and creative visualization, focused on self-healing, can and should he used later, by suitably trained counselors and therapists.
Beside the trauma and psychological needs experienced by cancer sufferers in general, Gerson patients have extra burdens to bear. Far too many come to the therapy as a last resort, after conventional treatments have failed them, leaving behind a sense of disappointment, betrayal, and a range of severe after-effects. For them, embarking on the Gerson Therapy is like taking a mad gamble, an end-of-the-line decision.
Others choose the Gerson path at an earlier, less serious stage of their disease, with fewer preventable changes in their bodies, but with a poor prognosis. Either way they embark on an unfamiliar treatment, much of which sounds bizarre at first.
They step outside the boundaries of orthodox medicine, the network of doctors, consultants, hospitals, referrals; a whole system which has been unable to heal them yet still carries an aura of great power. Some may have been shown the door by their physician. Others face pressure and doubts from family members and friends who don't see how a weird, never-heard-of therapy can succeed where modern high-tech medicine has failed.
The would-be patient's own doubts spring largely from the sheer length of the therapy. In the more familiar allopathic field of medicine there is a pill for every ill, you either recover or you die, but at least things happen fast. To face two years of unremitting effort, strict discipline and monotony sounds pretty horrendous, especially because there is no guarantee of success at the other end. This explains why only a small percentage of inquirers chooses to embark on the therapy (in the UK. the uptake is around 20%) after digesting the first batch of information.
We can assume a certain toughness and determination, or sheer despair, in those who are willing to make a start. At this stage, their main need is for reassurance, for sober hope mixed with honest realism. They need to hear that theirs is a serious disease indeed, but it is possible to recover from it, and the Gerson Therapy is the most logical way to regain their health. This is when the cognitive approach works best, explaining the "how" and the "why" of the Gerson program. It needs no medical background to understand why rebuilding the immune system is a better idea than knocking it out with radiation and a cocktail of toxic substances.
And so, by this stage having settled the emotional overload of the patient, we work along rational lines, explaining, answering questions, not asking anything to be taken on trust. This reinforces the patient's involvement in the healing process as an equal partner and ally of the doctor or specialist counselor.
To get an overview, it helps to imagine the two or more years of the Gerson Therapy as a drama in three acts.
Starting out. A time of excitement and exploration, unfamiliarity, drastic changes in lifestyle, diet, daily routine. Much to learn all the time. It is a great advantage to start the therapy at a Gerson clinic. But, sooner or later, there follows the expulsion from that Garden of Eden where everything is done for the patient, and reality must be faced at home. For the patient who starts at home, chaos sets in - temporarily from Day One.
At first, the sheer tasks of the day seem impossible: preparing juices, food, enema coffee, washing up endlessly, securing deliveries, checking on the helper, cleaning up after the helper - above all, remaining sane. At this stage, practical help is essential almost round the clock, to stop the patient from giving up at once.
Act One is so busy and active that there is little space and time for psychological matters.
The main part (possibly the longest second act on Earth). The daily routine has been established and is rolling along, but even with helpers it demands time, effort and perseverance. The monotony and boredom begin to tell on the patient who feels restricted, under virtual house arrest. In theory it is possible to go out after dinner, in practice it does not happen often.
Then there is the problem of flare-ups or healing reactions which can be vile yet have to be welcomed, since they signal that the body is responding to the therapy. By way of psychological support the reasons and symptoms of flare-ups must be explained in advance, so that the patient does not panic (while feeling terrible). "This, too, will pass" is the best comfort we can offer.
An opposite problem, admittedly much rarer, is when there are no flare-ups for a while, and the patient immediately concludes that the therapy is not working, there is no hope left. I remember my own despondency all those years ago when, except for one almighty flare-up, I did not have any for months. It really worried me. Then I had twenty-six in a row, which gave me something else to worry about.
Physical detoxification inevitably brings about psychological detoxification, too. Toxins passing through the central nervous system evoke strange reactions and out-of-character behavior: violent mood swings, snappiness, anger, instability, unfair accusations and aggression. The patient's normally civilized behavior gives way to drives and emotions that have been denied and repressed for a long time, perhaps since childhood. The adult "censor" within is pushed aside by a raging infant, at least for a while, and then takes over again, amidst profuse apologies.
