As a surgeon I have worked for many years with patients suffering from life-threatening and debilitating diseases. In the course of this work, I have discovered that if such people can be brought to love themselves, some incredibly wonderful things begin to happen to them, not only psychologically but also physically. The by-product of their improved psychological attitude is a corresponding physical improvement. So, for me, the most important focus of therapy is that of teaching people how to feel and express love. And this, I have found, depends on my ability to love them and show them they are lovable.
Why is love so important in healing? Simply because it is the most significant thing in human life. Genuine love must be given freely, of a person's own free will. Love is not something that can be taken for granted; it cannot be assigned as a task. It is boring and insignificant if one is "forced" to love (which is really an impossibility). Loving has to be chosen deliberately.
This possibility of choosing to love is what makes our having free will worth the risk of its abuse – even worth taking the chance of nuclear destruction and other potential catastrophes. For when we use our freedom properly and choose to love, then love becomes tremendously meaningful because it comes from our deepest essence, the source of all freedom. Then we can feel love, and others can feel it too, so deeply that it has an actual physical effect. There is a physiology of love; it is not just an emotional experience but a whole-body experience.
For this reason I believe that love is the golden thread that unites the many forms of healing. But this is a very abstract concept, and we need to see in a more practical way how love enters into the process of therapy. Let's consider an example.
When people come into my office suffering from cancer, it is often apparent that, short of putting a gun to their heads, they are on a quick course of killing themselves-abusing tobacco, alcohol, and drugs, and working very hard at dying. In such cases I do not say, "Don't smoke," or "For God's sake, lose weight, exercise, and take your medicine." Instead I say, "I care about you and I love you. Here are some ways you can help yourself and find love for yourself. I'll see you in two weeks."
If they return without having done a thing, I still say, "I love you." I give them a hug and say again, "I'll see you in two weeks." Through that love, they begin to say, "I want to thank you for loving me. I'm beginning to love myself. I'm starting to take care of myself." They begin to ask what else they can do for themselves.
At this point I tell them about group therapy meetings and say they are welcome to attend if they don't mind talking about their lives and sharing their feelings. After this I may suggest art therapy, books to read, or certain self-image exercises-for example, sitting naked in front of a mirror for twenty minutes twice a day and saying, "You have beautiful eyes, you have a lovely smile, and I love you." Or I may mention meditation, prayer, music, and laughter.
At some point the patient suddenly realizes, "I know I'm never going to be perfect, but it's wonderful working toward it!" This is what I call growing and blooming and becoming the blossom. Patients discover that they are a seed with vast untapped potential, just waiting to sprout. Then their perspective becomes, "Wow, look what I can grow into!"
Healing through love also can be described as helping people get back on the path of their own lives. Each of us seems to be born with a "blueprint" that not only turns us into a certain type of physical being, but also maps out the path of our psychological, intellectual, and spiritual development as well. When we deviate from that inner blueprint, it often takes a psychological or physical illness to get us back on course, as if saying to us, "Hey, you're not being the best person you can be. Get back on your path."
Psychiatrist Milton Erickson tells a story about finding a horse when he was a child. Erickson jumped on the horse and rode it five miles up the road, where it wandered onto a farm. The surprised farmer asked, "How did you know how to get back here with my horse?" Erickson replied, "I didn't know, the horse knew. All I did was keep him on the road." This is how one conducts psychotherapy as well. When it is done well, the client is merely put back in touch with his or her internal blueprint and begins to follow the right path again.
Sometimes, of course, we have trouble finding the way back, and then we need help. We need someone kind enough to give us a little kick to get us moving. In therapy this takes the form of confrontation, or what I call care-frontation, a loving confrontation between client and therapist that in many ways is like the confrontation between horse and rider: The rider loves the horse but gives it a little kick in the side now and then to keep it moving.
If we listen to our insides, we will also find that inner therapist who says, "Pay attention! I'm going to make you hurt a bit now so you will wake up." For this reason I sometimes call pain and suffering "God's reset button." It is sometimes the only thing that will make people change.
