In Is It Safe To Surrender, Part 1, we talked about the spiritual teaching of surrendering to divine will, to God, to a spiritual teacher. For control freaks like me, this teaching was quite helpful. I found that, rather than clinging to getting what I want and avoiding what I don’t want, letting go and trusting that Something Larger knew what was best for me better than my small self (parts) did help me relax, trust, and follow breadcrumbs of guidance I believed were being fed to me, one small sign at a time.

But then I read a book about spiritual surrender that made me question the whole shebang. Oprah-endorsed New Age spiritual teacher Michael Singer, author of The Untethered Soul, wrote an influential memoir about his own attempt to practice the ultimate surrender in his book The Surrender Experiment. After years of failed attempts to calm his monkey mind with meditation, Singer decided to take away the mind’s bait. Since realizing that his mind was mostly busy trying to figure out how to get what he wanted, avoid what he didn’t want, and solve a boatload of worries, he decided to just let the Universe decide. If something happened and his ego didn’t like it, he’d simply surrender to whatever life presented him.

Critiquing “The Surrender Experiment”

He then goes on to tell a wild story about how he was living like a monk on a piece of land in Florida, and suddenly, people started building houses on his land. He didn’t like it. He wanted to be a monk in solitude, but since he judged that it was only his ego that was averse to letting people usurp his private property, he decided to surrender to life and let life decide. A whole spiritual community popped up around him, and next thing he knew, these spiritual seekers then built The Temple of the Universe on his property. Voila! He was a guru. His surrender experiment apparently made him a multi-millionaire as the founder of the software company Medical Manager, suggesting that he was favored by the Universe. But he also got busted for government fraud and settled a $2.5 million lawsuit, so maybe, not so much.

I came away from reading The Surrender Experiment feeling very uneasy. As someone who was controlled by a narcissistic mother, I’m very vulnerable to letting other people take advantage of me, so if I were to spiritualize other people’s tendency to exploit me and interpret it as “Life is deciding for me,” I could get very hurt! I came away from reading that book thinking, “Wow, if I just let life pick and didn’t pay any attention to the parts of me that had preferences, aversions, discernment, spotted red flags of danger, or had earned (through a lot of therapy) the ability to set and enforce boundaries, how would I possibly resist the coercive control of someone who decided to take advantage of my passivity?”

And if my BIPOC sister was supposed to just surrender to systems of oppression intended to harm her, if she was to just surrender to whatever racism, oppression, and injustice life proffered up, how would systems of oppression ever end? How would she avoid just getting pummeled by life’s unjust choices that are stacked against her? It left me very aware of Michael Singer’s white male privilege and apparent lack of empathy for those for whom passive surrender could be very very dangerous.

Before reading The Surrender Experiment, I had been exposed to the teachings of another spiritual teacher who teaches about spiritual surrender, a two-time survivor of New Age cults. Like many cult survivors, she had gone all in with her gurus, devoting herself faithfully to the guru’s every whim, thereby seeing the dangers of surrendering to an actual human designated to represent God. While she renounced the cults and the idea of ever giving your power away to another fallible human, she made a valiant attempt in her post-cult life to cherry pick the fruits of these teachings about spiritual surrender.

I asked this spiritual teacher what she thought of the idea that we should just surrender to life and let life decide. She said, “If I’d done what Michael Singer did and let life decide, then this morning, when a young man asked me out on a date and I had an aversion to that because I’m a gay woman old enough to be his mother, then I’d have wound up on a very inappropriate date!” She explained, “Spiritual surrender doesn’t mean you give up critical thinking or throw your discernment out the window. It just means that you’re letting the wiser part of you take the lead, allowing the Divine Beloved inside to guide your life, rather than your younger parts. Once you’ve surrendered to that inner guide and helped your younger parts, or your ego, if you will, relax, life will indeed show you the way. But that doesn’t mean you should not protest injustice or stand up for your healthy boundaries.”

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I asked this teacher, “What about boundaries? Is it really a valid spiritual practice to just let people build houses on your land without your consent, or is that teaching just going to cause people to tolerate potentially criminal infringements upon your property rights?” I told her how I had recently said no to a big bucks prime time TV deal that would have cast me as the Simon Cowell of alternative medicine, but my intuition waved big red flags. Had I made a mistake? Should I have surrendered to this role that felt slimy to me because Life picked it for me?

The teacher laughed and told me a story about the crazy thing that would be happening in her own life if she had just said yes to Life. Validating that my intuition was correct to spot the glitch in an otherwise helpful teaching, she made me feel better about throwing Michael Singer’s book in the trash rather than sending it to the library like I normally do. She said, “Part of what Michael did not seem to see is that embodying surrender includes viveka, which is inner discrimination. You know when to say yes and when to say ‘hell no’ as you listen to that intuition that unfolds through inviting in the inner Divine.”

An IFS Lens On Spiritual Surrender

I encourage each of you to find your own baby and figure out your own bathwater regarding teaching about spiritual surrender, so please take anything I say with a grain of salt. Some people I know, especially my BIPOC family and friends, say their people have done enough surrendering, so no more. Fair enough. For more on this, I highly encourage you to read ‘s beautiful book Waking Up Alone: Navigating the Narrow Passage Through Master-Slave Narratives.

But for me, as a white woman who resists surrendering to anything, the way I’ve come to understand healthy, non-bypassing spiritual surrender is that we can trust the life force that animates the universe, however you define that. We can’t necessarily trust it to give us what we want, but we can trust that a germinating seed grows toward the light and practice turning over all of our unmet longings, unsolved problems, undecided decisions, all of our burdens and troubles, all of our desires and heartfelt yearnings, all of our obsessions and attachments—to this animating life force inside ourselves. In IFS, we call this the Self, or you might call it the soul or God or Goddess or a spirit guide or angel.

Offering these attachments and burdens that our parts usually carry is a way to acknowledge humility, ask for help from something larger than ourselves, and inviting in clarity, guidance, comfort, wisdom, and support from the wise adult in us, along with any spiritual forces you trust and believe in. We so often cling to the illusion of control, which is why 12 step programs begin with surrendering to a Higher Power, acknowledging that there are some things we are powerless to change on our own.

While the law of attraction casts the individual as the all-powerful Creator and also accepts all the credit when we “attract” whatever good or bad manifestations we attracted into our life, a healthy version of spiritual surrender offers narcissistic parts less catnip, which protects us from the inflation that can accompany believing you’re powerful enough to manifest everything you want or to white knuckle your way with the force of your will. It also spares us the self-flagellation that can happen when we believe we’re not powerful enough or pious enough or worthy enough to get what we want.

By inviting us to partner with this animating life force, by acknowledging our human vulnerability, honoring the limitations of our power and control, and humbly asking for support, the fragile ego is protected from either grandiosity or deflation. If we wind up getting what we want, we’re grateful. If we don’t, we understand the limitations of our human power to create and allow ourselves to feel the disappointment and move on.

Through the Internal Family Systems lens, we don’t talk about the ego’s attachments or demonize our parts in any way. It’s normal to want some things and not want others. Instead, we call such self-protective instincts “protector parts,” which are usually young parts that helped us survive and can still be very helpful in making sure we stay out of danger. We don’t exile or look down on our young parts if they cling to something or are scared of something or are busy trying to control something. Instead, we value them, appreciate them, become intimate with them, and seek to Self-lead them so they don’t run the show.

With IFS, we’re not necessarily surrendering to some deified human or even some transcendent God in the sky, but surrendering to the wisdom and guidance of the divine Self inside, the spark of Love inside that connects us to All That Is, from the purest source of our being. Allowing our protector parts to relax and trust the direction of Self inside can be a form of surrender that doesn’t put the trauma survivor at unnecessary risk of getting controlled by someone who does not have our best interests at heart. On the contrary, earning the trust of protector parts so Self can lead can actually make us safer, although there are limits to how safe we can make a world with systemic oppression built into it. Yes, when we heal and unburden the wounded inner children those protectors seek to protect, Self can lead the way from a much more spiritually guided, less reactive way, while still offering protection for the trauma survivor. But without political activism, that won’t do much to change white supremacy or patriarchy or other systemic forms of oppression.

While that healing process proceeds, we can encourage our “parts”- or ego, if you will- to surrender to the wisdom and guidance of the Self inside us all. This will help empower us to trust that there is a compassionate, curious, calm, confident, creative, connected, courageous divinity full of clarity inside each of us- not just some of us, not just the special ones, but all of us. This Self is inviolable and cannot be damaged by trauma. While it can put people at great harm to surrender their personal will to a spiritual leader or to anyone who claims to be interpreting the will of God, there is no danger in surrendering to the best aspects of our own Beingness.

Who do we offer these heavy burdens our parts carry to? Self, the soul, the Universe, Consciousness, God, Goddess, a guardian angel, a spirit guide- or if you don’t believe in such things, a redwood tree, a mountain, or whatever Force of Love you trust to carry those burdens, to lighten your load, and to help guide you towards that which is in the highest good for all involved. After offering, you wait for guidance, understanding that the clarity of Self and the instructions for walking the Self-led path come in life’s timing, not necessarily in yours. Part of the practice is learning to recognize and interpret the guidance, which is no small task, given how tricky our parts can be, pretending to pose as “intuition” or “spiritual guidance,” when they’re jonesing to get what they want or avoid what they don’t want.

The signs can be as obvious as billboards with arrows, pointing, “Go this way!” Or they can be as subtle as a small burst of energy that leaps you out of your chair to move in the direction of your dream or a closed door suggesting “Not this way.” Either way, the practice is to extend gratitude for the guidance, even if you feel disappointed or even devastated, because the answer is a solid “not yet” or even a “never.”

You’re Allowed To Feel Disappointed & Grieve

Those who teach spiritual surrender often encourage us to be grateful for spiritual guidance, even if the guidance is showing us that the direction we want to go isn’t best for us. Getting the “cosmic no,” we’re told should make us radically grateful, since the only thing we’re supposed to want is whatever God or Divine Will wants for us. But that can feel like gaslighting to our parts that long for something deeply.

But this can be a form of spiritual bypassing, skipping over normal feelings of let down or disappointment. As an OB/GYN who has ministered to hundreds of infertile women, it seems cruel and gaslighty to me to tell that woman she should feel grateful she can’t have her own baby, because it’s obviously what Divine Will wants for her. She is allowed to move through waves of grief and disappointment after she’s tried everything and all efforts have failed. Ironically, this is sometimes when spontaneous pregnancy will then arrive like a miracle, after she finally gives up the desperate attempt to force something that isn’t happening.

Spiritual bypassing teachers tend to encourage us to skip over any feelings we might have about our unmet desires, unsolved problems, or undecided decisions. Emotions like disappointment, sadness, grief, anger, anxiety, fear or confusion are anathema to spiritually bypassing teachers. But healthy teachers who promote spiritual surrender do not teach us to deny our desires or attachments, nor do they teach us to ignore the feelings that arise when we let go of our obsessive grasping. When we let go of attachment to outcomes or give something over to the wisdom of Self, we might have some young parts that feel like we have to control life, to cling to our attachments, to do our best to strong arm the Universe into granting our wishes like a fairy godmother. Surrender can feel wildly unsafe to some of our parts, like we’re giving up, resigning, and raising the white flag in total defeat. If feelings arise when we dare to let go, the non-bypassing approach is to allow those feelings to flow, rather than suppressing or bypassing them.

Don’t Stop Trying To Get Justice & Call It Surrender

Surrendering to Self is not passive and does not demand that we give up or avoid activism. It’s more of a way to pause, to find the Self-leadership in our activism, so that our actions are guided actions, rather than reactive ones, stemming from protector parts. We will always have natural attachment to certain outcomes,like equality for all in social justice contexts. As we should!

In my opinion, not caring deeply about making sure BIPOC, women, queer folks, immigrants, the disabled, and any oppressed or marginalized group get justice and equal rights is a character flaw. We should be attached to that outcome! Pretending not to care about something we long for deeply also isn’t helpful. It’s dishonest and can also reflect attachment wounding. For example, were my child to get sick, I would be very very attached to her getting better and staying alive. If I were not attached to that, there would be something wrong with secure attachment to her as her mother. If I felt neutral if my child died because I’ve just surrendered to Life and Life has decided she’s going to get sick and die, that would reflect something wrong with me. Good enough parents are supposed to attach to our children. We’re also supposed to detach a little as they get older, to let them grow up, individuate, and live their own lives.

Now, if she’d been on life support for months and the doctors had been advising me to turn off the machines and I was still refusing to accept the inevitable, then letting go and grieving might be the right thing to do. There’s a time to fight and there’s a time to throw your hands up in the air and bawl your eyes out.

At less extreme levels, the act of offering our desires, problems and decisions over to the leadership of Self can help our desires downgrade from raging attachments we must fulfill in order to achieve some impossible threshold of happiness to preferences we can accept either way. Instead of chasing after fleeting and fickle states of bliss as if they’re Olympic medals we might win, our desires relax into wishes we can still hope come true but which we can survive not happening. Our parts are still likely to want what they want and yearn for their wishes to come true, but we realize that even if all of the wishes of our parts were fulfilled, we wouldn’t necessarily achieve some permanent state of unwavering happiness.

Part of growing up and being an adult is accepting that we don’t always get what we want, and that’s life. We can’t always “manifest” everything we want, and we have to learn to be okay with let down, but without bypassing it.

Trusting In Mystery

My spiritual teacher Rachel Naomi Remen once told me that, in a perfectly spiritual universe, at some point, all of our specific desires for precise outcomes might start to melt into a singular desire- to live in alignment with what she called the soul, or what IFS calls Self. Following the soul’s path, she said, meant surrendering to Mystery, with life becoming a playful treasure hunt for the signs and clues signaling which way the soul’s calling might be flowing.

When letting our soul lead, Rachel said, synchronicity, intuition, somatic ways of knowing, dreams, signs from the Universe, and the support of other people often step in to help us navigate the mysterious unknown in ways that can feel miraculous. But we’re not in control of this kind of Mystery. It arrives, or not, in its own way, in its own timing.

When we surrender our parts’ longings to Self or the soul or Mystery or whatever you want to call it, sometimes those longings may wind up being fulfilled in the most unpredictable and magical sorts of ways. When you finally surrender and quit trying to manifest something, it can mysteriously arise, just like the countless examples of infertile couples who get spontaneously pregnant once they file for adoption. But this is not a funky way to trick the law of attraction. Letting go doesn’t actually attract what you want. It may, however, relieve some of the anxiety that accompanies obsessive attachments, and this may relax the nervous system enough to make some previously impossible outcomes possible, especially in the realm of mental and physical health or relationships we can’t control. When the nervous system can relax, it’s easier to be Self or soul-led. Then we can do a better job leading parts that might have a tendency to sabotage what we desire or create impediments to solving problems or making wise, clear, Self-led decisions.

Surrender As White Supremacy

From an anti-racism perspective, suggesting that people should just let life decide would mean tolerating oppression, because clearly, life is not always just and humans are not always granted equality. It might work for a cis white hetero male like Michael Singer to surrender to whatever life is choosing for him, because he’s probably not getting stopped unfairly and shot at by police, and he’s much more likely to get handed privileges he hasn’t earned. So we have to keep that in mind when we start spouting teachings about spiritual surrender that have historically been used to pacify resistance during periods of enslavement and colonization.

If oppressed people just let life decide, some people would still have slaves and others would still be slaves, Black people and women wouldn’t be able to vote in this country, police brutality would continue unchecked, and ICE would be rounding up immigrants in concentration camp like-settings even more so than they’re already doing, minus the frog protesters. Sometimes surrender is not the right action. Sometimes we have to stand up and say, “This is not okay. This must change.”

One BIPOC reader wrote, “Spiritually surrendering to Divine Will and allowing oneself to be used as a vessel has done a lot of damage to Black People and to me. Being able to connect to the Divine within is empowering and more spiritually aligned for me. Historically Black folks have been nothing but vessels for others’ agendas. Finding the Love within and the guidance within takes me to a much higher understanding. My spiritual core becomes strong, and I become one with the Divine. I don’t need to be ‘used’ because I’m aligned. Maybe the word ‘use’ just doesn’t sit with me.”

Finding your own peace with- or rejection of- the teachings of spiritual surrender needs to be very personal. While the teaching can be problematic when unskillfully and emphatically applied, it can also be helpful, especially for trauma survivors who have issues with power and control. If you’re the control freak type who thinks you have to make everything happen on your own and you don’t let go of anything unless there are claw marks on it, learning to let go so you can relax and learn to hear and interpret the guidance of that inner wisdom of Self/ soul can support navigating life with healthy assertiveness and agency without clinging to every aspect of life with an iron grip.

Let’s Deconstruct TOGETHER

I’d love to hear your thoughts on the teachings of spiritual surrender. What’s your baby? What’s your bathwater?

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*A Meditation To Help You “Unblend” From Parts That Might Leave You Confused

If you’re clinging or perseverating over an unmet longing, an unsolved problem, or an undecided decision, this IFS conference table meditation I recorded as a bonus for my paid subscribers might help you get clarity on whether you need right action, relaxed letting go, or some other way of being with regard to whatever issue you’re dealing with, from the energy of Self.

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I have such fond memories of the weeks I spent in musician Karen Drucker’s recording studio with my mentor and spiritual teacher Rachel Naomi Remen, MD over a decade ago. These were before the days of Zoom, when we sat across from each other with headphones on in a glass box and tried to read each other with our eyes.

Listening to this now, two weeks after Rachel died, brought grateful tears to my eyes. I just listened to it this morning, and I laughed when Rachel quoted Dolly Parton and ended our conversation with instructions for our students to “Find out who you are and do it on purpose.” I felt Rachel and Dolly wink at us from wherever they are now.

We recorded this before I was introduced to Internal Family Systems, so the language we use is not parts language and the Self; it’s the language of the small self and its operating instructions and the soul and its guiding principles. But the message is the same, that we behave the way we do, not because we were born this way, not because we’re even consciously choosing to do what we do and be who we are, but because our caregivers influenced us and filled us with limiting beliefs about ourselves and the world, beliefs that guide our actions and limit our potential.

Listening for the first time so long after we recorded this, I wish I’d been more silent. Every time Rachel opens her mouth, I just want to keep listening to her. Clearly part of my small self operating instructions was that you have to say something in order to be worthy or important. Now I just want to listen, and I want to share this precious gift of Rachel’s kitchen table wisdom with the world.

Something strange happened to me the day after Rachel died on August 8. Maybe I need to see an opthalmologist or neurologist. Maybe I’m having a medical issue. But I started seeing a little spark of light in the peripheral vision of my left eye when it’s dark. I can only see it when I look sharply to the left in the dark. It looks like a little firefly. Maybe this is just magical thinking putting me in denial of some eye problem I need to get checked out. But the minute it showed up, I knew in my soul it was Rachel, like a guardian angel light in the dark.

She never wanted me to grieve in her presence the fact that she would die before me. Every time I cried when I imagined her gone, she’d brush me off with a tsk tsk sound and tell me I’d better appreciate these last few years of privacy while she was still in the flesh, because once she was free of her chronically ill, burdened body, she’d never leave my side and she’d be stalking me until I died.

When Rachel was intuitively reading me, she always looked at me side-eyed, just to the left of me, right where this floater of light seems to have rested in my visual field when it’s dark. I honestly hope it doesn’t go away.

*This morning, my cousin Jana sent me this Dolly Parton song Don’t Make Me Have To Come Down There and it tickled me. So I’ll share that too.

If this recording of me and Rachel touches you, please send it to anyone who you think might benefit from it. And please subscribe as a free or paid subscriber. I’ll be sharing more recordings of me and Rachel in the future, as a way of filling the bathtub with some real Rachel gems after deconstructing what’s the baby and what’s the bathwater of a lot of garbage spiritual teachings.

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In my last essay The Medicinal Properties Of Friendship, I shared an excerpt from my book Mind Over Medicine about Roseto, Pennsylvania, a community that had half the rate of heart disease as the rest of the world while smoking cigarettes, drinking a lot of wine, and eating meatballs fried in lard, pizza, and pasta. Scientists studied them, thinking it must be something in their genes, but concluded that they had less heart disease because nobody was ever lonely.

My new book RELATIONSICK expands on this concept, honing in on how unbalanced relationships where you give too much and receive too little can make you ill, while healthy, balanced, mutually reciprocal relationships can improve disease recovery. For example, losing yourself in the orbit of someone highly narcissistic or being in a cult can predispose you to getting very sick long before it would be natural for your body to begin to break down with aging. On the flip side, shoring up your boundaries, giving someone abusive the boot, challenging cultic authority, and doing the hard work to stop fawning and start standing up for yourself can sometimes reverse disease in seemingly miraculous ways. (You can preorder RELATIONSICK here.)

It may seem obvious to you that healthy relationships are good for the body. You might be thinking, “Duh! No news flash here.” But when’s the last time your doctor asked you whether your toxic ex-husband might be causing your fibromyalgia, or your abusive mother’s tongue-lashings could be predisposing you to heart disease, or your boss might be the reason for your cancer recurrence? Have you considered whether your childhood traumas may have caused you to view others as dangerous, causing you to socially isolate and putting your body at risk? Is it possible that people-pleasing is causing you to self-abandon when what your body needs in order to heal is for you to prioritize getting your own needs met for a change?

The reality is that unbalanced relationships, the heartache of loneliness, and giving too much can all cause too much stress on your nervous system, while the right kind of loving community relaxes your nervous system. The effects of stress and relaxation don’t just affect the mind; they affect the body. When you lack supportive community and feel you must handle life alone, the daily overwhelm may trigger anxiety, which the brain perceives as a threat. Such overwhelm adversely affects everything from blood pressure to kidney function. The negative consequences of overwhelm and stress can be mitigated, as it turns out, when you are nurtured by friends, relatives, and neighbors who care. In fact, this factor alone may affect your body more profoundly than what you eat, how much you drink, whether or not you smoke, or how much you exercise.² As I described in my TEDx talk “The #1 Public Health Issue Your Doctor Isn’t Talking About,” loneliness is an epidemic in modern societies, and those of us interested in optimizing health outcomes must address this public health risk head on.

*If you’re curious how to make new friends as a grown up, Shasta Nelson, author of Frientimacy, and I start a six week Zoom class on Monday, August 24. I hope to connect with some of you there!

Learn more and register for Making New Friends As A Grown Up here.

Let me share these excerpts from my book Mind Over Medicine to make this point clear.

The Effect of Community on Life Expectancy

When you think about behaviors that will increase your life expectancy, you probably think about giving up booze, taking a daily walk, taking your vitamins, cutting back on processed foods, and wearing your seat belt more than you think about joining a club, inviting friends over for dinner, or getting a cool roommate. But perhaps it’s time to rethink your preventive health strategy and start treating yourself with the medicine of positive relationships.