This, too, has to be prepared for, and not taken personally; it is part of the process. In whatever capacity we work with the patient, we remain calm, caring, unchanged, waiting for the inner upheaval to pass.
However, we need to be more active if depression sets in. This, too, can be the result of the detoxification process, or of some small adverse symptom which is immediately seen as ominous. A bad result in the latest blood test or an apparent change in a palpable tumor can plunge the patient into black despair. This has to be dispelled fast by pointing out that there are many ups and downs and fluctuations within the healing process, so that single symptoms are not signals of doom.
Depression can also set in when the patient gets terminally fed up and wants to quit the therapy, although improvements are noticeable. It is best not to contradict the patient's grumbles but, on the contrary, agree that the process is demanding, monotonous, restricting and boring; and then point out the good results so far, ask tactless questions, such as, "Would you rather have chemotherapy?" or "All right, you give up - and then what?" and wait for the answer.
Remember: this, too, will pass.
Taking life day by day, one day at a time, is a good way to handle the apparent endlessness of the therapy, without losing sight of the ultimate aim. In fact, interim goal-setting - what would the patient want to achieve in one week, one month and three months - helps even further to break up the monotony. The aims should be realistic and modest, and warmly acknowledged when they are achieved. Those that did not work out can be rephrased or postponed but not written off as failures.
Food can be a major issue during the main part of the therapy. Many people take to Gerson food at once and enjoy it. Others do not. When resistance wells up and turns mealtimes into the adult equivalent of nursery tantrums, we are up against the deep emotional investment many people have in certain types of food, however unhealthy. Their attachment is probably to the food mother gave then in childhood when food equaled love, even if it was low-grade junk. At a fraught time such people may feel that what they eat is their last area of free choice, and even though on a mental level they accept the rightness of the Gerson diet, on a deeper non-rational level they reject it, sometimes literally.
This is where wise counseling is needed. The patient must be reminded that the food on offer is medicine, that the diet is not for ever, and that accepting it now is a sound investment in the future. I have found it helpful to make a solemn contract with the patient who undertook to stick to the diet meticulously for a fortnight. As a rule, quick improvement followed and extending the contract proved easy.
The need to observe the rules cannot be overstated. Small lapses and occasional exceptions, often asked for by patients, are out of the question, for what exactly is small, and how often does an occasional exception occur? Once the rules are broken, the safe boundaries of the therapy are damaged, and the consequences can be serious. However, as carers or therapists we must enforce the rules with tact and affection, otherwise we may end up in the role of the overstrict parent, with "Thou shalt not" written all over us.
During the long main part of the therapy, the patient's boredom can be relieved by providing relevant reading material and tapes, set up networking with other Gerson Persons, or encourage a fresh hobby or study that can be fitted in between juices, enemas and meals. Friends' behavior can be crucial. Can they bear the patient's illness and face their own fears, or do they fade out of the picture? And how are the family members coping? Are they bearing the burden of the therapy without making the patient feel guilty?
Winding down. The intensive therapy is over. Now is the time to taper it off more and more, cutting down gradually on juices, enemas, medication, preparing to re-enter the world.
This can be a very tricky phase. The same patients who used to ask, "Is there life after Gerson?" now are reluctant to let go of the routine. It has become a way of life which has served them superbly. They feel and look well, they are symptom-free, with good test results and no complaints. But they do not want to come off the therapy.
By then it has become their safety device and symbolic life-and-health insurance, with the implied fear that stopping the therapy may bring on a relapse. This fear must not be dismissed lightly: it requires a careful, patient "weaning process" to ensure that the tube of the enema bucket does not turn into a substitute umbilical cord. Sticking with the dietary principles set out by Dr. Gerson is very necessary for the rest of one's life, in order to safeguard one's bravely rebuilt health.
There are others, of course, who have to be restrained from rushing back into their erstwhile disastrous eating habits at the end of Act Three. As a rule, the attempt is doomed: their detoxified, cleared, optimally nourished systems tend to shrink away from so-called normal food, heavy with fat and painfully salty. If their understanding does not object to junk food, their taste buds will.
In my experience, after recovery there is no way back into the pre-disease state. The experience of the holistic Gerson Therapy changes you, not only in your lifestyle and eating habits but also-in your value system, priorities and general outlook. You have been reborn without the need to die first, and you may easily and naturally decide to help others, by way of repaying a debt to life.