Many external factors, of course, may contribute to our falling away from the path that is right for us – parental conditioning, peer pressure, and the like. But to get back on the path always means finding the way in which we can best contribute love to the world. For we all have our own individual way of expressing love, and when we discover what it is, then we will live the longest, be the healthiest, and enjoy life the most, as well as become able to receive the most love from others. For this reason, therapy must aim at helping clients rediscover their own unique paths of love.
Success in this work demands that the therapist find practical ways of tapping into his or her own love on a continuous basis, for without that reliable contact, the effectiveness of therapy is severely hindered. I have found three factors to be relevant to the therapist's quest for access to the inner resources of love: (1) the attempt to live one's own message; (2) the inspiration of courageous clients; (3) the awareness of one's own mortality.
Perhaps most importantly, a therapist must live his or her own message. By this I do not mean that one must be perfect. I like the way Elisabeth Kubler-Ross puts it: "I'm not okay, you're not okay, but that's okay." We are not perfect, but we can forgive each other for our imperfections. This means that in living my own message I must forgive myself for not being perfect, just as I forgive my patients. It means, too, that I will participate in the daily meditation, music, prayer, affirmations, exercise, diet, and all the other activities that our therapy groups do, because in this way it is easier for me to forgive my patients and to forgive myself.
For me, living my message also means that it is okay to work on my own wounds and to be vulnerable with the people I am caring for. In this way, my patients become my greatest resource. I can ask them to hug me if I'm having a tough day. It is not necessary to be superman. I can admit my mortality and humanness.
In this sense I am not a traditional therapist. I don't mind having body contact with patients, because they understand that this is love on a level that is safe. They know I love them in a way that has nothing to do with sexuality and is nonthreatening.
A colleague of mine, a psychiatrist, had been working for three years with a severely burned woman, trying to teach her that she was lovable in spite of her scars. After hearing me lecture on this subject, he told me, the next time the woman came in, he went over and hugged her. He said she improved more with that hug than with three years of therapy.
So there are times when body contact is appropriate. And if you really love the world, you don't have to worry about loving and hugging. If I love everybody in the hospital, I don't have to be concerned about hugging a nurse or a patient. Nobody will say, "Hey, what's he doing?" They know, "Oh, he loves everybody, so it's okay."
In my view, therapists need to learn these lessons: It's okay to love. It's okay to touch when the client is ready to let you. It's okay to let the love come back. And, if one is having a tough day, it's okay to tell the client, "I'm having a tough day today. I need a hug."
Similarly, the healer or therapist should not regard anger as something unhealthy or abnormal. Indeed, anger can be positive. If the operating room turns your world upside-down and you feel angry, it's okay to say something. People will allow you to have angry feelings, because they have them too, and they know what you are experiencing. By expressing the anger, by saying how you feel about yourself and your needs, you don't build up resentment against others. After you are done expressing yourself, you are ready to hug others and laugh with them again. Then you all know where you stand, you do not trample on each other's feelings, you respect each other, and you move on.
It is unexpressed anger that is harmful. Too many people confuse anger with resentment. Anger can be positive, whereas festering resentment can cause people to become murderous. It is the things we have never said that harm us most. For then our temper becomes hair-trigger and we may explode over some insignificant item with a reaction out of proportion to the cause.
Living your own message also involves an aspect of openness and humility. As a therapist, you are not seated at some remote vantage point looking down on the ignorant masses in need of help. You just do whatever is necessary, trusting that love will show what is necessary. This means not setting yourself up as an infallible expert with all the answers. Rather, it means regarding the healing process as a dialogue and a learning experience for both patient and therapist. So, if patients want to call me Bernie, it's okay. I don't have to be "Dr. Siegel. " I don't have to protect myself with barriers that get in the way of helping patients open up to love.