It’s not just Roseto that shows that a supportive community impacts health. Similar studies in Peru, Israel, Borneo, and elsewhere have confirmed what researchers discovered in the small Pennsylvania village, that a community of loved ones may affect your health more than what you eat, how you exercise, and whether or not you have good or bad health habits.³

One study examining the people of Alameda County, California, found that, in every age and sex category, people with the fewest social ties were three times more likely to die over a nine-year period than those who reported the most social ties, even when you account for preexisting health conditions, socioeconomic status, smoking, alcohol consumption, obesity, race, life satisfaction, physical activity, and use of preventive health services.⁴ Those with more social connections were even found to have lower rates of cancer.⁵

How much we commune with other people may prove to be as important as exercise when it comes to predicting life expectancy. A Harvard study examining the lives of almost 3,000 senior citizens found that those who gather together to go out to dinner, play cards, go on day trips, vacation with friends, go to the movies, attend sporting events, go to church, and engage in other social activities outlive their reclusive peers by an average of two and a half years. In fact, these kinds of mostly stationary social activities were found to benefit the health of the seniors as much as fitness-related activities did. The researchers concluded that social pursuits are equivalent to and independent of the merits of exercise.⁶ Many more studies confirm that social ties and life expectancy are inextricably linked.⁷

The degree of social support you experience even affects the likelihood of cure if you do wind up sick. A University of California, San Francisco study published in the Journal of Clinical Oncology investigated the social networks of nearly 3,000 nurses with breast cancer. This study found that the women who had been socially isolated before their breast cancer diagnosis had a 66 percent higher risk of mortality from any cause and a twofold risk of breast cancer mortality. The nurses who went through cancer alone were found to be four times more likely to die from their disease than those with ten or more friends supporting their journey. In fact, the data suggests that friendships may be even more health-inducing than having a spouse. In the same study, having a spouse did not show a survival benefit—but having many friendships did.⁸

The same protective effect of a strong support network was seen in a study performed at Sahlgrenska University in Sweden and published in the European Heart Journal, which investigated the social lives of 741 men with heart disease over a period of 15 years and determined that those with the highest measures of what they called “social integration” were the most protected against new heart attacks.⁹

In a New Scientist article about the effects of loneliness on health, Dr. Charles Raison, professor of psychiatry at Emory University School of Medicine, concluded, “People who have rich social lives and warm, open relationships don’t get sick and they live longer.”¹⁰

The Physiology of Loneliness

Healthy relationships are medicine for the mental and emotional body, and as we’ve already seen, the mind has powerful effects on the physiology of the body. So many people, especially those in the developed world, suffer from social isolation. While social isolation can sometimes be positive—a way to recharge the mind through retreats, meditation, personal time, and other nourishing, health-inducing activities—chronic social isolation can lead to loneliness, and multiple studies demonstrate that loneliness can trigger stress responses in the body, the same kind of fight-or-flight responses fear of bodily harm can elicit. Conversely, unhealed trauma can elicit the freeze response that leads to social isolation, which can cause a vicious cycle that interferes with healing. The good news is that this can be reversed. Some might need professional help to treat the underlying traumas that lead to social isolation and loneliness, but sometimes all it takes is the decision to make a change.

Everyone feels lonely from time to time, but for some people, loneliness becomes the norm. Canadian psychologist Vello Sermat, who studies loneliness, estimates that 10 to 30 percent of people suffer from a pervasive feeling of loneliness.³⁶ In another study, 16 percent of people responding to a newspaper advertisement described themselves as being “lonely most or all of the time.”³⁷ Among lonely people, 37 percent describe their health as “poor” or “very poor.”³⁸

As Robert Putnam put it in Bowling Alone, “As a rough rule of thumb, if you belong to no groups but decide to join one, you cut your risk of dying over the next year in half. If you smoke and belong to no groups, it’s a toss-up statistically whether you should stop smoking or start joining. These findings are in some way heartening. It’s easier to join a group than to lose weight, exercise regularly, or quit smoking.”³⁹

As it turns out, psychologist John Cacioppo, who has devoted his life’s work to studying the effects of social isolation and loneliness on the body, agrees that curing loneliness is as good for your health as giving up smoking. According to Cacioppo, lonely people are physiologically different from people with strong social networks when it comes to cortisol-signaling genes, the inflammatory response, and the immune system.⁴⁰ Lonely people demonstrate higher diastolic blood pressure responses to stress, altered immune response, and greater cortisol responses to stress.⁴¹

Lonely people have also been shown to have higher rates of heart disease, breast cancer, Alzheimer’s disease, and suicidal thoughts.⁴² Loneliness even affects mortality rates after coronary artery bypass surgery. A Swedish study examining 1,290 patients undergoing heart surgery found that patients who agreed with the statement “I feel lonely” had significantly higher mortality rates post-operatively.⁴³

In studies comparing lonely and non-lonely individuals, lonely people were found to have significantly altered cardiovascular function, including higher levels of peripheral resistance in the blood vessels, higher blood pressure, lower levels of blood-vessel-relaxing carbon monoxide, and alterations in heart rate and cardiac contractility that mimic what happens when the body is facing a threat.

Researchers also suspect that lonely individuals suffer from poor-quality sleep, and limited sleep is known to lower glucose tolerance, elevate cortisol levels, and increase fight-or-flight sympathetic nervous system activation. These effects mirror what is seen in normal aging and may explain why the body suffers in lonely individuals.⁴⁴

Chronically lonely individuals have been found to have higher salivary cortisol levels across the course of a day, suggesting more discharges of corticotropin-releasing hormone and activation of the HPA axis, which triggers stress responses.⁴⁵ Multiple studies also demonstrate that loneliness leads to suppressed immune function, which can alter the body’s ability to fight infection, mount an attack against cancer cells, and repair the body internally.⁴⁶

Cacioppo suggests that ending loneliness is not so much about spending more time with people. He thinks it is all about altering our attitude toward others. Traumatized individuals may come to view other human beings as potentially dangerous. My introverted housemate, who experienced a lot of childhood trauma, has a t-shirt emblazoned with the words “Ew, People,” which always makes me laugh. Because of my own traumas, I can relate to that feeling, and I imagine some of you can too. When we don’t know how to protect ourselves around others, when our boundaries are not shored up and protected, when we feel we are in danger when we’re around others, harmful stress hormones and other fear chemicals are triggered. Such intense feelings can make us isolate, and this can lead to loneliness. When we heal the loneliness, the body may follow.

The mind might recognize loneliness for what it is—a feeling of disconnection, of not belonging, of feeling unloved—but the lizard brain only knows one way to communicate with the rest of the body. “Houston, we have a problem!” While the mind might be able to differentiate between facing up against a wild animal on the prowl and feeling lonely, the slew of hormones the mind spews out in response to a threat is exactly the same in the body. When the mind signals the alert, your hypothalamus, pituitary gland, and adrenal glands come to life, and a surge of stress hormones, such as adrenaline, norepinephrine, and cortisol, course through your bloodstream, galloping off like Paul Revere to tell all the other organs there’s a wild animal on the loose.

Normally, when the lizard brain perceives that the lion is gone, the stress-response systems reset, alerting the organs to go back to business as usual. But if you feel chronically lonely, your body may switch on the stress-response alert and leave it on, which, in time, can activate the unmyelinated branch of the vagus nerve and lead to social isolation. The depleted stress hormones can lead to a freeze response, which can not only damage your health; it can shorten your life. When loneliness is known to pose as much health risk as smoking, shouldn’t doctors be prescribing social support, trauma treatment, and alleviation of loneliness as part of an optimally healthy lifestyle?

All Relationships Are Not Created Equal

The scientific data supports the notion that healthy relationships affect your nervous system, which in turn, affects the body. But clearly, all relationships are not created equal. Many lonely individuals have chosen to be alone as a response to traumatic relationships that can harm the mind and the body. We know that childhood abuse or neglect can shorten a person’s lifespan.⁴⁷ People who endure relationships characterized by conflict or hostility suffer physically and emotionally.⁴⁸ Clearly, physically abusive marriages can injure or kill you. When your clan is a street gang that engages in regular shoot-outs, your health is obviously at risk. When your community revolves around injecting heroin together, your health would be better served by being alone.

While these examples of how the wrong relationships can harm you may seem obvious, you might be less aware of how other, more subtle types of unsupportive social ties may damage your health. You may not realize that when your church community judges you because you don’t conform to social norms, your mind is likely to mount a stress response that could negatively affect your body. When your family routinely chews you a new one every time you go home to visit, Sunday afternoon family dinners might not be as beneficial to your health as they were in Roseto. When you’re hanging out with the mommy crowd from your kid’s school but you’re feeling like it’s unsafe to be authentic, your body may sense a threat.

It’s old news that unhealthy relationships are bad for you. This is no shocker. You probably have relationships in your life you know are harming you, but you may not realize how they affect the physiology of the body. When you get cancer, you may not automatically leap to the conclusion that your emotionally abusive marriage could have weakened your immune system through chronic activation of the stress response or that your immune system may have shut down because you were constantly caregiving others and neglecting your own needs. When you have a heart attack, you may not link it to your sister, who verbally beats you up every time you call, or your “friend” who cuts you down every time you see each other and gossips about you behind your back. When you’re struggling with chronic pain, you may not realize that your physical symptoms may be the result of your codependent relationship with your son. As When The Body Says No author Gabor Mate, MD teaches, when you can’t protect your own boundaries and say no when you mean it, your body may say no for you.

Although the data suggests that we need the company of other humans in order to be optimally healthy, what we really need are healthy, genuine relationships that allow us to be who we really are without judgment or criticism. Social contact simply isn’t enough. If you surround yourself with people who make you feel like it isn’t safe to be vulnerable, your body will manifest a stress response.

As a general rule, human beings are social animals. Historically, bonding in community offered an evolutionary advantage in a world rife with threats. Deep in our souls, we long for love, belonging, and human connection. Yes, some of us are introverts and some are extroverts, so as a fellow introvert, I’m not suggesting you need to force yourself to be a social butterfly. In her book Quiet: The Power of Introverts in a World That Can’t Stop Talking, Susan Cain makes the case that it can be traumatizing for people inclined towards introversion to be pressured to be extroverted. Introverts need time alone to recharge, regulate their nervous systems, and heal.

That said, don’t confuse unhealed trauma or poor boundaries for introversion. Some have had our hearts broken and seek isolation as a protective mechanism from further trauma to the heart. Some don’t know how to protect ourselves unless we’re alone. Some have a greater need for human connection, while others find that what our minds and bodies need in order to elicit physiological relaxation are hours of solitary meditation. Ultimately, you must tap into the healing wisdom of your own intuition in order to determine what will nourish you, your mind, and your body…

What’s The Solution?

I won’t offer you some pithy prescription for easing loneliness or shortcutting the labor investment building community sometimes requires. Because the truth is that loneliness is often a trauma symptom and requires the hard work of getting to know our parts, healing trauma, and gaining more connection to Self energy, using any number of trauma healing modalities that really do help. But I will give you a few tips we’ll be talking about more deeply in Making New Friends As A Grown Up.

Frientimacy author Shasta Nelson, who will be co-leading the friendship class with me, reminds us that friendship develops through three ingredients:

Positivity (sharing enjoyable experiences)

Consistency (seeing each other repeatedly)

Vulnerability (gradually sharing more of yourself)

You don’t need instant chemistry. You need enough opportunities for these three ingredients to grow. Instead of asking, “Where do I find friends?” ask “Where do I become someone people see consistently? Where do I share fun or meaningful interests with others? Where is vulnerability logistically possible?” Friendship grows from repeated exposure.

How To Meet New People

Volunteer for a cause you care about.

Join a hiking club.

Take an art class.

Join a choir.

Attend community concerts.

Go to the same coffee shop regularly.

Join a gym and attend the same class each week.

Take dance lessons.

Join a writing group.

Take gardening classes.

Attend lectures.

Join political or advocacy organizations.

Participate in local environmental restoration.

Join spiritual communities.

Attend maker spaces.

Join community theater.

Become a regular at the farmers market.

Take continuing education classes.

Participate in recreational sports leagues.

Join birding groups.

Join mushroom foraging groups.

Start something yourself if nothing exists.

Share What Helps You Build Community

I just joined Stitch & Bitch at the local organic food store, where women come together weekly to work on sewing or handiwork projects, building in consistency every Tuesday night, positivity (we have fun making creative projects) and vulnerability (we do actually rant about what’s heavy on our hearts sometimes!) I always come away feeling lighter.

What helps support your friendship network?

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^{*The photo is my new West County community at a local gathering at a nature preserve via LandPaths}

^[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910944/

After attending Rachel Naomi Remen’s Shiva service last week, in honor of her life and death, I couldn’t help reflecting back over the decades long conversation Rachel and I have had about the health benefits (and health risks) of relationships. With a new book coming out in October RELATIONSICK (preorder here) and with me launching a new six week online workshop Making New Friends As A Grown Up on August 24, and when I walked into that Shiva service and knew almost everyone there and felt such a strong sense of belonging, it hit me how much feeling part of a friend network makes us feel healthy, resilient, connected, and safe to navigate life’s inevitable hardships.

I’m currently reading the book Frientimacy, written by my co-teacher Shasta Nelson, and it’s reminding me how undervalued our friendships can be. We fixate on our romantic relationships, our family of origin, and our kids, without giving adequate priority and attention to how important our friend network is to our long term health. The science proves this very clearly.

Shasta and I will be sharing some tips, tools, and inspiration for building a strong community of friendship and belonging in Making New Friends As A Grown Up.

Learn more and register here.

If you’re not inspired to deepen meaningful friendship just for the joy of it, let’s talk about its medicinal properties, and how it can help you prevent relationsickness.

Let me share a few excerpts from the chapter about loneliness from Mind Over Medicine, which you can learn more about or order here.

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Mind Over Medicine Excerpts

When you consider how “healthy” you are, you’ve probably been programmed to think about your diet, your exercise regimen, your vitamins, your bad habits, your genes, and whether or not you’re following doctor’s orders. But have you thought about whether you feel intimately supported by a community of people you care about?

Probably not. But you should.

As it turns out, loneliness can make you sicker than smoking cigarettes and being part of a supportive community can increase your life expectancy. Don’t believe me? Let me take you back in time to Roseto, Pennsylvania, in 1961, a town where a community of Italian immigrants settled together in an enclave that recreated the Old Country in the New World.

Like its namesake in the mountains of southern Italy, Roseto Valfortore, the village of Roseto, Pennsylvania, clings to a forested ridge—this one in the Poconos, where a group of Italians who first set sail for the New World in 1882 came in search of a better life.

Because of its remoteness, few outsiders make their way into the village. But come with me into the village of Roseto, and let me show you around.

In the daytime, you’ll find ghost-town-empty streets, because the children are all in school and the men and the women of Roseto are working long, tedious shifts at either the stone quarry or the blouse factory, trying to earn enough money to send their kids to college.

Two-story stone houses built along the main street of Garibaldi Avenue are clustered on the rocky hillside. Our Lady of Mount Carmel Church, which came to life when the inspiring and enterprising young priest Father Pasquale de Nisco took over, towers over the other buildings. Father de Nisco can be credited with much of the success of the town of Roseto. He encouraged the townspeople to plant crops, raise pigs, grow grapes, set up spiritual societies, and plan celebratory festivals. Soon thereafter, schools, shops, the blouse factory, and other evidence of culture sprang to life.

In the evening, you’ll see the village of Roseto come alive as people return from work, strolling along the village’s main street, stopping to gossip with the neighbors, and maybe sharing a glass of wine before heading home to change into dinner clothes. As the church bell rings, you’ll see women gathering together in communal kitchens, preparing classic Italian feasts, while men push tables together in anticipation of the nightly ritual that gathers the community together over heaping piles of pasta, Italian sausage, meatballs fried in lard, and free-flowing vino.

As a community of new immigrants surrounded by English and Welsh neighbors who turn up their noses at the Italians, the people of Roseto in 1961 are forced to look out for one another. Multigenerational homes are the norm. Everyone goes to church together. Neighbors wander in and out of one another’s kitchens regularly, and holidays are joyously celebrated together. The work ethic in the community is strong. Not only does everyone work in Roseto; they share a common mission, a life purpose that fuels their often backbreaking work. They dream of a better life for their children.

The people of Roseto take care of one another. Nobody in Roseto is left to struggle through life alone. Roseto in 1961 is living proof of the power of the clan.

This little Pennsylvania town might have gone largely unnoticed by the rest of the world had it not been brought to the attention of Dr. Stewart Wolf, a professor at the University of Oklahoma School of Medicine, who bought a summer home in the Poconos, not far away.

One summer, Dr. Wolf was asked to speak to the local medical society, and after the talk, one of the local docs invited him to go out for a drink. Over a couple of beers, the local doc mused about how strange it was that heart disease seemed far less prevalent in the little town of Roseto than in the adjoining town of Bangor.

Dr. Wolf was all ears. This conversation took place when heart attacks were happening in epidemic proportions, ringing in as the number-one cause of death in men under 65. Intrigued, Dr. Wolf did his homework, scanning through death certificates from Roseto and comparing them to death certificates from the surrounding towns over a period of seven years. Amazingly, the men of Bangor had heart-attack rates paralleling the national average, but the heart-attack rate in Roseto was half the national average. In fact, it was nearly zero for men under 65. It wasn’t just heart disease, though. The death rate from all causes was 30 to 35 percent lower than average in Roseto.

This finding merited further investigation.

As Malcolm Gladwell reported in Outliers, John Bruhn, a sociologist hired to help investigate, recalls, “There was no suicide, no alcoholism, no drug addiction, and very little crime. They didn’t have anyone on welfare. Then we looked at peptic ulcers. They didn’t have any of those either. These people were dying of old age. That’s it.”¹

At this point Dr. Wolf and his team were committed to figuring out why the people of Roseto were so immune to disease. Attempting to answer this question, researchers poked, prodded, examined, and interviewed two-thirds of the village’s adults. Dr. Wolf initially suspected they must have some Old World dietary practice making them more immune to infection. Perhaps it was all the olive oil. So he hired 11 dieticians to follow the people of Roseto into the grocery stores and watch them cook.

But that wasn’t it. Unable to afford olive oil—the healthiest option—the people of Roseto cooked with lard, and they routinely ate pizza loaded with sausage, pepperoni, salami, and eggs. In fact, a shocking 41 percent of their calories came from fat.

Further, the Italian-Americans in Roseto weren’t physically fit. In fact, most smoked and remained sedentary, and many were obese. So what else might explain the disparity? Dr. Wolf suspected genetics. Because the Rosetans all originated from the same small village in Italy, Dr. Wolf suspected they might have inherited some disease-protective gene. So he tracked down other immigrants originating from Roseto Valfortore, who lived elsewhere in the United States, to see if they were as healthy as their Pennsylvania cousins.

But those who originated from the same village but were scattered about the United States were no more healthy than average. Genetics couldn’t explain it.

Dr. Wolf then evaluated Roseto’s geography. Perhaps it was something in their water or the quality of the hospital where they received medical care. The same kind of evaluation went on in two neighboring towns where the rates of heart disease were in line with the national average. But it wasn’t the water. They shared water with the neighboring communities of Nazareth and Bangor, where people were as sick as the general population. It wasn’t the hospital, which they also shared, or the climate, which was the same.

Dr. Wolf finally realized that, if it wasn’t their diet or their geography or their genes or the quality of their health care, there must be something disease-protective about Roseto itself. He concluded that a supportive, tight-knit community was a better predictor of heart health than cholesterol levels or tobacco use.

Dr. Wolf completed his initial study just as the golden age of Roseto’s community life began to disintegrate. While the people of Roseto slaved away in the quarry and the blouse factory, sacrificing so their children could go to college and live the American dream, the younger generation wasn’t so thrilled about life in Roseto, which to them seemed immune to modernization. When the young people went off to study at college, they brought back to Roseto new ideas, new dreams, and new people. Italian-Americans started marrying non-Italians. The children strayed from the church, joined country clubs, and moved into single-family suburban houses with fences and pools.

With these changes, the multigenerational homes disbanded and the community lifestyle shifted gears from nightly celebration to more of the typical “every man for himself” philosophy that fueled the neighboring communities. The neighbors who would regularly drop in for casual visits started phoning each other to schedule appointments. The evening rituals of adults singing songs while children played with marbles and jacks turned into nights in front of the television.

In 1971, when heart attack rates in other parts of the country were dropping because of widespread adoption of healthier diets and regular exercise programs, Roseto had its first heart attack death in someone younger than 45. Over the next decade, heart-disease rates in Roseto doubled. The incidence of high blood pressure tripled. And the number of strokes increased. Sadly, by the end of the 1970s, the number of fatal heart attacks in Roseto had increased to the national average.

As it turns out, human beings nourish one another, even more than spaghetti, and the health of the body reflects this. Dr. Wolf, who continued to study the community of Roseto for many years, concluded that an isolated individual may become easily overwhelmed by the challenges of everyday life, and this kind of overwhelm can trigger stress responses in the body. An individual surrounded by a supportive community, however, relaxes. This kind of relaxation translates into positive effects on the body’s physiology, leading to disease prevention and, sometimes, disease remission.

Being Proactive About Building Friendships

Most of us aren’t lucky enough to live in 1960’s Roseto, but we can cultivate closer connections intentionally and consciously, by being strategic about investing in building supportive connections in our lives. If you feel inspired to be proactive about this, we welcome you to join me and Shasta for Making New Friends As Grown Ups. We start on Zoom August 24, 2026, so register soon!

Join us for Making New Friends As Grown Ups.

*In the next excerpt from Mind Over Medicine, I’ll be sharing some of the science of healthy friendship, in case it inspires you to prioritize building deeper, safer, more meaningful community in your life and heart. Please subscribe if you’d like to read it.

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Long before I’d ever written a book or blog, before I’d ever taught a workshop or given a keynote, my beloved mentor Rachel Naomi Remen sat me down and lectured me on how to avoid joining a cult and how to avoid ever becoming a cult leader. This was important to her because she’d been in two cults, and she’d seen how destructive they can be. As someone who saw her as my mentor, she was careful to call out times when she thought I might be giving too much of my power away to her. And then when I started writing books and becoming a group facilitator, she wanted to make damn sure I never became a cult leader.

Rachel always told stories, and one story she told me was the story of the old fashioned ship gimbal. Back when ships had no electricity, they relied on candle flames for light, but since ships were also made of wood, it would be disastrous if the candle fell over and set the boat on fire. So all good captains knew the candle needed a gimbal, something that held the candle upright, no matter how much the waves tossed the ship about.

The structures of the communities we create, she said, must be like that gimbal, able to ride the waves without burning down the ship.

A few years ago, I decided to begin my in person workshops with a conversation about how to cult proof our communities. I started doing this while teaching at Esalen, when I was responsible for leading a month long program, and the longer a leader is responsible for a group of people, the more important it becomes to cult proof our communities. That same week, I met Anke Richter, a cult journalist and author of Cult Trip, who was next to me in a hot springs under a starry sky. I made a casual comment to Jeff about how we were actively trying to cult proof our community, when Anke asked if I would be willing to go on the record to say how we did that, so I thought I’d try to share some of the steps we took to create a safe enough container.

If deconstructing from harmful spiritual teachings, learning the red flags of narcissism and undue influence, practicing healthier boundaries, and challenging spiritual leadership is of interest to you, please consider becoming a free or paid subscriber.

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1. Students need to feel safe challenging the leadership, not just in lip service, but in practice.

First and foremost, leaders must acknowledge when they have been put in a position of authority, and invite students to challenge their authority, give negative feedback if need be, and speak up if the leader does or says anything that triggers them. They might confront the leader privately or in the presence of the group, but they need to feel free to hold leaders accountable for anything they might say or do that feels unsafe or out of balance to them. It’s a leader’s responsibility to respond to feedback without defensiveness, judgment, denial, minimizing, criticism, abandonment, exile from the group, or spiritual bypassing. Leaders need to understand that students may need to test the leader, to find out if they’re trustworthy and capable of ownership, accountability, and repair, to make sure they mean it. Leaders must prove that we can navigate that territory with delicacy if need be, in case anyone has a history of trauma when challenging authority figures.

A healthy community should explicitly communicate that students are not only allowed to disagree with the leader; they are encouraged to do so, understanding that questioning a leader’s teachings is not a sign of being undercommitted. It’s a sign of health. Students need to be clearly told that they do not have to adopt the leader’s worldview, that leaving the community is always permitted, without punishment or shunning, that former members are allowed to criticize the community, and that the leader is fallible and human and can be downright wrong sometimes.

One particularly powerful practice is to regularly invite challenge or disagreement, rather than merely tolerating it. This tests not only whether people are allowed to disagree, but whether disagreement will cost students belonging.

2. Decouple the leader from “the truth.”

In healthy communities, leaders offer ideas, and communities evaluate, challenge, question, contemplate, and sometimes accept and sometimes reject those ideas. A leader who can say “I don't know,” “I was wrong,” “I used to think this but now I’m not sure,” or “I changed my mind” is a green flag.

3. Resist creating “in groups” and “out groups.”

If your community are the Hogwarts magicians and everyone else are the Muggles, you’re on your way to a cult like dynamic. Humans are humans. Humans are all equal at the spiritual level, even if we have preferences for some behaviors of some humans and aversions to other behaviors. In our spiritual hearts, nobody is “better than” or “less than.” As Paul Farmer, MD said, “The idea that some lives matter less is the root of all that is wrong with the world.”

Cults break up humans into "good and special” and “bad outsiders.” If you find yourself judging some people as “spiritual” and others are “not spiritual,” or “doing their work" and “not doing their work,” you’re splitting, which is common in cult like dynamics. We have to catch ourselves as leaders to make sure we don’t pass this splitting along to those who might influence.

Of course, we all have our judgments, and that’s normal. I admit to judging Trump-loving MAGA people and preferring liberal Democrats, and I can get smug and self-righteous about why I feel that way. But you don’t have to agree with me to be in this community, as long as you follow the stated guidelines and don’t promote dangerous misinformation. I prefer people who care about social justice and aren’t overtly racist, sexist, homophobic, xenophobic, or otherwise practice and promoting hate. But I also know that people who are all those things are still human, and at the spiritual level, they are equal to everyone else.

*Ten more tips for leaders and students are available for paid subscribers. Please considering becoming one!

We just covered this topic in this week’s The Writer’s Calling, about how to make sure, as writers, we cult proof our communities. If you’re interested in writing classes, conversations about publishing, and discussions about accountability and support as a writer, please feel to join The Writer’s Calling.

Learn more and join The Writer’s Calling here.

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It was my mentor Rachel Naomi Remen, MD who taught me the profound difference between fixing, helping, and serving. Fixing and helping, she said, can be a form of control, a way to bolster our own egos, but often at the expense of someone else’s self esteem and wholeness. Fixing and helping can “one up” someone we view as weaker in ways that disempower them, rather than truly serving them. Serving, however, is the work of the soul. We serve as equals, in ways that empower rather than disempower, those we serve. In this audio, I read to you, in her words, as a testament to so many teachings that touched me profoundly.

Rachel’s memorial is today, so please accept this gift of her words in my words, as a way to honor Rachel who died of breast cancer on 8/8/26 at 88 years old.

I’ve spent a lot of words on this Substack deconstructing harmful spiritual teachings, and one of the reasons I’ve been able to do that is because Rachel let me learn my hard knock lessons but was always here to help me make sense of things when the spiritual shit hit the fan. I was very blessed to have such a trustworthy and wise teacher, who let me become myself while imbuing me and so many others with pieces of herself, like gems in our hearts. I’ll be sharing more about what I learned from twenty years of having Rachel as my spiritual teacher, so if you’d like to spend some time immersed in what I learned, please subscribe.

*This photo was taken by Rachel. It’s the gravestone of her cat Cashmere, taken in the backyard of her Mill Valley home before she moved to Concord. Now, I think it applies to her.

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Be here now. Don’t think about the past or project into the future. Only the present moment is real. Don’t identify with the pain body. Free yourself from your egoic mind by staying in the now. All suffering will go away forever and you’ll never again be triggered if only you stay in the present moment.

How can such teachings be anything but enlightening?

In the wake of the passing of my spiritual teacher and mentor Rachel Naomi Remen, MD, I’ve been thinking even more about what spiritual teachings have stuck for me, which ones no longer make sense, and which ones are somewhere in the middle, where we have the opportunity to parse out what’s helpful with tweezers from a haystick of things that might be not only not helpful, but outright harmful.

In 2015, Rachel and I went into Karen Drucker’s recording studio and recorded hours and hours of content. I was listening to those recordings yesterday, and Rachel led a meditation. I closed my eyes and followed along. Her voice is hynotic, and I can go very deep, very quickly when I hear it. She always says something like “Pay attention to that moment of peace at the end of your out breath.” And I can dive into the depths of my consciousness with a feeling of great peace.

But what Rachel never did is suggest, when I was in an acute trigger, that I should “be here now” or “let go of the past” or “stop thinking about the future.” She could guide me into the now without ever shaming me for having parts ruminating about the past or parts scared about the future.

Obviously, there is great benefit in mindfulness practices that allow us to be more present in the here and now, with less ruminating about things from the past that we cannot change or anxieties about an unknown and uncertain future. Trauma survivors have a tendency to have hurt or scared parts that get stuck in the painful past, as well as catastrophizing, future tripping parts that get anxious about the future. If our minds are so busy that we can’t actually be here in the present moment, we can miss so many of the joys of life that happen in the moment of now.

So, of course, being here now is often a useful teaching, but only if it’s trauma-informed.

It’s important to understand that not everyone has an equally easy time being here now. To suggest that all it takes is the reminder of a cliche can land on others as lacking in empathy and out of touch with lived reality. For untreated, unhealed trauma survivors still stuck reliving the past or for anyone who isn’t actually safe in the here and now because they’re actively getting oppressed, instructing someone to “Be here now” can come off as tone deaf.

Consider the utopian idea that “enlightenment” means that, like Eckhart Tolle and Byron Katie claim to do, you live only in the present moment and don’t get lost in ruminations about the past or anxieties about the future. First, that assumes that you’re safe in the present moment. Because if you’re being targeted for a hate crime in the present moment, if you’re an immigrant in the US right now being chased by ICE, if you’re a woman whose rights are being stripped by Trump America, if you’re a BIPOC male who just got stopped by cops, no amount of being here now is going to stop you from being legitimately scared about the reality of the dangers of such a present moment. Fear would be a legitimate response, informed by the historical knowledge that so many innocent people have been oppressed and murdered and that far too many injustices are real, right here, right now.

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Add to this that if you have Complex PTSD from lifelong trauma, whether from a high Adverse Childhood Experience (ACE) score, developmental trauma, or collective traumas like being BIPOC or LGBTQIA+ or Jewish or Gazan or an immigrant in America, you’re likely to have frequent emotional flashbacks, even if you don’t have visual ones. Unless you get treatment for all that lifelong trauma, you will be unlikely to be able to mindfully meditate yourself into focusing only on the present moment without dissociating and disembodying, which is a trauma symptom, not enlightenment.

Even if it’s safe in that particular moment, it wasn’t necessarily safe in the past, and it may not be safe again in the future. While these teachings may be very helpful for some, teachers who claim to only live in the perpetual NOW reveal their privilege through such teachings. Not only are they most likely deceiving people—because they’re human and I don’t believe in human enlightenment. It’s also true that not all sentient beings on the planet have the luxury of basking in detached, peaceful, dispassionate equanimity in the bliss of now.

What’s Wrong With The Power of Now?

We can probably all agree that it can be helpful to be more present—here in the now, aware of your emotions, embodied in your flesh, present with your pain, not looping old stories repetitively and not worrying too much about the future. That’s why trauma therapy is so important. Because unless we treat the traumas that all of us have, it’s unavoidable for us to flash into past hurts, regrets, or memories. It’s also normal for us to plan for, worry about, or fantasize about the future. Only when we know how to tend to and be with our past traumas, only when we’re present with the parts of us stuck in the past or concerned about the future without bypassing them, only when our future feels legitimately safe enough, and only when “now” is not dangerous can we truly be in the potential relaxation of the present moment.

But what if your “now” isn’t blissful? What if you’re a legal observer filming an immigrant raid and you’re innocent but getting killed by ICE in the present moment? What if your house is burning in a wildfire and the air is thick with smoke and burning your lungs and eyes? What if your belly is aching from hunger? What if a cop pulls you over for speeding and you wind up in a choke hold in the now? When your life is in danger—as so many lives are right now—now may not be such a happy place.

No amount of meditation is going to make you not scared when your safety is legitimately threatened, not in a healthy human body, anyway. Only people who are dissociating stop feeling real and necessary human emotions, like fear, when their safety is threatened. This is why “be here now” teachings can be confusing and may not be helpful to people whose safety is actually at risk or who have not had the privilege of access to cutting edge trauma therapies often not covered by insurance.

It can be especially confusing and potentially damaging when unintegrated, dissociated “presence teachers” sell the idea that enlightenment means you’ll never be triggered, you’ll never feel pain, suffering is optional, your ego will just die, and all human suffering will cease at that moment and never return. It’s such a lovely fantasy. Who doesn’t want instant enlightenment and the end of pain and suffering forever? Only it’s not true.

It certainly sets up a hierarchy, doesn’t it? The enlightened person is special and all those less special people who feel painful emotions must be in some way inferior. But where’s the empathy or honesty in this? Why would we even want to teach something that positions people who actually feel suffering in their hearts, minds, or bodies as “less than?”

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Dissociation Is Not To Be Glorified

I once heard Byron Katie say that she wakes up every day and sees her husband as a brand new human that she doesn’t even recognize, so fresh in the now that he has to introduce himself, like the traumatic brain injury survivor Drew Barrymore does to Adam Sandler in the romantic comedy 50 First Dates. How bewildering to suggest that enlightenment means that you’ll lose your memory of the past or your ability to plan for the future! That’s not enlightenment; that’s the result of severe physical or emotional trauma. While these teachers may not have experienced a traumatic brain injury, they do seem to be experiencing chronic dissociation, which is a severe trauma symptom.

We’ve all heard of the extreme cases of dissociation—the Multiple Personality Disorders (now called Dissociative Identity Disorders) typified by movies like Sybil and The Three Faces of Eve. Yet dissociation happens on a spectrum, and Dissociative Identity Disorder is a rare extreme of the common phenomena of dissociation. At its most benign and basic, dissociation happens to all of us when we’re daydreaming or when we drive somewhere on autopilot and arrive at our destination without really being aware how we got there. We even consciously choose to dissociate when we practice escapism and get absorbed into fiction novels, binge watch Netflix, use consciousness-altering substances like alcohol or marijuana, practice transcendent forms of meditation, or even sometimes when we wind up in flow states. When time/space awareness disappears and you’re fully absorbed in running, making art, making love, or otherwise entering ecstatic realms, that can feel really great. But it can also be a pleasant form of dissociation.

Voluntary dissociation is different than involuntary dissociation, which is a trauma symptom and happens on autopilot, sometimes as a default setting. When this happens, it’s like a switch flips and you disconnect and detach from your sensory experience, your thoughts, your sense of self, your body, your awareness of time, place, and identity, your sense that the world is real and you belong to it, and even your personal history and memories. Dissociation impacts your consciousness, identity, memory, emotions, self-awareness, awareness of your surroundings, and embodiment. You could say that its opposite is a kind of integrated wholeness alive with presence, awareness, sensation, embodiment, emotions, intact critical thinking, a healthy weaving between aspects of your being, and a good strong reality check.

Anytime you’ve had an out of body experience, like a near death experience, a sense of floating above yourself (as might occur during a traumatic event), astral travel, mystical journeying to other realms, meditative experiences when you transcend or leave your body, or even a kind of waking dream state, it’s likely that you’re dissociating. As such, it’s an intelligent strategy that may have helped you survive hard times—or even unbearable or deplorable times, such as childhood physical or sexual abuse or living through wartime.

When your body isn’t a safe place to be or when your emotions are just too intense for your young nervous system to handle, it makes sense that you’d leave your body and go someplace where it doesn’t hurt so much. As a child, you might even become so masterful at dissociating that you reflexively check out that way once you’re an adult. Or you might just dissociate automatically. When you’re dissociated, you don’t tend to feel your painful emotions, you can numb or leave your body, you may not remember bad things that happened to you, and you may even gain access to ecstatic mystical realms that fill you with hormones like oxytocin, endorphins, dopamine, and serotonin, giving you a kind of blissed out (but spaced out) high.

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What Is Dissociation?

You might notice that some of the characteristics of dissociation sound remarkably like what spiritual teachers associate with some transcendent state. Notice the similarities of the following characteristics, and then notice how they track with the awakening stories of Byron Katie and Eckhart Tolle, in their own words.

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*I apologize in advance for how long this is. I have so many more Rachel stories, but this is as short as I could make this one.

My spiritual teacher and mentor Rachel Naomi Remen, MD died on 8/8/26 at 8:24am at the age of 87 after a long battle with many lifetime illnesses, most fatally, breast cancer, a disease she survived for nearly ten years. She died peacefully at home under Hospice care, with her loved ones singing at her side.

I hardly slept last night, flooded as I was with memories of a side of Rachel many of yo probably don’t know. The internet will be swamped with stories of doctors, medical students, nurses, chronically ill patients, therapy clients, and readers of Kitchen Table Wisdom and My Grandfather’s Blessings, whose lives she touched. Many will share essays and videos that moved the needle in their lives. And I will share more about what she taught us all through her lifetime work. But right now, I want to tell you some of the stories behind the legend that she was and will continue being. Before I share with you some funny, poignant, humanizing memories of Rachel. let me tell you how I met her.

“I Was Waiting For You”

The year before we met was my Perfect Storm, so I was very vulnerable and in need of the right mentor. I gave birth by C-section and lost my dog a week later, the same week my brother wound up in liver failure as a rare side effect of an antibiotic he was taking for a sinus infection. A week after that, my father died, and then I had to go back to work four weeks post C-section. My daughter’s father, who was to be her caregiver while I was back in the hospital with an unhealed wound on my belly, cut two fingers off his hand and had to have multiple surgeries, so my grieving mother flew out to look after our baby.

A year later, I quit my job, left the hospital for good, and moved to the Monterey peninsula because some of part of me just had to be near Big Sur, which I considered the home of my soul. Now that I was unemployed, I spent a lot of time driving down Highway 1. Every time I drove past Esalen, where I’d never been, a persistent little voice said, “You’re supposed to come to Esalen. You’re supposed to meet someone here.”

I had no idea what Esalen was. It didn’t look like much—an unassuming wooden sign, a driveway down the hill, with a carefully monitored guardhouse keeping curious people like me from poking around. So I finally searched for it online. Esalen seemed like a New Age hippie retreat center with workshops like The NeuroDharma of Love or Discovering Your Soul Mandala or The Bioenergetics of Emotional Healing.

My first thought was, “This is where crazy people go!” I was not about to start wearing muumuus and talking about auras and rubbing crystals. I did not grow up crunchy. So when the increasingly persistent voice told me I was supposed to go to Esalen, I could just hear Dad laughing at me from wherever he was. But the guidance was so clear. I couldn’t ignore it anymore, so I flipped through the Esalen workshop catalog. By this point, it had been nine months since I had officially left medicine, and I had started writing a book about my life as a doctor. So when I saw a workshop with Nancy Aronie titled “Writing From The Heart,” I signed up. After all, how scary could a writing workshop be?

When I arrived at Esalen, the grounds were beautiful- a lush green lawn overlooking the ocean, dotted with Adirondack chairs, a pool with a view, and an immense garden sprouting with a rainbow of kale, multi-colored Swiss chard, zucchini, strawberries, and sunflowers, presided over by a red statue of a dancing goddess. The Esalen dining hall was fragrant with the heady yeast scent of freshly baked bread and the cardamom spice of chai tea. I served myself some tea, slathered peanut butter on a slice of bread, and took a breath.

When I asked the long-haired woman at the front desk what I should do first, explaining that I was new, she suggested I settle in with a trip to the natural hot springs baths, perched on a cliff above the Pacific. I love hot tubs, and it was a perfectly sunny but chilly 55-degree spring morning, so I took her advice.

What the long-haired woman failed to warn me about was that the people bathing in these sulfur springs were all naked. Men and women, all walking around in their birthday suits without towels, spotlighted in the bright sunlight. Now, I’m not a prude. I mean, I’m a gynecologist. I’ve spent my whole life around naked people. But that was clinical. This was Esalen.

The only one in a bathing suit, I felt all the raised eyebrows judging me. Trying to avert my eyes, I slipped into the only bath that didn’t have a naked man in it. The view of the ocean distracted me enough to relax a bit. I was falling into a sea trance when a brown-eyed, tattooed woman with enormous breasts and pierced nipples paddled over to me and asked, “So, what brings you to Esalen?”

I tried not to cry as I said, “I’m supposed to meet someone here.”

Looking to the left of me like she was talking to someone else, she said, “You’re supposed to meet Rachel Naomi Remen.”

I’d never heard of Rachel Naomi Remen, but I asked, “Is she here?”

She said mysteriously, “No. But she was…”

That week at Esalen changed my whole life, not only because I met Nancy Aronie, who taught me how to write, but because I looked up Rachel Naomi Remen once I was back in WiFi range and found out she’d written two books, Kitchen Table Wisdom and My Grandfather’s Blessings. I binge read both within about 48 hours, barely sleeping. And when I looked her up on the internet, I discovered she was teaching a workshop in Mill Valley, two hours away from me, just a few weeks later.

I was broke so I had to put the workshop on a credit card, but I knew I had to meet this extraordinary doctor who described herself as a marshmallow who had been crushed on all four sides until she was as flat as a business card. I felt the same way! I too was a marshmallow who’d been squished by the medical system!

When I arrived at the workshop with 100+ doctors, I was greeted by the statuesque and beautiful white-haired Rachel, who scared the crap out of me when she said, “I’ve been waiting for you” in a voice similar to the boy in The Sixth Sense when he says “I see dead people.”

I was not someone anyone was waiting for back then. I’d quit my job. I’d never written a book or written a word on the internet. I’d never heard of social media and barely had a hotmail email address. So nobody would have ever recognized me by name.

What did she mean she’d been waiting for me? At the end of the workshop, when I was leaving, transformed by the weekend, she said, “You know, the part of you I’ve been waiting for only has about 27% stock in the company of Lissa. Maybe if we hang out, we can get that part to 51%. You only need 51% stock in the company to make all the decisions.”

I had no idea what she was talking about, but when she invited me to start joining her and a circle of doctors who met monthly on Wednesday nights in her living room, I instantly said yes.

Looking back, I see that this is the kind of mysterious first meet up many people have with those who later turn out to be cult leaders. But Rachel had been in more than one cult. She was in a cult of doctors that she wouldn’t tell me any details about, so maybe someone else from that part of her life will tell that story. She also was a counselor in the Synanon cult, which she didn’t realize was a cult until I told her my sister had been unwittingly put in the Synanon-based troubled teen cult Rocky Mountain Academy. She fought me on that one, but I sent her the Wikipedia page about it, and we didn’t speak about Synanon any more.

The wonderful thing about Rachel being a cult survivor is that she was absolutely allergic to cults and the hierarchical coercive control inherent in them, which means part of my mentorship with her, from the get go, was how to avoid joining a cult and how to avoid starting one. I didn’t know then but Rachel made very sure that the Wednesday gatherings she was inviting me to would never become a cult. Those Wednesdays, which I wrote about here, would become one of the most profound influences on my spiritual and professional life.

For about two years, I sat in those Wednesday meetings and cried, because I had never sat in a circle of doctors who wished me well, who seemed to care about me, who didn’t judge me, and who didn’t seem scared of the flood of emotions that rushed forth once I felt safe enough to feel them. Rachel told me later that several of the doctors had asked her, “When is she going to say something?” Rachel said she told them, “You just wait…”

Come To Esalen

Rachel was the only female in her medical school class at Cornell, back when the only two career paths for a female physician were OB/GYN and pediatrician. She trained as a pediatrician and wound up on the faculty at Stanford, on her way to becoming the first female department chief, when she first went to Esalen Institute in the 1960’s. She hadn’t fully understood what she was signing up for. She simply responded to a mimeographed invitation to come to a spa in Big Sur, where they wanted to introduce a few academic doctors to some new ideas they were experimenting with.

Since she’d just lost yet another boyfriend because her career always came first, she figured this would be a good place to meet men. She told me later she didn’t meet a new boyfriend there. But she sure did meet men. She met Joseph Campbell and Abraham Maslow and Carl Rogers and Alan Watts and Fritz Perls and Michael Murphy and Moshe Feldenkrais and George Leonard and Hunter S. Thompson and Elmer Green—and so many more. Esalen was at the peak of the hub of the Human Potential Movement, in the height of the psychedelic hippie era of pushing boundaries and exploring the edges of the impossible.

Rachel rarely answered my countless questions about her time at Esalen. What she told me is that if you stand on the unceded Esalen land of the Esselen people, at the sacred convergance where the hot springs waters, the river, and the Pacific Ocean come together, a portal opens. She said if you look east, you look towards the bastions of academia, towards Harvard and Yale and Oxford and everything that is known to human beings. But if you look to west, across the Pacific, you gaze at the vast unknown, towards a sea of uncertainty.

“When you stand at that spot at Esalen,” she told me, “Sometimes that which has been unknown but is now ready to be known slips through that portal and into someone’s consciousness, and something new is born.” She often encouraged me to sit in the hot springs, and instead of chattering away with all the other interesting people, to go out very early or stay up very late and listen for that which is still unknown but might be ready to be known. Some of my best ideas came through in those moments.

Rachel writes about some of her years at Esalen in Kitchen Table Wisdom, so we have some record of them. But mostly what I know is that she never went back to Stanford after that. Her experiences were too shattering to return to the ordinary world of conventional medicine. Instead, she found Michael Lerner and Commonweal, and she started the Healer’s Art at UCSF. She told me that if she knew going to Esalen would have meant she’d never go back to Stanford, never achieved her ambition of becoming the first female department chair, if she knew how much of an uphill battle it would become to be one of the first women in medicine and also one of the first pioneers in mind-body medicine, she might never have gone to that little spa to find a boyfriend. But because she did, the world of medicine—and my world and so many other’s worlds—would never be the same.