In this way, therapy becomes a process in which client and therapist heal each other's pain. It is vital to keep in mind that you must genuinely look at your own pain and deal with it, not merely give advice without living it, without knowing how difficult it is for the client. Love will only be authentic when it comes from living experience; and if it is not authentic, it will not be convincing.
Another important facilitator of love in the therapeutic process is the fact that in this kind of work we are daily surrounded by people who are an inspiration. We see people affirming life in the midst of debilitating or life-threatening diseases, such as the courageous AIDS patient who is challenged rather than defeated by his disease, and the cancer patients who still choose to love the world, saying that their disease is a gift and their cancer a beauty mark. Such people are heartening. They keep you going and prevent you from burning out.
Yet if you get to the point where you are not loving what you are doing as a therapist, then it is better not to do it. I like to quote George Halas, the late owner and coach of the Chicago Bears football team, who lived into his eighties. One Sunday a colleague discovered him working in his office and said, "George, at your age what are you doing working on Sunday?" Halas said, "It's only work if there's someplace else I'd rather be." In the same way, if I feel there is someplace else I would rather be, I say so to my clients. I tell them that I cannot always see them.
For example, one woman had flown all the way from Georgia to Connecticut to see me. She got caught in a snowstorm and called my office on Friday afternoon to say she could not make the appointment until 7 or 8 PM. I told her, "I can't see you then. I've got to go home. I have to fly tomorrow." She was furious, but I firmly suggested that when she got to her hotel she should call me again. When she did, we talked some more and she calmed down. I said, "Look, there are other people you can see. Maybe you're supposed to spend the weekend in New Haven." I told her I would see her on Monday evening and that I would stay until midnight then if she needed me.
As it turned out, everything that happened to her over the weekend was so positive that by Monday she regarded it as a great experience. It was better that I did not see her on Friday night, for then I would have resented her for being there. It was better that I said no. This is a difficult lesson for many therapists to learn when to say no. We should remember that we are not going to live forever, and therefore we must say no at certain times. Then saying no is not something negative; it is actually a matter of saying yes to yourself. A healer does not always have to be at the beck and call of the world.
Lastly, love in the therapeutic relationship is facilitated by the knowledge that we are mortal, that we are all going to die someday no matter how much we jog or love or eat organically grown vegetables. With this awareness I make the most of my life in the present moment, doing today what I would most like to do with the rest of my life. My attitude is that if I should die tonight or tomorrow, my life has been complete; I have been fulfilled because I have loved fully. This is part of the message I share with people at workshops: the sense that we can use our own mortality in a positive way to get the most out of life.
Therapists also need to develop the idea that death is not a failure. In traditional medical training, of course, success is measured in terms of removing disease, or "curing," and therefore a patient's death is regarded as a failure. But with this attitude we start to distance ourselves from patients, losing sight of ways to help them in their transition through death.
It is not always possible to cure; AIDS reminds us of this. Fifty years ago diphtheria took many lives; in another fifty years no doubt we will have some new disease that resists treatment. People are always going to die, to have incurable illnesses; but they will also always have disorders that can be healed.
I tell people, healthy or not, that they should live as if they were going to die at any moment. Then it is easy to help others, because there is never a point at which such advice is no longer valid. You say you are going to die tomorrow? Fine, then live as if you were going to die tonight. Then, who knows, you might feel too good to die tomorrow. Or you may indeed die because you are tired and feel like going. We have much more control over the time of our death than most people realize. It is all right to die if that is what one needs to do. Because everybody dies someday, dying can't be a failure. With this attitude, death can be a healing.
Of course, there is always grief when we lose a loved one. But we must learn to take that pain and to love others with it. Consider those who have lived ninety, ninety-five, or one hundred years. They may have lost their spouses, their children, and many other loved ones. Yet after such terrible losses, people find the strength to go on, because they learn to love others. We cannot outlive everyone we love if we choose to keep loving new people. This is what survivors do: They roll the love on continuously. Thus healing, like love, becomes a never-ending process.