The Healer’s Art

The way Rachel tells the story of the beginning of her acclaimed medical school curriculum The Healer’s Art is one of my favorite stories. She says she never intended to create it. The medical students at UCSF are the ones responsible for it. Apparently, they were trying to find someone to teach them about the mysteries of medicine, the things we can’t explain, the way we know things about our patients that we can’t possibly know, the way their loved ones show up on the other side as they’re dying, the near death experiences our patients tell us about, and countless other spiritual phenomena that inevitably happen in hospitals, in spite of all attempts to pretend they don’t.

They approached one of the UCSF professors, who declined, assuming it would be the end of his reputation as a trustworthy scientist. But since Rachel had left academia, he told the students to hit her up. So they did, and she said yes. She wasn’t exactly hired by UCSF. Through a loophole the students had found, they were required to give her space in the medical school to teach a class of the student’s choosing. She was relegated to the basement, after hours.

Word spread, and that basement room filled up with first and second year medical students who heard that The Healer’s Art was the best part of medical school. The following year, as she was completing the course, a handsome young man approached her and said, “Rachel, you know, I’m not a medical student here.”

She was nonplussed. They didn’t exactly take attendance at this elective class. She assumed he might be a nursing student or maybe a dental student, since they didn’t discriminate. But he corrected her. No, he was a medical student, alright. A medical student at Yale. His best friend had taken the class the year before and assured him he wouldn’t want to miss it. So he’d been flying out from New Haven to attend the class.

Then he sprung on her his big idea. “Rachel, we’re going to take this to Yale, right?”

Rachel laughed. No, no, no, this is a California thing, she assured him. Nobody at Yale would ever be interested in something so “woo.”

“But aren’t we at least going to try, Rachel?”

So he convinced her to fly out to Yale and pitch their medical school to incorporate The Healer’s Art into their teachings—and by golly, they did. And once Yale had it, Harvard wanted it, and the rest is history.

That young medical student grew up to be Surgeon General under Obama and Biden, Vivek Murthy. You can listen to the two of them tell their mutual love story on Vivek’s podcast here. When I was preparing my TEDx talk about loneliness as a public health epidemic and talking to Rachel about it, Rachel picked up the phone and said, “We need to get Vivek Murthy to declare this a public health emergency.” He did. And then he wrote a book about it Together, which ironically came out March 2020. Rachel and I both helped promote it.

Although it’s taught at 77 medical schools in nine countries last I heard, The Healer’s Art, the only spiritual teaching in medical school, wasn’t taught at my medical school back then. But I was lucky enough to get invited, as a practicing physician, to be part of a pilot program that offered The Healer’s Art at UCSF to older doctors. The idea was that The Healer’s Art, which is taught to first and second year medical students, get beaten out of them by the time they finish residency. So maybe reminding practicing physicians about mystery, awe, how to grieve, empathy, and how to journey with a patient without overpowering them or making them feel weak could have more impact.

That experience was life-changing for me. I’ll never forget the small group of doctors who journeyed with me through that, most notably Rick Loftus, whose Covid advice I broadcast all over the internet during the pandemic, and BJ Miller, whose TED talk What Really Matters At The End Of Life and work at Zen Hospice has touched many. At the end of The Healer’s Art, we were all given little felted “feely hearts” to wear in our white lab coat pockets, to remind us what we learned in The Healer’s Art. I kept mine for many years, until I felt an impulse to pass it on to one of my physician students. When I told Rachel I’d done so, she gave me another one. I have it with me now.

Extraordinary Knowing

I didn’t believe in psychics until I met Rachel. The way I understand Rachel’s intuition is that, because she was born so premature and was untouched by human hands for six months, she never fully landed in her body. She joked that she “lived in the vicinity of her body.” Part of her became human, but another part of her freely journeyed between dimensions and had access to ways of knowing and being that I don’t have. Those of us who knew her knew that if she looked just to the side of looking you in the eye, she was probably reading something in your energy field that was dead on accurate.

The number of times that she knew something she couldn’t possibly know rationally floored me. I quit trying to explain it to myself and just accepted that Rachel was psychic, even though I didn’t believe in such things. She never misused this superpower with me or made me feel controlled or manipulated with it. It usually made me feel seen and known and understood, and often left me in tears, because my mother had never seen or known or understood me.

I have one vivid memory related to this kind of extraordinary knowing. I’d met a Dutch scientist at the Institute Of Noetic Sciences (IONS) who asked me to read a book Dean Radin had recommended to him called Extraordinary Knowing, by Elizabeth “Lisby” Lloyd Mayer. She was a psychologist at UC-Berkeley, an academician, a penultimate scientist and researcher, I’d been told, who studied psi phenomena rigorously.

I took the book to Wilbur Hot Springs and binged the book in four days. Strange things started happening when I was reading that book. After I read it, after some strange dreams and mysterious hunches, I felt the urge to include some of Lisby’s research in my book The Fear Cure. I had completed the manuscript, and it was almost time to turn it into my publisher. But I felt a strong calling to honor Lisby’s work in the book. But I thought it might be career suicide to tread into such controversial, at-the-edge of pseudoscience territory. I made a pact to myself that I would drive straight to Rachel’s house, tell her about the book, ask her to read it, and then give me her advice about whether it would be wise or foolish to write about Lisby’s work in my book. Here’s the way I told the story in a letter I wrote to Rachel on her 84th birthday.

Downsizing Rachel

Rachel lived ten minutes away from me for over a decade, so I made many trips over the hill into town to the local Starbucks to get her drug of choice—a quad espresso over ice in a Venti cup with a shot of cream, with a pump of simple syrup, and two packets of saccharine on the side. All I had to order was “The Rachel Special” and the baristas knew exactly what to give me.

She lived on Mount Tamalpais in Mill Valley, right at Four Corners, just past Muir Woods, on the other side of Muir Beach, where I lived. You could see all of the San Francisco Bay Area from her front deck, the deck where I have so many memories of so many things she said to me that landed like a soul thud.

Because I lived so close and was hungry for time with Rachel, we often went on errands together. She loved to go thrift shopping and is responsible for the fact that I buy almost nothing retail and am now upcycling my own clothing line Wilderloom, which I’ll be debuting at Art At The Source open studios in Sonoma County in June 2027. Sometimes I’d come over and she’d have bags and bags of clothes she’d bought for me at Diamonds In The Rough, the consignment shop on Miller Avenue.

She’d say, “I’m too old for this, but it will look perfect on you.” And “Aren’t we lucky these Mill Valley women go all over the world, wear something once, and then sell it to us for a tenth of what they paid for it?” Nobody had ever bought me clothes other than my mother, but Rachel knew my taste much better than my mother did.

We’d go to the grocery store to buy the few things she could eat with her ileostomy bag, the one that replaced part of her small intestines because of Crohn’s disease when she was still nearly a child. Suffice it to say her diet was more about See’s Candy’s lollipops than health food, so just remember that longevity is about far more than healthy nutrition, and soul nutrition, which Rachel got plenty of, can sometimes keep us alive longer than kale.

Rachel had lived a lifetime of chronic illness. After being born premature at a time when babies didn’t survive that early, she spent the first six months in an iron lung, untouched by human hands, because we didn’t know back then what it did to preemies to be deprived of human touch. Her avoidant attachment style, which was always hard for my more anxiously attached parts to deal with, was an obvious result of that very early attachment injury.

Over the years, she got more and more activated during our grocery store runs. Here, I was with this woman thirty years my senior but also thirty times more accomplished than me. Rachel had been a powerhouse of a woman in so many ways. Yet when it came time to pay the grocery bill, the store clerks would look to me to give them a credit card. Rachel said the hardest thing about getting old was how invisible you become, which much have been challenging after so much visibility in her highly accomplished life.

Fast forward over a decade, and I was at the Mill Valley house, helping Rachel prepare to sell her house. Having believed the doctors who advised her to never get married or have children because she would die by thirty, Rachel didn’t have immediate caregivers as she got older, so she moved near her cousins, in Concord, CA, since the steep, banisterless stairs to her bedroom and bathroom at her Mill Valley became dangerous after her hip fracture. Although this decision was not about me, I was devastated. I couldn’t imagine having her two hours away instead of the quick ten minute drive I was accustomed to. I would have moved in with her and looked after her, but fiercely independent Rachel never wanted that. She made it clear that I had my own life to live, my own career to blossom, and she would not in a million years let me sacrifice my own life to help her at the end of hers. The story I tell myself is that this would have been too intimate for her taste, but maybe it’s just that I was too intrusive and she didn’t want me. Regardless of why, she wasn’t going to let me take care of her, but she did want me to help her move.

Some of my funniest and most poignant memories are from those weeks of deconstructing a rich life Rachel had lived in that house. Many others who loved her joined in on that process, and we all laugh when we remember it, because let’s just say it gently…Rachel was fussy. And bossy. And adorable. Most of us who knew her well knew this already, because if you’ve ever tried to work with Rachel the way I did, having co-taught many in person and online programs with her, you know she likes things just so.

But none of us had ever tried to relate with her during the emotional upheaval of a move. My aunt and uncle, who loved her work, were in town, so they joined in on moving duties, along with my daughter and others. I was trying to help Rachel downsize, since she was moving to a smaller house and we didn’t want to have to do all this again when she passed. But it wasn’t going so well. She had two huge wooden chests full of doilies, and I asked if we could donate some to the thrift shop.

She stood up in a huff, towering over me even in her frailty, and said, “You don’t understand!” Clearly, I didn’t.

“Before accomplished women like you and me could go to medical school, back when they had very few outlets for their genius or creativity, women made these.” She fingered the hand batted lace delicately. “Now, everyone wants to throw these away at thrift shops.” She looked impossibly sad at this idea. She explained that she’s been collecting them for years, as her own act of feminism, to honor the genius of long gone women.

I have now taken on that way of cherishing the women before me, collecting handmade lace and doilies and other works of art I’m now sewing onto clothing as part of my Wilderloom brand.

.While Rachel and I were folding doilies, my aunt and uncle were in the garage sorting through boxes and boxes of The New Yorker. When I asked if we could recycle these, Rachel was equally livid, but less willing to sustain the fight than she was with the doilies. She finally conceded to letting my aunt and uncle remove every front cover while recycling the interior. After hundreds of tedious cover removals, Rachel came to check on their progress and had a conniption because they hadn’t used a razor blade to remove the covers, so they had a ragged torn edge. She found a razor blade and a cutting board and my aunt and uncle still laugh about how they had to go back and recut all those hundreds of New Yorker covers, which someone, I suspect, will have to deal with now that she’s passed.

I came away from that move with so many treasures she gave me—the four pieces of stained glass she’d made herself, which she assured me nobody else would ever want, the leather and crystal mandala hanging over my altar now, the antique chest that holds my blankets, the antique birdcage that reminded her of the birdcage on the cover of my book The Fear Cure, and the journal of her notes from the years of creating Kitchen Table Wisdom. What I most wanted, she wouldn’t give me. It was a photo of Rachel at about twenty, getting ready to get into her racecar, the DeLorean, just like the one in Back To The Future.

She raced that DeLorean on a track after she lost her small intestines. Her mother told her they could take away her guts, but they couldn’t take away her power. She said she loved putting pedal to the metal and outracing all the men on that track. That photo represented her strength, her courage, her grit, her raw power, and her unwillingness to ever let the turkeys get her down. Somewhere on an old hard drive, back before we had iPhones, I have a digital copy of that photo somewhere. It’s burned into my brain forever.

Filming The PBS Special With Byron Katie and Martha Beck

Rachel and I drove to Ojai together for the shit show experience I described here.

I won’t get into the whole story, because I wrote about it earlier. But I’ll never forget sitting on a sofa next to Byron Katie, with Martha Beck refusing to get off her knees on the floor in front of Katie, and Rachel literally sitting on the armrest behind me. I kept trying to get Rachel to get on the sofa with me, in a more comfortable position, but she kept saying “I have your back because nobody else here does.”

After the shit show unfolded on camera, Rachel and I were driving back to Marin County, when Rachel explained to me what I hadn’t been able to see. “You let people exploit you,” she said. “You even act grateful when they do.” She explained that it made her nauseous, that she couldn’t just sit back and watch in silence.

Rachel had been roommates a long time ago with Stephen Mitchell, Byron Katie’s husband, who tried very hard to control the out of control scene, and who treated me very badly after I’d gone down to film the PBS special with Katie, Martha, and Rachel. Rachel told me lots of juicy stories about the good old days with she and Stephen, stories I won’t share because they’re hers.

But I’ll never forget the six hour lecture I got on that drive home, the one that began my deconstruction from the New Age bullshit I’d gotten swept into, in spite of Rachel’s attempt to keep me grounded. That act of love lies at the root of many of the essays you may have been reading here on Substack, about deconstructing New Age indoctrination and how spiritual teachings can lock in abuse, make us vulnerable to cultic leaders, and seduce us off the true spiritual path Rachel had always tried to guide me towards. So thank you Rachel. Your legacy lives on in my series of essays LOVE BIGGER, here on Substack.

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As “out there” as Rachel could be, she was also very “right here.” I suspect she too had gotten seduced by Esalen and all things New Age when she was young and vulnerable like I was. But she’d found her way to a place of grounded credibility, discernment, wisdom, and true service. I owe so much of my life, being, and career to Rachel. I am at a loss of words to express my profound gratitude for the gift of having had her in my life for twenty years. I know so many others feel the same.

I’m sure I will be writing more about the profoundly positive impact Rachel had on me and so many others, sharing some of my Greatest Hits of her work. If you haven’t read Kitchen Table Wisdom or My Grandfather’s Blessings, this is your chance! I swear you won’t regret it. On my iPod, I have a recording of her own voice reading both books, but it’s not longer available in Rachel’s voice. Maybe I’ll share some snippets of that original recording as I help those of you who might be new to Rachel’s work get to know the legacy she leaves behind.

As A Final Memory (For Now)…

I wrote this in another birthday letter to Rachel.

If you’d like to gather around Rachel’s feet and let her read you a bedtime story, skip forward to 20:00 here in this video, where she reads the children’s book she published just a few years ago The Birthday of the World, flanked by her longtime collaborator at Commonweal, Michael Lerner.

Last night, I didn’t sleep. I was sad and grieving, so I went to bed early, hoping for some peace. But instead, I felt like I spent the entire night with Rachel. Memories of her flooded in, and I could feel her with me in a mystical sort of way. When she was diagnosed with breast cancer shortly after my mother died from cancer in 2017, I had been so scared I’d lose Rachel right after losing my mother. But she assured me she wasn’t going yet, that I would know when it was her time, and that I should enjoy these years of privacy while she was still in a body. Because, after that, she assured me, I’d never be without her.

I could feel that fullness of her being in my room last night, larger than life and yet as small as a feely heart in my chest. Which is why I woke up and wrote this, to honor her memory and get this all written down before 8:24am, the 24 hour anniversary of her Angel Day.

To all of you who loved Rachel and were touched by her teachings, please share your memories here. She has touched so many, and we will always have her in our feely hearts. If you know anyone else who was moved by Rachel, please feel free to share this.

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I write a lot about bad spiritual teachers. Part of why I can tell the good ones from the bad ones is because I was blessed to have a really wonderful teacher, who swept me under her wing right after I quit my hospital job at 37 years old. Last year for Mother’s Day, when we all knew Rachel had end stage cancer, those of us doctors lucky enough to have Rachel as our mentor compiled a book for her, to honor her role as a mother in our lives. This is what I wrote. I’m sure I’ll write more, but Rachel died today at 8:24am, 57 years after doctors told her she would die by the age of 30. So for now, this is all I can muster to honor her memory.

After reading Tuesdays with Morrie, I always joked that one day, I’d write Wednesdays With Rachel.

Wednesdays With Rachel

By Lissa Rankin, MD

When I first became a “Remenista,” I’d anticipate with great enthusiasm our Wednesday night Finding Meaning in Medicine meetups at her Mill Valley home, which was just around the corner from my home in Muir Beach. I often noticed a part of me that showed up at these gatherings seriously hoping to please the teacher. I tried all the tricks and tools I learned by the age of 4 for pleasing teachers, but somehow, Rachel seemed immune to my 4 year old charms. The foods I brought for her, she couldn’t eat because of her Crohn’s disease and ileostomy. The poems I wrote for her didn’t elicit the reaction I’d hoped for. Most difficult for me, the work I tried to put out in the world, inspired by her influence on me and intended to win her approval, usually backfired.

This often led to Rachel asking me to stay behind on Wednesday night until after everyone else left. I came to call these post-meeting late nights with Rachel Wednesdays With Rachel, since I’d just read Tuesdays With Morrie.

Although I appreciated the one-on-one time, I quickly learned that this meant I was in trouble with the teacher, quite the opposite of what my approval-seeking 4 year old part was hoping to achieve. Usually, I’d upset her in some way. I’d let her down. I’d made her angry. My work was too similar to her work and I hadn’t offered appropriate attribution, Or I’d failed to ask for consent about something I should have known better about, like the time I posted a blog post about her with a photo of the two of us at Commonweal in front of a large painting of a naked man, something I hadn’t even considered might be taboo.

When I told her I wanted to be part of whatever she was doing, to join the Rachel Remen bandwagon, she said, “Don’t join something. Build something.” So I did. At one point, I bragged to her, “I’m stepping into my power!”

She corrected me. “No.You’re stepping into your ambition.” I felt deflated.

No matter what I did, I couldn’t seem to get it right, like the more I tried to please her, to win her affection, to broadcast her work into the world, to prove how much I appreciated her, to thank her for saving me when I was at my lowest point, the more it felt like Rachel just didn’t like me. That pain felt familiar- just like my unpleasable mother.

One day, when I was desperate and despairing, when my attempts to please her had failed once again, Rachel’s eyes and voice softened. Calling me “sweetheart” in the most motherly of voices, using a term of endearment she didn’t usually apply to me, she explained that I could quit trying to impress her now, that I could relax and just be myself. She said she wanted to let me in on a little secret, that she was never going to approve of me, no matter how much of a dog and pony show I put on for her.

I was confused.

“Approval,” she said, “is just another form of judgment. It’s positive judgment instead of negative judgment, but it’s judgment nonetheless. If I judge you in a positive way, if I approve of you, then I can always withhold my approval. I could use that threat of withdrawing my approval to control you, just like your mother did.” She swore she would never do that to me, that her love wasn’t for sale and I couldn’t buy it with flowers or love-bombing poems or acts of service intended to win her love or professional achievements to finally prove that I was good enough.

“I won’t approve of you because I love you, and that’s not ever going to go away, whether I approve of you or not.”

I heard her words all the way down to my most ruined heart

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I didn’t immediately stop trying to impress Rachel after that. Old habits die hard. But something young, something vigilant, hardworking, and distrusting did eventually soften and fall away. I didn’t need to impress Rachel, because she just loved me, just the way I am, fucked up parts and all. This is how she loves all of us, I learned over time, not just from her words, but from her unconditionally loving actions.

Years later, Rachel was the one on speaker phone with me when my mother took her last labored breath just before midnight on the night before Halloween, when my mother died at her home, under Hospice care. No Hospice workers were in the room at the time, but Rachel was there. After the last labored breath, Rachel spoke to all of us in the room. It was me, my sister, my mother’s two sisters, my daughter…and Rachel. My mother had three brothers, a son, and two grandsons, but somehow, this dying thing became women’s work.

Rachel said, “Take a moment to be with the silence in the room.”

The room had been so noisy with the death rattle of my mother’s last moments alive and the loud sobbing tears of the rest of us. We would never have noticed that moment of silence at the end of the out breath, just like Rachel prompts us to do at the end of each FMM meditation, had she not reminded us. I will cherish that moment of soft, relieved silence for the rest of my life.

I had been grieving hard over the loss of my mother, getting up at 5am during Hospice care to write about my grief before giving my mother her first dose of meds of the day. So I was shocked when I woke up at 5am the morning after she died, after only a few hours of sleep. I felt enraged. This bewildered and frightened me, so I called Rachel, worried that I’d turned into some kind of sociopath.

Rachel said, “Thank your mother, Lissa. She left you a precious inheritance. She gave you your anger back.”

Her comment reminded me of the New Years Eve I’d spent with Rachel, SARK, and Karen Drucker, playing The Transformation Game. Rachel picked the Appreciation card and decided to give me what felt like a backhanded compliment at the time. She said she appreciated me because somehow, people could do the most God awful things to me, and I’d stick around and tolerate their mistreatment, maybe even thanking them for being such a good tor-mentor that I could learn from their abuse.

This part of me seemed to be crazy-making to Rachel. When I’d tell her something distressing that someone else had done, she’d challenge me. “Where is your anger? Why aren’t you enraged right now?” She insisted that my mother had stolen my anger, which confused me.

I just couldn’t feel my anger most of the time. I felt compassion for my perpetrators. But I also felt confused over why I kept getting betrayed and exploited.

Rachel was right. When my mother died, she gave me back that anger. That anger prompted me to get into the best therapy of my life with a Jewish New Yorker of a certain age who was one of the few women professors at Princeton back when women weren’t becoming professors at Princeton. I told her she reminded me of Rachel, and she felt flattered. She’d admired Rachel’s work for much of her life.

When Rachel got cancer soon after my mother died, I had a part that was terrified of losing both my birth mother and my spiritual mother so close together. I told Rachel about my fear, and she assured me she wasn’t dying anytime soon. She swore that she would warn me before she died and that I should enjoy this time that she’s still in a body, because I’d still have privacy until she was gone. Once she was on the other side, she said, I’d never get rid of her because she’d be there right beside me, looking out for me for all eternity.

But I didn’t believe her and I cried every time I thought about losing her, just like I had done when I imagined my mother gone. I tried doing my Internal Family Systems work with the part of me terrified of losing Rachel. I attempted to convince that scared part that it had me now, that I would be its mother, even if Rachel left her body and went wherever she was meant to go next.

This part was not buying it. She called me “Shit Rachel,” as in I’d be a shitty substitute for Rachel. I did a therapy session around this dynamic and finally had to concede that this part was right. I would be Shit Rachel. I’d never be capable of replacing Rachel for my hurt parts. But I could be something else, something different, the mother I never quite had- for myself.

The therapist who helped me heal told me I’d been lucky. Rachel had been my “good enough” mother, the way she’s been for so many of us. She helped me play out just enough of my childhood dynamics to give me a restorative experience, a different ending, to help rewire my neural circuitry to cure me of my incessant approval-seeking.

I approached her years later with embarrassment and shame and asked her how she put up with me back then. How did she and all the rest of you put up with what a hot mess I was, how hard I tried to get you all to like me, how traumatized I was, how attention-seeking I was, how much I craved your validation?

She looked at me with those same soft eyes and said, “Lissa, you were our Siena.”

And just like that, the spell my mother had cast on me was broken.

Siena, who now goes by Mira, is my wonderful daughter. Rachel gifted me with that beautiful image of the little girl I love. If I was Rachel’s Siena, if I was the Siena to the elders in the room, then of course I’d be easy to love, even with all my flaws. I’d be adorable in my messiness, lovable in my imperfections, forgivable in my mistakes, just the way I feel about my daughter. And as I become an elder, maybe I can pass on that gift to the next generation of Sienas.

At one point, when Rachel and I were talking about writing, legacy, her impact on my work, and how writers mentor other writers, she told me there is a point at which someone’s influence over you becomes so ingrained that it becomes you. She says she periodically reads things I write and can see the ways that her influence over me has become so much a part of me that, although I try to give her credit anytime I realize I’ve been inspired by her, I may not even remember to quote her. The idea may feel like it’s coming directly from me, even though the seeds for it may have been implanted by Rachel 15 years ago. She said that when this happens, she doesn’t feel like those she’s mentored have “stolen” her work, but that her legacy is complete. She lives on in each of us. Her legacy may be colored by our own personalities but growing from the same seeds into full bloom, long after she leaves us to walk beside us from the other side.

Rachel, words feel vastly inadequate to express my gratitude for all you’ve done for me, for all of us, for this community, and for the world you’ve impacted. My debt of gratitude to you feels impossible to repay, so we can only pay it forward. May you feel the love of all of us that you’ve mothered in your own way and may you know how profound your love has transformed us all. As my own mother used to say, “I love you to the moon and back.”

Lissa’s Note Today

I can’t quite imagine life without Rachel in it. And yet, that moment has come. I cannot give words to my gratitude that Rachel has been in my life for almost twenty years. My parts that have attached to her so strongly still think I’m going to be Shit Rachel, and they’re right. I will never replace her presence in my life. But I also know she will never leave me, because she lives in me always.

If you’ve been touched by Rachel Naomi Remen, whether through reading Kitchen Table Wisdom or My Grandfather’s Blessings, or by other way she might have impacted you, please tell me your stories. I am reaching out across the ethers to anyone who was touched by her. My heart is with us all in our grief and gratitude.

I will be writing more about Rachel’s impact on me, but for now, I can only say….wow. And thank you Rachel. For ever and ever and ever.

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I’m preparing to teach a class Making Friends As A Grown Up with friendship expert Shasta Nelson, author of Frientimacy. I want to focus on making new friends, especially after you’ve done a lot of therapeutic work, broken old patterns, and become more of yourself rather than the person you were on auto-pilot from old programming.

Shasta says healthy friendships require three things- consistency, vulnerability, and positivity. She says every thriving friendship—every thriving relationship, for that matter—is simply these three things, practiced over time. So as I try to make new friends in West Sonoma County, I’m consciously trying to offer those three things, and I want it to be reciprocated, so I’m not the only one doing all the friendship building work.

Shasta just moved too, and she’s writing a new book about making friends after relocating. But before that, she’s written several books about friendships and jet sets all over the world keynoting about how to make (and keep) healthy friendships. We had several fun girl chats and then dreamed up the idea of maybe teaching a class about friendship, so please join us if this idea sounds fun to you!

Learn more and register for Making New Friends As A Grown Up.

I’ve taught the last three LOVE SCHOOL sessions on making new friends after doing your personal growth and therapy work, which is part of what inspired this class. I thought I’d teach one session and we’d move on, but talking about friendship brought up deep wounds in our students. Soulmate friends that ruptured. Besties who ghosted us. Being the ghoster—and why. Friends who just aren’t reliable. The pain rose to the surface, and we met it with tender kid gloves, the way we always try to while learning relational skills and practicing Internal Family Systems together.

All of this got me thinking about what I offer as a friend—and what I look for in friends, now that I’ve done a lot of therapy. Therapy helped me see my patterns, how I’d seek out people I could rescue/control, or how I’d get intrusive in the name of being close/enmeshed. But I don’t want to repeat those old patterns anymore! Now that I’m new in town, I feel like I have the opportunity to choose healthier relationships, and I’m excited to journey with new chosen family, creating community and practicing what I learned in therapy, in real time, with new people.

I decided against trying Bumble BFF, the online dating app for finding friends, because the reviews on it are dismal. But I decided I’d play with writing a profile for myself, just to get clear what I’m seeking. I just went on a lovely new friend date yesterday with a lovely woman I’m planning to see again tonight. I’ll share my meet new friends “dating” profile, in case it inspires you. You might try doing the same!

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What I Offer As A Friend

I’ve made the list of what I wanted in a romantic partner before, but until now, I have never articulated the kinds of qualities and values I’m looking for in friendships with women and men or what I’m looking for.

First, a little about me. I am not cool. I have no idea how to do cool. When I’m around cool people, I freeze up and shrink. But when I’m around real people, my nervous system relaxes, and I can breathe. I don’t care if someone farts or burps out loud, because I’d rather someone let it out than keep it in, and then if I have a little toot that needs to squeak its way out, I won’t feel as uncool for having biological functions.

I don’t expect my friends to show up polished or made up or pretending they didn’t just have a blow up with their partner or mother, and I don’t want to have to perform with my friends either. I might straighten up the house before someone comes over, but my close friends will tell you there will probably be dishes in the sink, sand on the floor, dog fur on the sofa, and flies buzzing around because we live in a barn next to a cow pasture.

I can be a little hypo-manic sometimes (if you haven’t figured that out already), so people tend to find me interesting, stimulating, and inspiring. But I can be slowed down and calmed down pretty easily if someone suggests we close our eyes and have a moment of silence or just sit next to each other, like kids engaging in parallel play, doing our own introverty thing without having to center each other.

I care about consistency, vulnerability, and positivity, as long as it’s not the toxic positivity version, where you fake happy even when you’re crying or angry inside. I cherish authenticity and people who are comfortable in their own skin, who are not sycophantic chameleons pretending to be what they think you want them to be. I’ve done my share of fawning and people pleasing in the past, but it always backfires. Friends who have done at least some of their own work and are not averse to going to therapy if things get hard are easier on my system than people who try to keep everything inauthentically positive, while denying what actually hurts.

I like people who say “Ouch,” if you hurt them, so I can learn where the boundaries are and make quick repair. People who hold grudges but are conflict avoidant and won’t tell you why make me crazy! I once heard that if you’re looking for an animal to walk you through the desert, you’re better off on a horse than a camel. Because if horses get tired or thirsty, they slow down, start looking weary, and make it clear it’s time to find an oasis for a water break and a nap. Camels, on the other hand, go and go and go with no warning, and then they keel over dead. I’m looking for horses who give me warning if something isn’t going right in the friendship, not camels who just ghost people.

But of course, feeling good together, having fun together, coming away from meet ups feeling better than before we came together, that all matters too. I’m kind of humor-impaired and not very funny myself, but I laugh hard at other people’s humor. My partner Jeff and I both have a kind of twisted, dark humor, but I usually hide that from other people. If I get to know someone well, I might let it out.

I love getting to know people who are different than me, because I learn so much and my heart gets bigger, and I’m actively looking to make more non-white friends. I like having enough in common to feel comfortable but I also like being challenged to grow and deepen my empathy and scope. Single or partnered, straight or queer, BIPOC or white, I don’t need someone to be just like me.

What really matters to me is equality and reciprocity. I don’t want someone who insists on one-upping me and being grandiose, unduly self-absorbed, or narcissistic. And I certainly don’t want someone sycophantic, who fangirls me or puts me on a pedestal and expects me to go one up. I like being friends with people who meet me eye to eye, as equals, as two people who know our worth and know we all bring something of precious value to the world and to each other.

I love attending live music and will regularly be at Peacetown (Fleetwood Macrame tonight!) or the Windsor Town Green for music, picnics, and dancing. I can be socially awkward, but if there’s a dance floor, I am a Dancing Queen fool and I know just what to do. The minute the music stops, I get tongue-tied in a crowd, but one on one, I’m much more comfortable. I love hiking and taking my dog Moose to Doran or Dillon Beach, and I’m hoping to explore new hiking trails around here. I just discovered Sea To Sky trail in Jenner Headlands and Estero Americano trail in Bodega Bay, and I am in love.

I’ve always been an artist and a writer, so art time and writing time is always welcome. Sonoma County is so bountiful with art workshops and fun crafty projects. My main artistic medium for the past 25 years has been encaustic painting and sculpture, but my new “She Shed” has no ventilation, so I’m trying to find my next artistic outlet. I’m upcycling clothing and have fun rummaging around the Goodwill outlet for cashmere cloth and lace and other salvageable treasures. I just got my first sewing machine, which I completely suck at using. I’m also learning to do botanical gelli printing, eco-printing fabric, cyanotype on fabric, weaving wall hangings, and collage on panel, since I can’t use my encaustic studio at my new home.

I also write every day. I know there are tons of other writers in West Sonoma County. But one of my main sources of income is mentoring writers, so I’d want to avoid mentoring another writer. I’d rather hang out with writing peers, peer to peer, since it’s too easy for me to go into mentor/client mode if someone is new to writing or publishing. But if someone just wanted to meet someplace cool and write together, I’d be down for that.

I’m also a foodie and learning to garden, and I love entertaining and throwing dinner parties, bringing people together. I joined the West County Community Farm and will be there and at the Sebastopol Grange farm swaps on Tuesdays. It’s my dream to have a life of rustic bounty with soulful people huddled together to weather these hard times.

I go to every No Kings rally and I’m one of those people who honks like mad every time I drive through Sebastopol and the protesters are protesting. But I also think we need solace, and a little line dancing should be able to help us endure.

I’m always up for nature rituals, women’s circles, book clubs, sewing circles, and the kind of witchy goddessy stuff that can make me sound like a trad wife, which I’m not. But I’m not into the grandiosity that can ride shotgun with some of the goddessy stuff, and I won’t do man hating for the purposes of female empowerment. I’m happy to go to a Stich & Bitch circle or “Unhappy Hour,” but only to vent temporarily for the purposes of healing and giving ourselves a way to wail and get angry and express when it’s needed.

I love hot springs and sometimes get day passes in Calistoga or Harbin Hot Springs or stay for an overnight if I’m splurging. I love all things makerly and my friends tend to get to enjoy the benefits of that. Yesterday, I made cherry tomato confit and then miso-salted caramel sauce for ice cream or coffee, and I make a mean raw chocolate. I just made aromatherapy bath salts and am about to sew denim jeans jacket sleeves into little wine bags, since I’m cutting off denim sleeves from jackets to sew on cashmere sleeves from holey cashmere sweaters.

I’m afraid that description of myself might make me sound intimidating, so please don’t interpret it that way! I certainly am not looking for other people who are carbon copies of me. I’m happy to do things I don’t know much about or am not good at, and I’m also happy to share some of my interests with others who are curious to play without attachment to being good at any of these activities.

Most of all, I’m loyal, I’m generous, I show up as best I can when things get rough in my friendships, and I’m not just a fair weather, fun-only friend. I show up at hospitals, at funerals, and in the daily grind of caregiving our loved ones. I do have high expectations though—for honesty, for integrity, for mutuality, for caring about social justice, for taking a firm stand about the issues of our day, for owning our shadows and not pretending we don’t have them, and for doing our best to keep commitments, even if it means stretching a bit. I’m happy to accommodate special needs, but I wouldn’t want to be the only one with a car. I do like to be active and love having hiking friends or dancing friends, but many of the activities I like to engage in are sedentary, like making art, writing, or sewing, so being active isn’t a prerequisite. I also have some disabled friends and we accommodate those needs, of course.

I feel so shy writing this! But I learned from thirty first dates when I did my online dating experiment in 2020-2021 that I learn a lot about myself when I meet new people. Different parts of me come forward in the presence of different kinds of people, and it’s so curious to discover what parts new people bring out in me. I think intentionally meeting new people can be a great journey of discovery, so even if I don’t find my new BFF while going on a bunch of friend dates, I’m sure I’ll have some wonderful experiences and I hope others will too.

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What I’m Looking For In New Friends

So what qualities am I seeking in my new friends? My taste has changed a lot since many years of therapy. I used to be much more attracted to smart, spiritually-inclined, charismatic, multi-talented friends. But that matters so much less to me now. Now, I care a lot about kindness, courage, and taking the risk to be honestly open about who you are and who you’re not.

I guess the most important thing is geographic proximity. I live off Highway One in West Sonoma County, so with gas prices the way they are, I’m not looking for new friends in the town of Sonoma or Napa or San Francisco. I’m looking hyper-local—Occidental, Sebastopol, Petaluma, Santa Rosa, Jenner, Bodega Bay, Graton, Forestville, Guerneville, with Healdsburg or Geyserville or Glen Ellen at the farthest. Two new friends both live 8 minutes away in Occidental, which is ideal, but not a deal breaker if I have to drive further.

Honestly, the most important thing I look for is someone skilled at relational repair. No relationship can stay healthy if there isn’t room to mess up and make up. When I meet new friends, a part of me is always waiting for the first conflict, so I can find out whether we have the chops to make it to the next level of intimacy. When we survive the first big issue with a friend and come out the other side with more trust that you can make it through the inevitable ruptures, trust builds and my system relaxes.

I’m obviously looking for friends with shared interests, but I’m also willing to explore new interests I haven’t explored before. I’d have zero interest in someone who wanted to watch sports with me or someone MAGA who wanted to talk politics. Having fun, relaxed time and doing fun, meaningful things together is what I value. Whether it’s hiking, going to protests together, making art, dancing, listening to concerts, dinner parties, picking strawberries at the local farm, or volunteering for local festivals, it’s in person activities that I value, not texting or phone calls, unless we’re arranging other in person activities. (Speaking of which, if you live nearby, I’ll be volunteering at the kids art booth both days for the Gravenstein Apple Fair, so swing by and say hello!)

One thing I know is that I can’t do conflict avoidance, passive aggressive punishing, or withdrawing without explanation. I’m sure I fuck up on the regular, but I’m not defensive and I’ll own up to stuff if I do something upsetting. I just want someone who trusts me enough to tell it to me straight and set boundaries if need be. Someone who knows how to protect their own boundaries is such a relief to me. Then I don’t have to worry that I’ll be a bull in a china shop, unwittingly crashing around and hurting someone. It works best if both of us can just say “that didn’t feel good,” talk about it, own up to what happened, hug and make up, and move on with more clarity about what we need.

I also look for empathy and am instantly turned off if I see someone treating wait staff badly, harming animals, or acting unduly entitled. That means spiritual bypassers don’t usually fit well with me. If I tell someone I’m missing my Muir Beach community or it’s been hard to feel displaced, the last thing I want is for someone to tell me God doesn’t give me any struggles I can’t handle, that my soul chose this, that there’s a silver lining to my loss, or any other fuckwad attempt to make me not feel what I’m feeling. I cherish those who can just hold sacred space when I’m in pain, and I do my best to offer the same in return—no fixing, no bypassing, no silver lining, just presence.

Reciprocity is really important to me. I pay attention to how much space each person takes up, whether there’s a fair back and forth of conversation, whether both parties put themselves out to accommodate the other, whether one person is always doing the chasing or whether there’s genuine interest in doing the labor of getting together to do something meaningful and fun.

I’m also looking for friends with bandwidth. I know what it’s like to have a full life. When I first moved to Muir Beach 18 years ago, I had only one friend, so I was happy to hike with a stranger from social media, just to build a social life. But once my dance card was full, I didn’t have time to meet new strangers, no matter how wonderful they seemed, and my “no” to new friends wasn’t personal. I knew that if I said yes to strangers, I’d be stretching myself too thin and my child, my partner, and my chosen family of friends would suffer. I had to reject very sweet new people to be a true yes to those I put first.

But that’s all changed now. So I’m looking for others who have free time, who work from home or have time off mid-week, or whose weekends aren’t so jam packed that they might have an interest in a new friendship.

It’s Not Just People New In Town Who Need New Friends

I can’t tell you how much it moved me when I asked one woman if she wanted to be friends, explaining that I’m new in town. She got tears in her eyes and said, “You’re so lucky you have that excuse. I’ve been here thirty years and I need new friends.” It made me realize that the loneliness epidemic is legit, especially since the pandemic. And people are craving in person connection, even as we’re scared of taking those risks.

So if you read this and you’re new in town, or if you’re wanting new friends even if you’re not new in town, or if you have plenty of friends but they’ve all let you down and you’re ready for a friend overhaul, or if you started therapy or twelve-stepping or some other transformational journey and your friends did not, I imagine you can relate. And if you’re not, if your friend group is full, cherish them! Life is full of curveballs, and you never know when you’ll be uprooted unexpectedly and plopped down somewhere strange and lonely.

What would your “looking for a new friend” profile look like? What works and doesn’t work for you with your friendships? I highly recommend at least going through the exercise of trying to articulate what you want and need and what you wish for and desire. For bonus points, send it to your closest friends or anyone new you’re hoping to get to know better. I’m going to send mine to a new friend I just met, and like a seven year old girl on the schoolyard, I’ll hope that she likes me.

If you feel inspired to make a conscious effort to build a stronger social network, please join me and Shasta Nelson for Making New Friends As A Grown Up, where we’ll be talking not only about how to meet new people but also how to invest in the friends you already have and how to repair friendships that soured.

Learn more and register here.

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Hi everyone! Before I dig into more deconstruction of harmful New Age belief systems, I just wanted to share with you the news that my co-author Jeff Rediger and I got copies of our book RELATIONSICK this week! I took a video of Jeff opening the boxes. It’s such an exciting moment!

We have a whole chapter in RELATIONSICK deconstructing indoctrinated spiritual beliefs and examining how spiritual bypassing belief systems can influence you to tolerate unbalanced relationships where you give more than you receive and maybe even tolerate outright abuse, in the name of choosing love. This can make you sick, and we explain how in the book.

You can learn more and preorder the book here. We have lots of bonuses if you preorder before October 6!

Okay, thanks for humoring our excitement. Now onto A Course In Miracles. If you haven’t heard of A Course In Miracles, it’s a 1976 spiritual text allegedly channeled by Helen Schucman. The book defines a “miracle” as the simply act of gaining a full “awareness of love’s presence” in a person’s life. Schucman claimed that the message came directly from Jesus Christ, handed to her through a sort of inner dictation. Some consider it the New Age Bible, while many Christians consider it heresy or the work of the devil. Whatever you believe about it, its teachings are all over the New Age, so let’s deconstruct some of its primary teachings, so you can find the baby and throw out the harmful bathwater.

A Course in Miracles and many of its New Age teachers teach the primacy of the belief that fear and love cannot coexist and that every time we choose love over fear, it’s a kind of miracle. Of course, choosing love is a beautiful aspiration and one that lies at the heart of every spiritual teaching. Who doesn’t want to choose love?

Many people have benefited from A Course in Miracles teachings and books like Marianne Williamson’s bestselling book A Return To Love, which I adored when I first read it in 2007, right after I quit my job as a doctor and was grasping for meaning and purpose in an uncertain world. I didn’t feel the same after I met Marianne in person and sat in the first row to listen to her speak about that book and wound up running to the bathroom to vomit (literally.) I don’t know her well, but my experience was one of incongruence. The words coming out of her mouth were hypnotic and inspiring, and yet the energy with which they were poured into the room was nauseating, hypocritical, and dysregulating for my nervous system. I’m not one of those people who are super sensitive to energy, so this surprised me and led me to leave the conference and keep my distance after that.

But it took me many more years to critically examine those teachings from A Course In Miracles, popularized by teachers like Marianne Williamson, Gabby Bernstein, and many others. As part of my ongoing deconstruction from New Age teachings and desire to support others in recovery from spiritual bypassing belief systems that can cause you to tolerate abuse, unwittingly harm others, and lose access to your natural empathy, let’s take a closer look.

First, let me just say that it’s not my desire to strip anyone of teachings that help make you a happier, kinder, more balanced human. Take what works and ignore me if anything I say doesn’t resonate. But if you’re curious to see another side of these teachings, let’s critically examine some of the core premises of A Course in Miracles through a social justice and deconstruction of indoctrination lens.

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Dissecting A Course in Miracles in a few paragraphs would be like trying to pick apart the Bible in a meme. It’s dense, it’s deep, and the teachings can be contradictory, just like the Bible. So I won’t attempt to do anything more than poke a crack in any dogmatic beliefs you might hold regarding this spiritual text. For the purposes of this discourse, let’s just look at the primacy of two A Course In Miracles ideas- that fear is the opposite of love and that the mind is the solution to what stands between you and choosing love.

What if it’s not actually true that fear is the opposite of love? What if it’s true that I can love my BIPOC sister and be legitimately afraid for her safety in an increasingly fascist country because I love her? What if my fear is red-blooded, open-hearted, trauma-informed true fear rooted in love, care, compassion, empathy, and a desire for social justice?

Not only do the teachings of A Course In Miracles lull us into tolerating abuse from people who are happy to get off the hook as we choose love over distancing ourselves because we’re afraid of abusers. I’ve also been given the feedback that A Course in Miracles does not sit well with a lot of marginalized people. Why might this be? Why might we want to rethink imposing its beliefs on others for whom it might not feel empathic, sensitive, or inclusive?

How does “Choose love, not fear” make sense to an immigrant who works three jobs but whose kids are starving, who can’t get ahead because of systems of oppression, who goes to church on Sundays after working all Saturday night, but who doesn’t feel peace most of the time because ICE is breathing down her neck, someone whose thoughts are fearful because of legitimate threats to survival?

I asked ChatGPT to list what’s harmful about A Course In Miracles from a critical thinking, spiritual bypassing, trauma-informed, and social justice lens, and it spit out this:

• ACIM may confuse dissociation with transcendence.

• It often privileges cognitive reinterpretation over nervous system integration.

• It can encourage premature forgiveness before grief, anger, fear, or boundary-setting have been metabolized.

• By framing suffering as a perceptual error, it can inadvertently minimize the reality of abuse, relational trauma, and systems of oppression.

• It offers a universal metaphysical solution to what are often developmental, attachment-based, and neurobiological injuries.

I agree with all that, but let’s get more granular. Let me deconstruct just one phrase. I could do this with almost any passage from the text, but let’s start with one.

What is our purpose?
To attain a peace that passeth understanding.
What is it that attains this peace?
It is the mind.
How do we attain this peace?
Through the practice of true forgiveness.
How do we know when we have it?
When absolutely nothing of this world can disturb you in any way.
You have finally realized, there is no world.

-A Course in Miracles

This all sounds great, right? (To white privileged people). Who doesn’t want peace, forgiveness, and a way to be undisturbed in a disturbing world? Let’s start with unpacking how it might land on someone who’s really struggling in a world not made to privilege them.

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Yesterday, I got on a video call with Maria Shriver’s The Sunday Paper to answer eight questions they sent me via email about the intersection between spirituality and healing. Because this topic is so fraught for me, in the wake of deconstructing from both the scientific materialism of my medical school training and also the religious and spiritual indoctrination of my upbringing and the New Age, I took the time to answer each question in writing. That meant we could go deeper, and we had a very in depth conversation about how spirituality can both heal and harm those with medical illness. I’ll let you know when the article is published in September, but I thought I’d share with you my attempted answers.

1. When you talk about “spirituality” in the context of health and healing, what do you mean—and how is it distinct from religion?

First, let me clarify that I no longer speak about mind-body medicine or spiritual healing. Ten years of research for my book Sacred Medicine taught me that. Now, after doing my own trauma healing work and realizing how important healing trauma can be for those with medical illness, I talk about nervous system-body medicine, which can lead to spiritual experiences. When I’m talking about spirituality, I’m talking about feeling connected to a source of love inside our own hearts, which connects us to the source of love within the hearts of other people, of other living beings, of the plant and animal world, of the Earth and the cosmos. You might call that God or the Universe or Love. I call it my Inner Pilot Light, and I think of that source of love inside each of us as that drop of the ocean of consciousness that splits off to become YOU. I don’t know what happens when we die, but I imagine that drop going back to the ocean and merging once more with the collective consciousness.

As a practitioner and educator of the trauma healing modality Internal Family Systems, that source of love gets called Self with a capital S. The Self in me is connected to the Self in others and can be a powerful healer, inner parent, guide, friend, and source of comfort when we are sick, scared, or vulnerable. It can also be the gateway to experiences of awe, connection, and wonder.

When I talk about spirituality, I’m rarely talking about religion, although some people connect with their spirituality through formal religion. I’m talking more about an experience of mystery, meaning, and awe, something larger than our small selves. Maybe it’s a sense of being in communion with God, but it might just as well be a great piece of art or music, a beautiful sport like watching an Olympic gold winner pull off the impossible. It might be an act of moral courage or heroism, something in nature, synchronicity, a feeling of profound oneness and connectedness, an astronomical event like a solar eclipse or the Northern Lights, a deep, meaningful conversation, a peak mystical experience, or a sense of being connected to someone who has died or knowing something you wouldn’t have any logical way of knowing. I’ve cared for atheists who are deeply in touch with a sense of mystery and awe, and I’ve cared for very religious people who are profoundly disconnected.

When people experience great fear or loss because of medical illness or even a terminal diagnosis, they often come much closer to what really matters, and this can evoke awe-inspiring spiritual experiences for people. Even being close to someone sick or dying can be a spiritual experience for loved ones, so some people experience this by proxy.

Spirituality and religion can also cause great harm. Just look at the course of history to see how religion has been used to annihilate and oppress the masses while a few powerful, mostly white men dominated the world (and still continue to do so), exterminating entire civilizations of nature-worshipping Indigenous peoples. Even New Age spirituality can be very oppressive, fostering spiritual bypassing and causing people to avoid dealing with the kinds of core traumas that can make people sick and make it difficult to get well.

I spent a decade spiritually seeking, but I was also spiritually bypassing, using my spirituality as conflict avoidance in holy drag, as a way to avoid confronting people about behaviors that were not okay with me, as a way to anesthetize the pain of past traumas without dealing with them, and as a way to bypass accountability. But the path that really helped me was Internal Family Systems, which allowed me to continue my spiritual path, to connect with the source of love inside of me (which IFS calls “Self” and which I call my “Inner Pilot Light”), but to do so without avoiding healing my trauma or holding myself and others to account. That was a game changer for me because it’s a non-bypassing spiritual path.

Lately, on Substack, especially since Deepak Chopra showed up in the Epstein files, I’ve been calling out a lot of rot in the wellness and spirituality space, the culty dynamics, the commoditization of spirituality, and the ways certain spiritual beliefs and practices can be used to shut down people’s healthy protest of mistreatment, or to oppress marginalized groups, or to quell dissent. So some forms of spirituality can cause as much harm as healing. But when we learn discernment, we can keep the baby and throw out the muddy bathwater, when we can tap into awe and mystery, calm our nervous systems, and find healthy community to participate in rituals together, when we can use our IFS practices or other non-bypassing, trauma-informed spiritual paths to aid our healing, the comfort we can receive from coming into closer contact with the source of love inside our own hearts can have a profound impact on the healing process.

2. What does the evidence tell us about how spirituality—including meaning, purpose, connection, faith, awe, or belonging—can influence physical health? Where is the science strongest?

In my book Mind Over Medicine, I shared some of the evidence about how people who regularly attend places of worship have better long term health outcomes, not because church or temple or the mosque magically improve your health, but because they bundle together community connection, medicine to ease loneliness, sacred rituals, a connection to the holy, a sense of belonging, social support during hard times, a sense of purpose, healthier lifestyle habits, volunteering, gratitude, and nervous system regulating practices like contemplative prayer or meditation.

Dacher Keltner also presented some research on the science of awe and it’s relationship to health in his book AWE. When we tap into feelings of awe, we wind up less self-absorbed, more generous of heart, less narcissistic and entitled, more willing to cooperate and negotiate needs, and more of a sense of connection to each other and the natural world. Tapping into feelings of awe can lower inflammatory cytokines, reduce the frequency of chronic repetitive stress responses, improve vagal tone, bolster immunity, enhance psychological well-being, and deepen resilience.

But keep in mind that not all awe is benign. If people don’t have solid enough ego strength, unexplainable mysteries of experiences of overwhelming vastness can evoke fear, helplessness, or dissociation. Too much awe can make some psychologically vulnerable people psychotic. The line between awe and overwhelm may depend on whether the nervous system has sufficient safety and support to integrate the experience afterwards, which is often lacking in spiritual communities that might push someone to the edge and then fail to gently ground them back into the world.

To answer the question slightly differently, because my interest these days is primarily in the relational aspects of healing, I also view relational intimacy as a spiritual practice. The feelings of belonging, of being loved, of knowing you’re not alone in the world can be fulfilled as much by a close inner circle of beloveds as by some God in the sky. It brings to mind my friend Jarman.

I told Jarman’s story in my book Sacred Medicine:

That was ten years ago, and Jarman is cancer free and still dancing. That’s the kind of spirituality I’m talking about.

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3. If spirituality can affect health, what might be happening biologically in the brain, nervous system, immune system, or elsewhere in the body?

When we practice trauma-informed spirituality, not the spiritually bypassing kind, we don’t bypass our wounds; we heal them. When we get in touch with the authentic core of who we really are, as both spiritual and Earthly beings, we reawaken something within us that can have profound healing powers. My favorite way of practicing this kind of trauma-informed spirituality is through the spiritual practice of Internal Family Systems, but there are many other paths as well.

When we reconnect to the core of who we are and how belong in the world, we can experience awe, wonder, and mystery, in addition to love, gratitude, and transcendence. Tapping into these kinds of ecstatic emotions, especially if it happens in community, can create the nervous system regulation and hormonal milieu of healing. When we feel safe, loved, connected to something larger, a greater sense of belonging, and a sense of awe in the face of mystery, we move our nervous system into the ventral vagal state and out of fight, flight, freeze, and fawn. Stress hormones like cortisol, epinephrine, and norepinephrine drop and are replaced by the healing hormones of oxytocin, endorphins, serotonin, and dopamine. Inflammation can decrease and immune function can improve. The body’s natural self healing processes are no longer competing with chronic survival responses.

This stands in sharp contrast to those who live under a sense of threat, because of relational trauma, unresolved childhood trauma, ongoing abuse, profound loneliness, or the kind of uncertainty we all experienced during the pandemic and now during such intense political stress. Spiritual experiences can flip people out of that chronic threat physiology, opening up the possibility for not just bodily repair, but relief from psychological stress as well.

The key is to balance spiritual experiences with trauma healing. If we use our spirituality to bypass healing trauma, it can backfire. It might make us feel better in the short term, but if it’s used to avoid conflict, avoid holding abusers accountable, or skip over the deeper work of healing trauma, it can actually be harmful and lead to worse health outcomes. Especially if spiritual experiences are happening in cult-like power dynamics, oppression in the name of spirituality can actually make people “relationsick.” (Preorder RELATIONSICK: Why Putting Yourself Last Is Making You Sick—And How To Heal here.)

4. We often hear about diet, exercise, sleep, and stress as pillars of healthy aging. What might be missing from that list?

Healthy, well-boundaried, reciprocal relationships. In our book RELATIONSICK, Harvard psychiatrist and Princeton seminarian Jeffrey Rediger and I made the case that one of the most overlooked factors that predicts healthy longevity is a strong support network of people who help co-regulate you, whereas the health implications of unbalanced, non-reciprocal or narcissistic relationships can make you sick. If you give until you’re depleted and you’re draining your life force, you won’t have the energetic resources and nervous system regulation to fight off things that can make you sick and activate healing.

Beyond that, a sense of purpose, a spirit of play, tapping into creativity, active community, and a feeling of belonging to a place, to the land, to each other. And we can’t forget the systems that make us sick- white supremacy, patriarchy, homophobia, ableism, poverty, war, and other systems of oppression. Healing is not an individual phenomenon. We can only heal so much inside oppressive systems we only have so much control over.

5. Can someone do everything “right” for their health yet have aspects of their relationships, environment, or inner life that undermine their wellbeing?

Absolutely. When I first took a job as an integrative medicine doctor in Marin County, my very sick, way too young patients were mostly health nuts. They were eating vegan diets, doing green juice cleanses quarterly, working out with their personal trainers, going to yoga and meditating, getting the best conventional medical care at Stanford and UCSF while also seeing their acupuncturist, their naturopath and their herbalist, and taking 100 supplements.

I’ve met Olympic athletes who are getting abused by their coaches, yoga teachers whose nervous systems are on high alert all the time because of what greets them at the door when they leave the yoga studio, and corporate executives with expensive wellness programs at work whose biomarkers look perfect while they’re selling their souls in businesses that are not congruent with their values.

We sometimes ask patients, “What are you eating?” when we should be asking “Who are you eating dinner with?” Optimal health is relational. No amount of kale salads can override the impact on our bodies of chronic, ongoing relational trauma. Optimal health is inherently relational. No amount of kale can protect us from the chronic repetitive stress responses caused by relational trauma, along with the nervous system dysregulation, immune system dysfunction, and chronic inflammation that accompanies not feeling safe, loved, and connected relationally. The same goes for systems of oppression. No amount of supplements can counterbalance the impact of racism on a BIPOC American or the impact of patriarchy on women around the world or the impact of poverty on access to health care, healthy food and water, and other influences that can greatly impair health.

6. What’s the difference between healing and curing? Can someone become healthier or more whole even when an illness cannot be cured?

There’s a vast difference between healing and curing. When we talk about healing a fracture, we usually mean curing a fracture (the broken bone grows back together). In this instance, they mean the same thing. But the etymology of the word “heal” is the Old English hǣlan, which translates as “whole.” To heal is “to become whole.” To be cured means to be free of disease or symptoms. It’s possible to be healed but not cured, and it’s possible to be cured but not healed. Ideally, healing and curing happen together, but this isn’t always the case.

So what does it mean to be healed? Through the lens of Internal Family Systems, healing means recognizing that we’re all a bunch of parts that don’t necessarily agree with each other. That’s why we all make New Years Resolutions that we break two weeks later, because one self-improving part of us made the resolution and another rebellious part never had any intention of sticking with the program. In the same way, some of us can have some parts that want to be cured but other parts that think they’re protecting us by keeping us sick. For example, cancer might take hold because it’s the only way we can get care instead of being expected to give it. Or migraines might be the only excuse we have to avoid our toxic mother in law. Or an autoimmune disease might be the only thing that slows us down enough to practice self care, because otherwise we’re over-functioning, caregiving others, and depleting ourselves.

With IFS, we become whole by getting to know all of our “parts” and bonding them to the wise, mature divine aspect of our being, which IFS calls “Self.” Then we can start making Self-led decisions that are negotiations between many parts. It’s kind of like the soul retrievals we see in shamanic medicine. Sometimes parts of us get split off from the rest of us, and we have to bring them back home, into our own hearts, under the care of the divine Self, back into wholeness.

I don’t believe anyone is ever 100% healed, and I wouldn’t trust anyone who said they were. But when you have done a lot of healing work, wholeness can sometimes be restored at a level that transcends but can also include the body. Whether or not your illness resolves, healing is possible, as anyone who has witnessed a beautiful death can verify. You can be healed and still die, and you can be cured and still largely fragmented and under the weight of a lot of unhealed, bypassed trauma.

When you’re dealing with an illness, the process of being sick can be a spiritual or psychological wake up call, and when we wake up to what’s true about ourselves and our lives, when we can face and deal with current or past traumas that might be impacting our body’s ability to self-repair, when we can integrate the fragmented parts of ourselves that can be the result of trauma, we have the opportunity to come closer to returning to our natural state of wholeness. This state of wholeness can restore the nervous system and body to an optimally relaxed state so the self-repair mechanisms of the body can best do their job and life force can course through you, bringing with it the conditions that help the body repair optimally.

If that’s the case, why doesn’t everyone who does the hard work of healing wind up cured? Why does one person experience radical remission and another doesn’t? The truth is that nobody knows the answer to this question. Some believe that all illness is the result of disordered thinking, that even if your conscious mind believes you can get well, you’ll be sabotaged if your subconscious mind disagrees with you. Some believe that disease is the result of blocked energy in the “biofield,” with energetic interference preceding the physical manifestation of disease, and if the biofield stays blocked, no intervention that excludes clearing this block will lead to the desired outcome.

Others believe that illness results from harmful behaviors committed in past lives, which must be atoned for in this one—that it’s karma which much be expiated. Still others cite divine destiny or believe that your soul chooses to experience certain hardships in a body in order learn lessons here in “earth school” as a way to develop one’s consciousness over lifetimes. Some believe that unavoidable tragedies simply happen at random, rationalizing that our psychological or spiritual attempts to make meaning out of our suffering are just a cover for our discomfort with the uncertainty of an uncontrollable universe and that there’s simply no way to avoid having bad things happen to good people.

I’m not here to discuss theology or spout off about things I don’t fully understand, but I also don’t want to skirt the issue altogether. So what’s my point of view? Why some are cured when they heal and others aren’t? All I can say is this: when my patients have been ready and willing to engage in deep inquiry regarding psycho-spiritual trauma-healing work, stayed open to lifestyle modifications aimed at living a more aligned life, and remained willing to sacrifice comfort, certainty, and security in favor of authenticity, self compassion, relational and spiritual healing, and a commitment to life purpose, seemingly miraculous feats of physical self-repair have sometimes happened.

7. How can we talk responsibly about spirituality and healing without suggesting that people cause their illnesses—or could cure themselves if they simply believed, thought, or lived differently?

Of course it would never facilitate healing to blame someone for their illness. If someone says “Your thoughts created your illness and your thoughts can cure you,” the law of attraction way of thinking, that can be very shaming—and it’s also just false. Most illnesses are multi-factorial. You can get sick because of genetic mutations, living next to a toxic waste dump, eating garbage while smoking two packs of cigarettes per day, never exercising. You can also get sick because childhood relational trauma and ongoing stressors keep the nervous system chronically dysregulated and put the body is a constant fight, flight, freeze, or fawn state that makes physiological self repair nearly impossible.

You’re not to blame for your illness, but you are responsible for doing what is within your power to try on your healing journey. Making that move from “It’s your fault” to “There are behaviors you have the power to change” can make all the difference. Some people do not want to take responsibility for healing. They just want a pill or a surgery and they don’t want to be any more involved than that. Which is fine. Everyone is entitled to their own journey, and we shouldn’t pressure or judge someone who doesn’t want to do the hard work of change.

The truth is that we never know what’s going to happen if someone embarks upon a healing path. Changing your diet might do the trick. Leaving a toxic relationship or working on your boundaries and getting into couples therapy might lead to symptom resolution. Getting in touch with your true purpose and being willing to give up soul-sucking ways of being in the world could turn everything around. Giving up smoking and drinking and training for a marathon might be the solution. But you never know. It’s always a gamble. You could make all the sacrifices, try all the tricks, get all the therapy, and spend a lot of money trying to get well, only to stay sick or even die.

Healing trauma, regular spiritual practice, and non-culty spiritual community can help quiet the nervous system and support people in feeling safe, loved, supported, and open to awe, wonder, mystery, and the healing properties of ritual, so their physiological self-repair mechanisms can function optimally. But even people who do everything “right,” including not just lifestyle choices but spirituality, healing trauma, and avoiding toxic relational dynamics cannot control who stays sick and who gets cured, who lives and who dies.

It’s comforting to some people to believe that they have 100% control over their lives, that there’s no such thing as random suffering. But no matter how much it comforts them to believe this, it’s just not true. Bad things happen to good people who do everything “right,” and sometimes, there’s no explanation for that at all.

What can be empowering, however, is to take responsibility for what you do have the power to control, so you’re not just a helpless, powerless victim of your illness, and to restore some agency. You get to exercise your agency to change the things you choose to change, and then to let go of the handle of control and trust that you’ve done what you can.

8. For someone who isn’t religious but wants to explore the spiritual dimension of health while staying grounded in evidence-based medicine, where would you suggest they begin?

I wouldn’t even talk about spirituality with someone like that. I’d say “What makes you come alive?” I’d talk more about vitality, life force, and joie de vivre than spirituality. Anything that helps us get in touch with the will to live is a spiritual experience.

That might be feeling the wind in your hair as you walk beneath redwood trees. Or gazing into the eyes of your newborn grandbaby. Or letting your heart blast open while listening to music that moves you to the core. Or losing time because you’re so in the flow of a creative project that you forgot you were sick. It could mean fighting the good fight protesting injustices in the world that leave you outraged and make you feel like you’re living in alignment with your core values. Going on a retreat by the sea. Giving thirty gifts in thirty days to feel more generous. Volunteering.

If you’re more of a giver and you need to learn to receive, that could mean surrendering yourself into the loving arms of a caregiver who takes joy in making your days beautiful. It could mean staring at the night sky and remembering how small we are, but also how precious. It could be attending a workshop where you feel seen, heard, and loved, without judgment and with full openness of heart. It could mean being inspired by people with the moral courage to do brave things that benefit the world, reminding us that we can all choose to become morally courageous people whose lives have meaning as well.

The healing aspects of spirituality have nothing to do with religious or New Age beliefs. People with vastly different belief systems can still benefit from the increasingly sophisticated body of scientific research linking health and trauma-informed spirituality.

What Do You Think About Spirituality & Medical Illness?

I’d love to hear how YOU would answer these questions! Post your comments below and let’s crowd source this.

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*Photo credit Monique Feil

Last year was a hard one because, against my wishes, I had to leave my home of 17 years in Muir Beach at the same time as I had a new empty nest, my housemate and chosen family of 15 years moved to New Hampshire, my daughter’s father, who lived next door for the decade after our divorce, expatriated to Portugal, and I lost my local community. This put me far away from my previous friends.

What I got in exchange was my partner Jeff and a new life in West Sonoma County, after Jeff quit his job at Harvard and took a psychiatry job in Santa Rosa to be closer to me. We’d been bicoastal for three years, so that was a huge boon, because a long distance relationship was hard. I literally never knew what was in which refrigerator where, and I felt like my heart was split—between two sets of friends in two locations. I kept missing important milestones with both, and I felt like I was a sucky friend on both coasts.

And now I’m far away from all those friends, East Coast and West. Some of them will make the drive and come for a sleepover, and I’ll do the same. But it’s not the same as walking next door or meeting up halfway for a daytime activity.

So now I’m new here in West Sonoma County and I don’t have a single close friend or family member within easy driving distance for lunch, an art project, or a hike. And that’s tough. I never truly comprehended what it felt like to be “placed” until I was displaced. I still get teary when I write that.

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Here in West Sonoma County, I don’t know my neighbors. I don’t know the plants or animals. It’s far enough north of Muir Beach that many things in my coastal environment are different. In Muir Beach, I knew where every patch of bloom lived and what time of year it would bloom. I knew many of the animals, some of them by name—the fox babies, the bobcat that liked to sit on the cliff and gaze at the ocean, the two owls in the eucalyptus tree on the Owl Trail, the whales that breached as they passed by.

Here, I’m meeting the swallows nesting under my roof and there’s far less fog, so I can actually grow tomatoes! But the hardest part is that I went from living in community, in a small town where I’d know at least half the people if I walked down the street, where I could walk next door for coffee with Nicki to process how our “parts” are doing with IFS work. Now, I’m mostly alone all day until Jeff gets home from work, and if I do walk down the street, it’s busy coastal highway that’s not safe to walk on, and I won’t see a single person I know.

I don’t mind being alone. I’m a writer. Writers can be entertained anywhere there’s a computer or empty note pad. But I’m realizing it’s too much pressure to put on Jeff to expect all of my needs to get met in one place. And so…after a year of settling in, of moving twice, of getting my daughter off to art school and thriving, of making some big changes in my business, of finishing up two books I’m publishing, of teaching myself how to sew (very badly), I’m finally prioritizing trying to make new friends and embed myself in the local community. I’m ready to feel “placed” again.

The Quest To Feel Embedded In Community

Trying to find my new people feels soooo vulnerable. Especially after lots of therapy and realizing that my previous ways of connecting were sometimes fawning trauma responses or controlling and rescuing people I deemed in need of help. Especially after being onto myself for sometimes selecting as friends either individuals high on the narcissism spectrum who I could look up to or those too low on the narcissism spectrum who I could control, I want to be intentional about how I go about this after lots of therapy.

So now I’m starting over again, and I’m wanting to be very intentional about my new friend-seeking journey. I took a weaving workshop at the Sebastopol Center For The Arts and vibed with the woman at the table next to mine, who is a middle school art teacher. At the end of the workshop, I approached her and said something messy like, “I’m new in town and I don’t have any friends here yet. Do you want to be my art friend?” I felt like an 8 year old on the schoolyard, shy and awkward and hoping she’d like me. She smiled and said she’s love that and gave me her number. We met up for a live outdoor concert with both our daughters and spent a couple days going to open art studios with our kids before she went off to vacation for the summer. Both Mira and I had a blast with them and I miss her already and am looking forward to her return, but feel too shy to tell her that.

I met another woman through the Empty Nest Supper Club I started. She invited me to come over to lunch at her new home in Occidental, to plan our next supper club. She made me this gorgeous lunch—lentil soup, the best bread with beet hummus, a salad with just the right salad dressing. Curiously, when I entered the home, I realized it was the same house Jeff and I had considered moving into when we were trying to find our next home! She gave me some great advice about making new friends later in life, namely, that you have to make it a real commitment, because once you’re not in school any longer and once your kids are not in school, it’s just so much more challenging to make new friendships work. She told me to be persistent, to push people for actual dates on the calendar, to refuse to settle for text friends, who aren’t really friends at all. We’ve had several fun friend dates, and I really like her. I said “I hope we can be friends” and she said “We already are.”

I’ve been going to Stitch & Bitch on Tuesdays, a handiwork circle at the Community Market in Sebastopol, where I met another girlfriend whose art studio I recently visited. She makes the coolest felted witchy hats and Dickens Fair-eque capes and shawls. We might join up at my Art Barn to participate in open studios for Art At The Source next summer, with my new upcycled clothing line Wilderloom and all her amazing hats and capes and woven treasures.

I’ve already tried on a few other potential friendships that didn’t quite work out, so not every friend date turns into a friend. I’ve realized I’m way more picky at this phase of my life. I met one woman who seemed cool, and we hung out a few times. But after inviting her to an event I had to buy tickets for, and after she cancelled without any explanation and didn’t offer to even pay for her unused ticket, I realized I don’t have a lot of patience for flakiness or for making and breaking plans for no good reason. I also pick up real quick whether someone lacks much capacity for empathy, and I’m allergic to that.

I had another friend date that quickly soured when she started killing living things in a protected sanctuary that she wasn’t planning to eat. As the “squirrel girl” who spent my childhood taking in injured baby squirrels and birds, and as the one who throws back the starfish and sand dollars when they’re stranded on the beach, this behavior made me question whether she lacked empathy. Empathy and a love and protection of living things is a key quality I’m looking for in friends. Both of these realizations put me in touch with parts of myself that are important to me and also parts of me that don’t like it when someone else doesn’t share those values.

Frientimacy

When I found out I was going to have to leave my longtime home and I told my literary agent Michele Martin, she asked if she could connect me with another client of hers, Shasta Nelson, who calls herself the Chief Friendship Office and is the author of Frientimacy. I was a quick yes and hoped she’d live close enough to me to be my new bestie. She too had just moved and was writing a book about friendship after relocation. She asked if she could interview me and I said it was too soon! I’d only just moved weeks before. I hadn’t made a single new friend and didn’t have a lick of advice to give her for her book.

But a year later, we just reconnected to compare notes on how building our friend circles is going. She was font of knowledge about friendship! When I told her what I was doing, she started spouting off research and reassuring me that what I was doing—bonding through play and shared interests—was actually the most successful way to make new friends of all six strategies.

We started talking about the vulnerability of making new friends, and I told her a story about one woman whose number I asked for. I said, “I’m new in town and I don’t have any friend, and I enjoyed dancing with you. Would you like to share numbers and consider being my friend?” She got a little weepy and said, “You have no idea how lucky you are that you have that excuse.” And then I got a little teary, because I imagine she’s right. It’s maybe what’s motivating me to bring casseroles to my new neighbors quickly and take advantage of being new in town.

But that got me thinking. How many of us are not new in town, but we’ve lost friendships because they weren’t healthy or because we got ghosted and don’t know why or because we never really knew how to make friends that weren’t transactions to begin with or because when inevitable ruptures happened, we didn’t have the relational skills to repair or to own up to our mistakes and hold other people accountable for theirs?

In Navigating Changing Friendships When You’re Healing Trauma, I wrote about how we might no longer feel like we belong in our friend group once we’ve healed old relational patterns in therapy. But then what? What do you do if you best friend insists on controlling you and isn’t interested in learning how to share power and negotiate needs reciprocally? What if you’ve only attracted people who expect free listening, caregiving, and emotional support but don’t have any interest in returning the favor?

How many of us never got taught how to relate without transacting? Or how to have good enough boundaries not to lose ourselves or drive people away? How many of us had a friend group but those friendships were trauma bonds we outgrew when we got therapy or started doing our healing work? How would we even know how to discern whether someone new we’re meeting is a good fit?

Shasta and I talked about how to go on friend dates and get to know our own parts and practice what we’ve learned in therapy, to spot our tendencies and try something different. Like what if we don’t have to choose friends who are injured birds we can rescue or find someone powerful and competent we can give our power away to? What if we don’t tolerate one-way friendships and only accept reciprocal bonds? What if we don’t sell ourselves as someone useful to another person but just have enough self confidence to know and trust that we’re lovable just as we are? What if we also aren’t engaging in magical thinking and assuming people will just show up at our door, introducing themselves as our new bestie?

All this got me and Shasta excited to collaborate. She’s a super busy jet setter, so we can’t do a whole class together. But she’s agreed to be a special guest in a class I’m hosting Make New Friends As A Grown Up & Make Old Friendships Better.

Learn more and register for the early bird discount here

We can get so obsessed about dating, finding a partner, making our marriages and long term relationships better, building a family, and establishing a career. But friends often get relegated to the back burner, even though the statistics show that it’s more often our friend group that gives us the greatest joy and ease and the longest, healthiest lives.

I’m super psyched to teach this IFS-informed six week online class about friendship and hope those of you who are awkwardly shy alongside me will feel inspired to join me (and an awesome bit of Shasta) live on Zoom starting August 24 (or listen to the recordings.)

I'd love to hear about how you make new friends once you're no longer in school. What has worked for you? Where have you found your people? What tips would you give to someone new in town or someone who finally stopped being a workaholic or someone with a new empty nest or someone who did a lot of therapy and no longer fits with their former friend group because they've healed unhealthy relational patterns?

*Image credit Nicolay Kreidler

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Yesterday, I gave y’all the back story about why my co-author of Relationsick Jeffrey Rediger and I included Chapter Six in our discussion about why some people give too much, receive too little, get exploited, and wind up relationsick. (If you didn’t read it, read this first.)

Today, as promised, I’m sharing with you an excerpt from Chapter Six explaining how religious and spiritual indoctrination can set us up to tolerate relationships that aren’t balanced or healthy. So let’s dive in!

You can preorder RELATIONSICK here.

Excerpt from Chapter Six of RELATIONSICK

While this book was originally inspired by the radical remission survivors from our research, the kinds of relational trauma that lead to relationsickness, and the belief systems that cement them in place, are very personal for Jeff, the coauthor of this book. Jeff grew up on a farm in Indiana, in a house where chores were done early, the Bible sat open on the kitchen counter like a command, and nightly Christian readings were followed by kneeling by their dinner chairs for long, droning prayers. Jeff’s mother followed her church’s interpretations of the Bible’s teachings like she was steering a ship through a storm.

But it wasn’t just the Bible she followed; it was also cult leader Bill Gothard, founder of the Institute in Basic Life Principles (IBLP). Gothard’s teachings were treated as gospel in Jeff’s house, even more than the scriptures themselves. Gothard had a formula for everything: how to raise children, how to handle sin, how to be a godly man, and especially how to break the will of children in order to keep them in line.

By the time Jeff was six, he knew how to sit still as stone in church with a smile plastered on his face, even as his stomach was in knots. He knew that boys obeyed their parents, and mothers were supposed to obey their husbands, even though his iron-fisted mother seemed to be the one who wore the pants in the family.

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Maybe Jeff’s mother believed with her whole heart that she was protecting her boys, that she was saving their souls from the ruin of willfulness. But those teachings hollowed her children from the inside out. They were designed to separate children from their bodies and from their natural instinct about right and wrong, to install an inverted morality of obedience and conformity, rather than a morality built on dignity, justice, or the belief that all human beings have equal value. Having feelings, opinions, or your own perception of reality was dangerous and ungodly. Good little boys and girls bowed to whoever dominated, keeping any sense they had that something was “off” to themselves.

During the normal stages of childhood development when children practice setting boundaries, saying no, and asserting themselves, Jeff was beaten by both his mother and his father, trained to fawn—to please, submit, comply—or else face physical and emotional consequences. Otherwise, they told him, he would bring shame to the family and burn in the endless fiery flames of eternal damnation. Questioning authority was framed as rebellion against God Himself. Self-sacrifice was seen as holy. In IBLP’s teachings, martyrdom isn’t a tragedy—it’s a goal.

Along the way, Jeff internalized the idea that his body was not his own, and that his unique thoughts and feelings were a threat. So when physical, emotional, or other lines got crossed, when things got dark or confusing, he didn’t fight or flee. He performed. Until he started dissociating and couldn’t concentrate anymore, he wowed the teachers, got straight A’s, and won the spelling bees. He also got quieter, shyer, and more obedient. He tried his best to become the good son, the respectful Christian boy, and later, the dutiful husband. He wore the mask so well, no one ever thought to look behind it and wonder who he really was. Because he was trained not to draw attention to himself, he told no one when at age sixteen he had severe chest pain in the basement of his house, later diagnosed (when an EKG showed the resulting permanent changes) as a heart attack. He also developed chronic, debilitating back pain.

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My co-author Dr. Jeffrey Rediger and I are busy preparing to birth our book RELATIONSICK, which you can preorder here. If you don’t know Jeff, he’s a super interesting, brilliant, funny, and kind Harvard medical school professor and psychiatrist who also went to Princeton seminary, making him an authority on talking about all things at the intersection of science and spirituality. He’s also a cult survivor who was born into a fundamentalist cult in Indiana, was raised in a culty family, joined another cult in his mid-thirties, and then got involved in several culty relationships where he got severely financially exploited. Jeff shares much more about his personal trauma history and his Adverse Childhood Experiences (ACE) score of 8 in the book Relationsick, but let me give you just a bit of his history, so you understand why I asked him to co-write this book with me.

As we get ready for the book launch, Jeff and I are spending so much time, in conversation and in therapy together, pondering how Jeff tolerated decades of ongoing mistreatment from the family that shunned him, how he repeated a pattern of tolerating exploitative relationships, how he serially let women use him for his money without expecting them to contribute in a balanced way, and how his religious upbringing and New Age spiritual beliefs rendered him conflict avoidant to the point of not holding people who exploited him to account and not pursuing justice when he was the victim of countless injustices.

Even as he became wildly successful in his professional life—as a Harvard medical school professor, widely respected psychiatrist appearing on The Oprah Winfrey Show, and bestselling author of CURED, he had to eventually face the hard reality of realizing that what makes you successful in your career has nothing to do with what it takes to be successful in intimate relationships, and intimate relationships is where we replay childhood wounds.

We spend some time nearly every day deconstructing the patriarchal and religious beliefs he acquired while growing up in the IBLP cult, which were then further reinforced when he went to Princeton seminary and then joined an Eastern Orthodox cult. Once he broke free of those cults, he got indoctrinated into the New Age nonsense we’ve been deconstructing here on my Substack. All of that indoctrination caused him to repeat a pattern of attracting and choosing people who exploited him—all while being blind to the fact that this was even happening. With Jeff’s consent, let me give you an example of what I mean.

“Men Have Responsibilities; Women Have Choices”

When he was studying John of God, the now imprisoned cult leader who sexually assaulted 500+ women, Jeff met an American woman in Brazil, a meditation teacher. She made her own money teaching workshops, but after the two of them hooked up romantically, she quit her job and stopped contributing financially. They didn’t have children for her to take care of, and she didn’t cook or take care of him in the ways a traditional stay home wife might, but she still assumed he’d pay all her bills, take her out for dinner every night, and put her on his health insurance. As a man indoctrinated into patriarchy and Christianity, Jeff didn’t question this. He thought it was his job to financially provide for her, even though he did not want that responsibility, felt burdened by it, and had to get a second job in order to afford doing so.

When they were dating, he felt a breast lump in his then girlfriend, and when he asked her about it, she told him it had been worked up, and it was a benign cyst. But shortly after they got married and he put her on his insurance, she told him she had breast cancer and needed cancer treatment. (Benign breast cysts don’t just become cancer.) He didn’t think about it that way at the time, but looking back now, it’s obvious she lied to him, tricked him, and used him for his health insurance.

She then convinced him to turn over financial power of attorney to her, which he didn’t resist, because he didn’t quite understand what that meant. She started paying herself a $120,000/year salary, to do nothing but stay home and meditate and let construction workers into the house to renovate their mansion. She claimed she needed this salary so she could max out her 401K.

When I asked Jeff why he didn’t get upset when he found out he’d been lied to about the breast lump, and when I asked him why he agreed to pay her bills after she quit her job, and when I asked why he agreed to pay her a six figure salary to do nothing, he said, “I thought back then that that’s what the guy is supposed to do, pay for everything women want. Men have responsibilities; women have choices.”

As the full financial provider for 13 years for my daughter’s father, my daughter, and I, as someone who has not once had a man pay her bills since my parents paid for college, I scoffed at this sexist comment that revealed the extent of his patriarchal indoctrination. But Jeff really believed that when I first met him, that women could choose to stay home and not work, but men had to be providers, even if the women in their lives wanted to sit home eating bonbons, without being homemakers or stay home mothers.

Keep in mind that this distorted way of thinking is not Jeff’s fault. Patriarchy and bad religion harm not just women but also men. Jeff had been groomed since early childhood to believe that his only value in the world rested in his ability to earn money. He started working at the age of 13 and was working full time from the time he got his driver’s license, working multiple jobs. His violently abusive mother let him keep 10% of his income but took 90% for herself. Even that 10%, which he thought he was saving for college, was stolen by his mother, such that his bank account was empty when he went to pay for college after getting accepted to Wheaton College at 18.

Jeff has been actively in the process of deconstructing his indoctrination, so when I ask Jeff now why he didn’t hold his ex-wife accountable for lying about having breast cancer, using him for his health insurance, requiring him to give over power of attorney of his money, and then paying herself a six figure salary, he said:

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I Was Indoctrinated Too

My own indoctrination was less severe than Jeff’s, but in the past, I shared with him my tendency to avoid conflict. I failed to hold people who hurt me accountable, and I inflated myself with the grandiose belief that this meant I was a good and spiritual person, thinking that angry people or people who pursued justice were less than. I told Jeff how busted I felt when I read the Robert Augustus Masters book Spiritual Bypassing, based on John Welwood’s coining of that term. The following section took the wind out of my lungs and knocked me flat.

Gulp.

I just read this to Jeff right now and Jeff said, “Yup. Me too.” We were both so naive. We honestly thought that’s what love requires.

Then there was the dawning reality of what I’d done, the number of times I should have called the police and hadn’t, the number of abuses and exploitations I had endured without confrontation, the way I tolerated abuse and blamed myself, all in the name of being a good and spiritual person practicing unconditional love and non-judgment. A wave of grief flooded over me when I realized how I’d participated in enabling abuse and attracting more exploitation and trauma, all in the name of spirituality, femininity, and being good.

Deconstructing indoctrination and healing the trauma that underlies it is a brutal task. I’ve been doing it for 13 years now, and since Jeff and I started talking about indoctrination and deconstructing spiritual beliefs seven years ago, I’ve watched Jeff reclaim his healthy, boundary-protecting anger, just like I’ve reclaimed mine. I’ve watched Jeff twist his brain into a million contortions to avoid throwing out all of Christianity and New Age spirituality categorically, to find his own baby in the wildly oppressive bathwater of patriarchy, fundamentalist Christianity, and New Age spirituality. I’ve watched him struggle with the question of “What is masculinity if not to provide for the financial needs of women while remaining a stoic rock with no feelings and zero boundaries?” I’ve watched him wonder about power and privilege, attempting to own and understand things like white supremacy, patriarchy, and how religion and New Age spirituality anchor in systems of oppression. And how he’s personally benefitted from those systems of oppression, even as his mother (with internalized patriarchy) was the one to beat him the most aggressively.

This is why we included Chapter Six in Relationsick, which is about spiritual bypassing and how this form of conflict avoidance in holy drag enables some people to use people exploitively, to take advantage of others, to abusively take without giving much in return—and to get away with it. Leading up to that chapter, we talk about fawning behaviors, how some people go “one up” in relationships while others go “one down,” and how a lack of healthy confrontation, accountability, justice-seeking, and boundaries can get you sick.

Some people fawn and get exploited without religion, spirituality, or patriarchy as part of it. But more often than not, especially for fawning women, it’s the practice of spiritual bypassing (and patriarchy) that anchors in the conflict avoidance that leaves us unboundaried and unprotected.

I used to obsess over the lyrics of this one song by Alanis Morissette’s song You Own Me Nothing In Return.

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I’d listen to this song on repeat. I was convinced this was the most divine love one could give to someone, and I wanted to be the giver of that much love, even if I didn’t get anything back. It felt blissful, even ecstatic, to try to love someone this much. I played this out in one relationship after another until things hit rock bottom and I could no longer avoid facing how I participated in this exploitative dance—because my own boundaryless mother had used me for her own narcissistic purposes, which set me up to normalize transactional relationships that weren’t balanced.

Of course this set me up to attract people who are more than happy to accept one way giving, without any expectation of reciprocity. When we give until we’re depleted, expecting little in return, we might as well have a mark on our foreheads for people who have no qualms about taking advantage of our generosity. Con artists and even mostly good people who might have some opportunistic tendencies are then free to run amok with our hearts, our money, our bodies, our status, our caregiving, and anything else they might want—with no strings attached.

When we’re doing this—and thinking of ourselves as especially spiritual for doing so— we’re not just saying yes to things that don’t feel okay. We’re also not saying no, because in our indoctrinated minds, doing so would mean we’re not being generous and unconditionally loving, with no strings attached. We’re thinking, in our distortions, that protecting ourselves and expressing displeasure would mean that we’re not enlightened enough or loving unconditionally. We’re thinking we’ve outgrown the low vibe of anger or resentment, and we’re in a high vibe state of love, when we’re actually just enabling others to take advantage of us, which is self-sacrificing martyrdom, not healthy spirituality. When we believe that tolerating the intolerable or holding someone accountable means we’re not loving them enough, we’ve set ourselves up for relationships that lack healthy, appropriate reciprocity—not bean counting, but reasonable fairness between giving and receiving.

Underneath all that naively neurotic tolerance is a little whimper that’s saying, “I’m not worth reciprocity. I don’t deserve justice. Nobody will love me if they’re not allowed to exploit me. My only value is in being used.” In other words, we’re not being unconditionally loving with our wounded inner children.

Back in 2013, when people were exploiting me right, left, and center, my repeating. mantra was “Who’s got my back?” I didn’t know who to trust and I started to get paranoid. But that’s because I didn’t have my own back. I wasn’t in Self, protecting my parts and helping them get their needs met. I was blended with a Self-like spiritual bypassing part that inflated me into thinking I was so spiritual with all that over-giving.

Here’s the bitter pill.

This is not love. This is getting used. And this kind of relational exploitation can make you relationsick. We explain how this happens physiologically, with evidence based science and a six step program for healing relationsickness, in our new book Relationsick. (Order it here.)

Jeff is lucky that his body held out through these experiences, but not everyone’s does. In our research on people who were cured from seemingly incurable diseases without conventional medical treatment, one of the most common explanations they cited in our combined research of 33 years was that they removed themselves from exploitative dynamics, stopped overgiving and learned to receive, did their boundary work and learned to say no, deconstructed indoctrinated belief systems that anchored those unbalanced relationships in place, and did the therapy work to insist on more reciprocal relationships. We hope all of you are interested in doing that same work, as preventive medicine or as part of a balanced medical treatment plan for a chronic or life-threatening illness.

In my next post, I’m going to share an excerpt from Chapter Six, so please subscribe if you want to make sure you don’t miss it.

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Have You Been Subjected To Indoctrination?

We can’t break free from indoctrinated belief systems until we start getting curious about our beliefs and doing the hard work of deconstructing what’s really true and helpful and what’s nonsense. We’ve all been indoctrinated in some ways, because the culture overlays beliefs on us that we never chose. What’s your story? What’s your relationship to indoctrination? Feel free to share in the comments below.

*If you preorder Relationsick now, it really helps us! Please considering giving the book a head start by showing the publishers and booksellers that you care about this book about the health implications of giving too much, receiving too little, narcissistic abuse, coercive control, indoctrination, and how it impacts your physical body. Preorder Relationsick here.

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“Your ego is the problem,” says the guy on stage from the lotus position. “You have to transcend your ego,” he bellows, while claiming he has the 411 direct dial to God and seeming clueless about how egotistical such a claim might be. While informing you that the monkey mind is a pig you need to kill, while demanding that you meditate more in order to shut up that monkey, while inviting you to get your ticket to the next workshop, he promises you that if you do this, all of your optional suffering will finally be over. Then you can rest in enlightened bliss, no matter what’s happening around you, just like him, the one who has successfully killed his ego and is now perpetually in the “no self” of non-duality.

If you’ve spent any time in spiritual circles, you’ve probably heard some version of these “get out of your ego” teachings. They are repeated so often that they’ve become almost unquestioned in certain communities. The implication is that your ego is the sole obstacle standing between you and enlightenment, inner peace, divine love, awakening, spiritual guidance, perpetual bliss, and freedom from suffering.

But what if that’s exactly backwards? What if, instead of needing to destroy your ego, you actually need to strengthen it? Sure, some people are full of themselves and humility might be the right medicine for them. But many people who are drawn to spiritual seeking are not suffering because they have too much ego; they’re suffering because they don’t have enough.

Your Ego Is Not Your Enemy

Your ego is not a demon you need to slay. It’s not a monkey mind that needs to be silenced. It’s not an annoying stream of thoughts floating by like clouds during meditation. Your ego is a child in need of your unconditional tender-hearted love.

It’s the psychological structure that allows you to know who you are. It helps you distinguish “me” from “you.” It’s a constellation of parts that, when reasonably integrated, help you build a stable identity that allows you distinguish yourself from someone else, that helps prevent enmeshment and boundarylessness, that protects you from cult leaders who want to encourage you to merge with them (in the name of divine merging.)

Your ego lets you make clear decisions, tolerate not getting what you want, delay gratification, regulate reckless impulses, and maintain healthy boundaries. It allows you to remain yourself while staying connected to others.

When we think of egos, we tend to think of loud, arrogant, or narcissistic people, but those people don’t have healthy egos. They have overbearing, unhealthy egos that often mask an unstable identity because of childhood trauma. A healthy ego is quietly sturdy. It knows where you end and someone else begins. It can say yes without collapsing into people pleasing, and it can say no without drowning in guilt or fear. A healthy ego can tolerate disagreement without feeling annihilated. It can admit mistakes without falling apart and receive feedback without becoming defensive. Ironically, when someone has genuine ego strength, they usually don’t spend much time defending their ego. They don’t need to. They have enough ego strength to handle the nuance of “I’m a generally good person who just did something not so great.”

Early Childhood Trauma Impairs Healthy Ego Development

Developmental trauma doesn’t simply leave painful memories; it interrupts the normal development of the self.

Children who grow up with chronic neglect, emotional abuse, coercive control, parentification, enmeshment, narcissistic parenting, addiction in the family, or unpredictable caregivers often never get the opportunity to develop a stable internal sense of who they really are. This core confusion of identity actually makes people with weak ego strength more likely to pursue spiritual seeking, to try to fill a void that wouldn’t feel so empty if they had a healthy ego.

When there’s not enough ego strength, kids grow up not knowing how they actually feel and what they really need. Instead, they learn to ask, “What does everyone else need me to feel?” Instead of wondering, “What do I want?” they become experts at asking, “What will keep me safe?” Instead of trusting their own perceptions, they learn to distrust themselves and depend on external authorities to tell them what’s real.

Survivors of the kinds of trauma that impair healthy ego development often develop wobbly identities organized around pleasing others, avoiding conflict, disappearing, caretaking, perfectionism, over-achievement, or hyper-independence. These strategies may look like a self, but underneath them is often a fragile sense of self that never got the chance to fully form.

When people like this encounter teachings that tell them to “let go of your ego,” they may eagerly comply. This isn’t spiritual surrender. It’s survival. One problem with this is that there isn’t much self there yet to let go of. The other problem is that it’s also catnip for cult leaders who are looking for people with weak enough egos that they’ll cooperate with the program of surrendering their free will, personal agency, and self protection—and do whatever the cult leader orders them to do.

The Difference Between An Unstable Self Or Weak Ego Strength & IFS’s “Self”

One of the reasons conversations about the ego become so confusing is that psychology and spirituality are often talking about two different things using the same language. When psychologists talk about a healthy ego, they’re talking about the developmental achievement of having a stable sense of selfhood, of identity. This includes knowing who you are, being able to separate and distinguish yourself from others, trusting your own perceptions, regulating your emotions, making choices aligned with your values, maintaining healthy boundaries, and staying connected to others without losing yourself. Developmental psychologists sometimes call this ego strength. Internal Family Systems would describe much of this as having protectors (parts) that are no longer forced into extreme roles because the inner system feels fundamentally safe.

Self, with a capital “S” in Internal Family Systems, is something else entirely. The IFS version of “Self” is not your personality, identity, or a constellation of parts. It’s not your life story, the roles you play, your preferences, your beliefs, or even your character strengths. Self is the spacious, compassionate awareness that can hold all of those things without becoming identified with any of them. Every religion has a name for this aspect of your being that is your birthright, that you’re born with, that can’t be damaged by trauma. The IFS “Self” isn’t something you create. It’s something you uncover as your wounded and protective parts begin to trust that they no longer have to run your life.

What creates a lot of suffering is that people with developmental trauma often have less access to both a coherent, healthy ego and to Self. Self is already there, but a healthy ego often has to be built, because you’re not born with a healthy ego. You’re supposed to develop it as a developmental task of childhood.

When your nervous system has spent decades organized around survival, you’ll tend to stay blended with protective parts almost continuously. The inner critic is bashing you. The people pleaser is fawning and accommodating and throwing other parts under the bus to keep the peace. The perfectionist is striving. The overachieving part is succeeding. The caretaker is scanning everyone else’s emotions and trying to juggle everyone’s needs. The intimacy avoider is trying not to bond, not to love, not to feel. These parts aren’t your Self, but they often become mistaken for your identity because they’ve been running the show for so long. But they’re not a solid, stable core identity, or ego.

Trauma treatment helps build ego strength by healing the developmental injuries that left the personality fragmented or unstable. As that healing unfolds, something else happens. Protective parts begin to relax, and when they relax, Self naturally becomes more available.

Notice the order. We don’t try to kill an unstable ego, and we don’t strengthen the ego instead of accessing Self. We strengthen the ego enough that it no longer has to defend itself so relentlessly or act out in unhealthy or even reckless ways. A healthy ego becomes a good steward of ordinary life while Self becomes the wise, compassionate leader of the inner family. They’re partners, not competitors.

If your psyche is a sailboat, Self is the captain. It knows the destination, remains calm during storms, and can see the horizon. But your ego is the ship itself. It provides structure, stability, boundaries, navigation systems, and protection from the waves. Your parts are the crew, each with different jobs, strengths, and fears. No one would suggest throwing the ship overboard because the captain is what really matters. Without a sturdy ship, the captain has nowhere to stand. Likewise, a strong ego doesn’t compete with Self; it makes it possible for Self to lead.

Ego Development Comes Before Transcendence.

Long before anyone can transcend the ego, they first have to develop one. Erik Erikson described healthy psychological development as unfolding through predictable stages across the lifespan. In the earliest years, infants develop basic trust. Toddlers discover autonomy. Young children begin to experience initiative, competence, and eventually a coherent sense of identity. Each stage builds upon the one before it. When these developmental tasks are interrupted by trauma, neglect, abuse, or insecure attachment, the resulting wounds don’t simply disappear because someone starts meditating or attends a spiritual retreat. They wait, undeveloped, often remaining hidden beneath spiritual language, under spiritual bypassing belief systems and practices, until life’s inevitable challenges expose them and reveal the cracks.

Object relations theorists like Donald Winnicott similarly recognized that a child develops a stable sense of self only when caregivers consistently mirror, protect, and delight in the child’s authentic experience. A securely attached child gradually internalizes the feeling, “I exist. I matter. My thoughts and feelings make sense. I can survive disappointment without losing myself.”

When those developmental experiences are missing, people often grow into adults with weak ego strength. They may struggle to know what they feel, what they want, or where their boundaries belong. This makes these people vulnerable to enmeshment, coercive control, authoritarian leaders, or dominating, narcissistic relationships in which someone else defines reality for them and they give their power away because they lack the ego strength to stay separate enough without collapsing.

This is why trauma therapy often begins not with helping people become less attached to themselves, but with helping them become more securely attached to themselves—parts to Self. We learn to notice our feelings and bodily sensations. We learn to trust our own perceptions of reality. We discover that we can tolerate conflict and hold people who hurt us accountable without exploding. We learn to protect our boundaries, to recover a sense of agency, to become someone who can remain connected without disappearing.

In Internal Family Systems, this process isn’t viewed as inflating the ego, as cultic narcissistic spiritual leaders would have you think. It makes sense that spiritual teachers who seek power and control over vulnerable spiritual seekers without enough ego strength would perceive someone else’s no, someone’s firm boundaries, or someone holding them accountable as “being in your ego.” If your ego is bad and you’re in your ego when you’re angry or calling out the cult leader, then by golly, that ego best be smashed so the cult leader can get away with anything they want, no matter how out of control their own overbearing ego might be.

But don’t take the bait. That’s just a strategy to silence dissent, shut down your healthy protest, demonize anger, and scare you into spinny-eyed compliance.

Your ego is supposed to protest when someone is controlling you. It’s supposed to hold your boundaries when someone else is crossing them. It’s supposed to feel angry when you’re being violated or someone else you care about is getting hurt. It’s supposed to resist oppression and retain agency. That way, your ego can ultimately surrender to the greater wisdom of your own Self inside.

Only then does genuine surrender become possible. Otherwise, what looks like surrender is often unhealthy compliance. What might look like egolessness is often identity diffusion. Identity diffusion can masquerade as egolessness, but healthy egolessness is the ability to loosen your identification with a stable identity, to be less rigid and more flexible. Identity diffusion is what happens when there was never a stable identity to loosen. Healthy surrender of the ego to the Self reflects psychological integration; whereas identity diffusion reflects developmental disruption and can make people vulnerable to coercive control and other forms of oppression.

The mystics of every tradition speak of becoming “nobody,” of “no self,” of non-duality. But paradoxically, that invitation only becomes psychologically safe after you’ve first had the chance to become a somebody. If the pursuit of “no self” happens before your identity solidifies, you can become much psychologically sicker, sometimes to the point of psychosis or a dissociative disorder.

Only a solid self that feels securely rooted can safely relax into the experience of being part of something infinitely larger.

Ego Strength Is Not The Same As Egotism

A strong ego is not the same thing as a big ego. Egotism is often an unstable identity, marked by insecurity, wearing a costume of grandiose superiority (like that of many spiritual teachers.) Healthy ego strength is something entirely different.

Healthy ego strength means you can:

• Know who you are without needing constant validation.

• Maintain your own thoughts even when others disagree.

• Set boundaries without excessive guilt.

• Hold people accountable when they’re hurting you.

• Say no.

• Respect the autonomy of other people.

• Protect yourself from abuse.

• Take responsibility for your mistakes.

• Recover after failure.

• Stay connected during conflict without losing yourself.

• Trust your own perceptions.

• Make choices based on your values rather than blending with scared parts.

Notice that none of these qualities make someone arrogant or narcissistic. Quite the opposite. They’re the very qualities that make genuine humility possible.

Suffice it to say you can’t voluntarily surrender a self you never developed. And if you’re working with spiritual teachers who demand that you do, please…for your own protection, consider seeing a therapist with experience treating spirituality-related psychological issues, like those who specialize is cult recovery.

Spiritual Bypassing Often Mistakes Dissociation For Enlightenment

Many traumatized people with weak ego strength are drawn toward spirituality because they genuinely long for healing, belonging, transcendence, and unconditional love. There’s nothing wrong with that longing. But some spiritual communities unknowingly reward trauma adaptations.

People who have poor boundaries are praised for being “selfless.” People who suppress anger are called “peacemakers” or praised for their dispassionate equanimity. People who abandon their own needs or safety are considered spiritual martyrs. People who tolerate mistreatment without holding anyone accountable are admired for their endless compassion. People who ignore their self-protective spidey senses are congratulated for trusting the teacher.

What psychology recognizes as fawning can easily be mistaken for spiritual surrender. What looks like ego transcendence may actually be self-abandonment. The nervous system cannot tell the difference between “I am surrendering to God” and “I am giving away my agency in order to survive in the presence of this flaming narcissist.”

Only careful discernment can make that distinction, and learning that kind of discernment requires healthy ego strength.

Cult Leaders Love Weak Egos

There is a really important reason so many high-demand spiritual groups emphasize ego death long before they emphasize psychological health. If every disagreement can be dismissed as “your ego talking,” legitimate concerns become impossible to raise. If someone questions financial exploitation, sexual misconduct, emotional manipulation, or abuse of power, they are told they simply haven’t transcended their ego yet, and blame is redirected to the one protesting, who is insulted for not being spiritually advanced enough.

If you say no, your ego is resisting. If you call out hypocrisy, notice contradictions, or protest two sets of rules, then your ego is judging. If you express hurt, your ego has got the best of you. If you’re grieving, you aren’t practicing non-attachment enough. If you leave, your ego has won. Lather. Rinse. Repeat.

This is psychologically dangerous. Healthy ego strength is precisely what allows someone to recognize oppression, resist manipulation, trust their own perceptions, spot gaslighting and reality distortions, maintain boundaries, and leave abusive people or systems.

A person with healthy ego development can still be deeply spiritual. They’re simply much harder to exploit.

You Need A St

You need a strong ego before you can safely loosen your grip on it.

The paradox is beautiful.

The stronger your psychological foundation becomes, the less desperately you need to defend it.

People with secure identities don’t cling so tightly to being right. They don’t require constant admiration. They don’t collapse when criticized. They don’t lose themselves inside relationships. Because they’re internally anchored, they can become more flexible, more compassionate, more open, and more capable of experiencing awe, wonder, bliss, and interconnectedness.

That’s not because they destroyed their ego. It’s because their ego became healthy enough to relax. A mature ego is not a prison; it’s a secure home from which we can safely explore the vastness of consciousness. Without that home, transcendence can become dissociation. Surrender can become submission. Devotion can become dependency. Community can become cultic. And spiritual seeking can become exploitation.

Instead Of Ego Death…Healing

If any of this sounds familiar or feels confusing, give yourself a big hug. Take a deep breath. Take a moment of silence to regulate yourself. Then read on…

Perhaps the frightened child inside you doesn’t need another lecture about letting go of yourself. Perhaps he or she or they need someone to finally help them become themselves. To know where they end and another person begins, to trust their own perceptions, to protect what is sacred, to say yes with their whole heart, to say no without apology or justification, to love without disappearing, to belong without conforming, to surrender without abandoning themselves.

When that happens, something remarkable unfolds. The ego doesn’t have to be bullied or crushed into silence. It no longer needs to shout or act out so strongly. The child inside can finally exhale. And from that place of safety, something deeper naturally emerges: the spacious awareness, compassion, and connectedness that spiritual traditions have pointed toward all along.

Not because the ego was destroyed, but because it was finally loved enough to stop being so lonely, lost, confused, and scared.

The wrong kinds of spiritual teachers don’t want you to figure this out. If you send them this article, they’re likely to say “Don’t listen to her. She’s in her ego.” But the right spiritual teachers will celebrate you, support you, encourage you, gently nurture your ego strengthening, tolerate being challenged, admit when they’re wrong, and get curious about your efforts to deconstruct harmful spiritual teachings.

If you need support with ego strengthening, practicing IFS, or learning relational life skills to help you learn to love (yourself and others) in healthier ways, please join us for LOVE SCHOOL, a twice monthly IFS community of practice where we focus on learning, healing, practicing IFS meditation and other IFS tools, writing for the purposes of healing, and rest in Self together, in community.

In our next session, we’ll be focusing on Self-led friendship, how to meet new people, get to know the parts of you that show up when meeting new people, build healthy, safe enough community, heal ruptures with friends, practice discernment, spot red flags, and build more nourishing, reciprocal offline friendships. And we’re always focusing on building healthy ego strength—coming down from grandiosity and coming up from pits of shame or low self esteem.

Join LOVE SCHOOL here.

If you’ve been harmed by spiritual teachings, especially if you developed psychiatric or medical problems because of it, my heart goes out to you. My partner Dr. Jeffrey Rediger, a Harvard medical school professor who also went to Princeton seminary, who is the co-author of our upcoming book RELATIONSICK, has started a small private psychiatric practice for those who live in California or Massachusetts, and he’s uniquely qualified to treat those in recovery from spirituality-based psychiatric or psychological issues. He sees clients remotely via Zoom. You can learn more about him here. And buy our book RELATIONSICK here.

If posts like this, deconstructing unhelpful or harmful spiritual teachings are helpful, please subscribe and share with others who you think might benefit.

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If you missed Part 1 of this series 10 Things I Still Believe About Health After Debunking Everything I Now Think Is Nonsense, please start there. This is a continuation of what’s left after getting indoctrinated into (and then deconstructing) both the world of academic medicine and then the New Age wellness industry teachings. I’ve so appreciated all of your feedback and applause about this synthesis of what’s the baby and what’s the bathwater. Please do continue to engage in this deconstruction/ reconstruction alongside me, and share what arises for you, so we can crowd source this!

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1. Healing is an interdisciplinary process.

The human body is not a car, and doctors are not auto mechanics. It might work to take an engine out of a car, fix the engine or replace it, leave the rest of the car alone, and expect the car to run smoothly. But the car mechanic approach to practicing medicine doesn’t work for human bodies. Often, what happens in the bodies of people who have experienced psychological, emotional, and/or spiritual trauma (and the resulting nervous system dysregulation) is that physiological systems start to break down one by one, and all those systems are interrelated because the nervous system and other whole systems in the body link every cell to every other cell.

This means you usually wind up with one diagnosis first, and then the medical system gets to work trying to treat that one condition. The problem is that, even if the medical system winds up curing the initial problem, if the trauma is still untreated and the nervous system is still firing stress responses, and all the body systems are interrelated, the next disease may be already underway. So you wind up playing medical whack-a-mole with medical conditions that keep popping up once the threshold of tolerance for the body is crossed. In other words, you might cure one medical condition successfully with conventional medicine, but if you don’t treat the underlying root cause of what is dysregulating the nervous system, causing the body to break down, there’s a good chance you’ll get sick from something else.

Western culture is celebrated for its focus on breaking whole systems down into their constituent parts and then developing expertise in smaller and smaller reductionistic splits. For example, you have a medical problem, you go see the doctor. If you have a psychological problem, you go see a psychotherapist. If you have a spiritual problem, you go see a chaplain, minister, rabbi, priest, iman, or other spiritual leader. If you’re “relationsick” (as Jeffrey Rediger and I write about in our new book RELATIONSICK), you go see a family therapist or couples therapist.

But if nobody stands back to look at the larger picture, which should be the role of the family doctor but often gets overlooked, crucial insights necessary for healing may be missed. Healing, by definition, requires wholeness, which requires stepping back and looking at all those aspects of yourself in relationship with each other. Breaking up the healing process into silos robs you of your opportunity for wholeness.

The truth is that you can’t heal psychologically without having it impact your physiology. But medical schools and psychology PhD programs don’t tend to teach that psychological healing could reverse medical diseases. You can’t heal medically without having it impact your psychological and spiritual well-being, but almost nobody in academia talks about how a cancer journey or recovery from an autoimmune disease or surviving a near death experience after a heart attack can be a spiritual experience. If you experience spiritual healing, it could impact you psychologically and medically, but divinity schools, medical schools, and psychology graduate schools aren’t teaching us this.

Medicine, psychology, spirituality, and science are all tangled together and cannot (and should not) be peeled apart, even by those who try to separate them. As much as we’d like to believe we can divide these categories into different academic silos that belong in different departments of universities, healing fails to play by such rules. Healing does not behave according to the principles of the Cartesian mind/body/spirit split. The etymology of the word “healing” comes from the Proto-Germanic word “khailaz,” which translates as “to make whole.” Healing is, almost by definition, a unifying phenomena that restores the academic splits into a reunion of integration.

2. Your habitat matters.

Where you reside, where you hang out, whether you’re surrounded by natural wild beauty or the tidy beauty of an organized, well-designed space matters. Whether you’re starved in a concrete jungle or living in a chaotic environment matters. Whether there’s noise pollution, toxic chemicals or mold in your environment, or lack of nature, your environment impacts your health. One of the reasons people tend to experience temporary relief when they go away on a healing retreat is that they’re removed from what might be a toxic living environment and they’re awash in a beauty bath. Sure, you can go away from a poisonous habitat and get temporarily transfused, but as soon as you go back to a habitat that doesn’t help you heal, your nervous system will register the poison.

And…living in a healing environment is a privilege not everyone can afford or access. Not everybody has the choice to live in a beautiful habitat, go away on a healing retreat, or free themselves from the kind of chaos one might experience in inner city public housing. And that’s not fair. Everyone should be entitled to beauty baths in nature and a habitat that fosters healing. But we have a long way to go when it comes to health equity around healing habitats.

3. Life force is essential to the healing process.

Call it life force, call it chi, call it prana, call it energy, call it love or Self or God or Shakti or the Holy Spirit. What you call it doesn’t matter. All of us have times in life when our life force wanes, and we become anemic on life force. Trauma and its sequelae, like depression, loneliness, or paralyzing fear, is the most common reason for dwindling life force and reduced will to live. We all need life force to flow freely in our bodies in order to be optimally healthy, and if that flow gets impeded or our overall life force gets dangerously low, we may wind up with physical symptoms—and we might not survive. You might need drugs, surgeries, or other conventional medical interventions to save your life or spare an organ while your dwindling life force or reduced will to live gets addressed. But those interventions won’t solve the underlying problem of what interfered with your life force flow any more than a blood transfusion solves a bleeding problem or a bone marrow dysfunction.

4. Pleasure, play, and laughter are good medicine.

Trauma healing work can be painful, as we face everything we have compartmentalized into trauma bubbles we typically don’t touch. As we gently and patiently penetrate these bubbles so healing can happen, we need both compassion and accountability. Compassion helps us accept ourselves, what happened to us, and what we have lost because of what happened to us. Accountability helps us reckon with who we have become because of what happened to us and who we have hurt because of the way trauma has impacted our ability to trust or love.

Many of us who have been in therapy long enough to know well how painful it is to face the ways you’ve been the victim of trauma. But the hardest part is where you get the dawning sense that you have also become the perpetrator of trauma—because of your trauma. And that pain, the pain of hurting others, can be excruciating. It can also help reverse medical illness, as I wrote about in the Advanced Integrative Therapy (AIT) chapter in my book Sacred Medicine.

Nobody can tolerate constant discomfort, so we need to be intentional about counterbalancing the emotional pain with play, pleasure, laughter, and deep nurturing experiences. As your tolerance for pain increases, your tolerance for pleasure needs to increase just as much. Many trauma survivors have unconscious resistance against feeling good and receiving deliciously pleasurable experiences, usually because we don’t feel worthy of experiencing awe, joy, and pleasure. Feeling the pain of being human needs to be counterbalanced with feeling all the pleasures of all the senses that only creatures with human bodies can experience. Otherwise, healing can quickly devolve into masochism- which, of course, is not healing.

Take beauty baths in nature. Watch dolphins and whales jumping and breaching. Dance to playlists you make for yourself. (Or try one of mine.) Sing in a choir or sing along to a playlist. Make art or otherwise express your creativity. Have orgasms, partnered or with yourself. Get a massage if you can afford it, ask someone to do a trade with you, or massage your own hands and feet. Read fiction, for fun. Watch a comedy show. Listen to public music in your local town green or enjoy buskers on local street corners. Garden. Take a workshop. Put your feet in a body of water. Take baths if you can. Throw a ball or swing on a swingset. Play!

And…play can be a privilege. Some people are working three jobs just to make ends meet, and play is beyond their access, even if it costs nothing.

5. Optimal health requires regular nervous system hygiene.

If your nervous system is in Type A hyperdrive 24/7, or if it’s in dorsal vagal hypodrive beyond when you’re resting and sleeping, your body is practically guaranteed to pay the price. This is why it’s ridiculous to even think about practicing medicine without considering the state of a patient’s nervous system. As I said in Part 1, it’s my point of view that we shouldn’t even be talking about mind-body- because the nervous system IS the body. Every single part of your body is connected to the nervous system, because the nervous system is far bigger and more diffusely distributed than your mind/brain.

Most diseases are the result of the long term consequences of chronic nervous system dysregulation—the immune system breakdown, the chronic inflammation, the microbiome disruption, the epigenetic influences, and such. Therefore, most disease treatments will be mere Band-Aids that are ultimately inadequate and ineffective unless they include nervous system hygiene. Nervous system hygiene requires caring about your own safety, emotional health, relationships, and protection from abuse, overfunctioning, or exploitation.

To practice nervous system hygiene and bring your nervous system into an optimally healthy state capable of somatic self-repair, you have to heal trauma. It’s not just war veterans that have trauma that can make them sick. Everyone has some trauma that likely needs healing. Some people have experienced the Big T traumas, the ones researchers call the Adverse Childhood Experiences.). But 100% of us have experienced what might seem like smaller traumas, such as the developmental traumas that interfere with our healthy individuation, capacity for intimacy, ability to assert agency and autonomy over our lives, and other natural full expression of our authentic selves. (Learn more about whether you might have experienced developmental trauma here and here.)

Developmental trauma and other “little t” traumas, which Buddhist psychiatrist Mark Epstein, MD calls “the trauma of everyday life,” affects every one of us and impacts our health. Therefore healing and adequately treating psychological, emotional, and spiritual trauma is essential for whole health healing.

Nervous system hygiene require “interoception,” the ability to accurately interpret the state of our own nervous system, to sense when we’re in “fight or flight” hyperdrive (sympathetic nervous system) and when we’re in a dissociated freeze or combination dorsal vagal/ activated fawn state. Only then we can employ strategies to help bring us back to healthy ventral vagal “tend and befriend” nervous system states.

And…nervous system hygiene can be a privilege. If you’re living in a war zone, running away from ICE, facing homelessness, or otherwise under constant nervous system distress, it might be impossible to calm the nervous system. Likewise, many of the somatic treatments that help develop interoception cost a lot and are largely inaccessible to the majority of people who need them.

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6. There’s a difference between healing and curing.

Healing and curing are not the same thing. You can be physically cured without being healed, and you can be psychologically, emotionally, and spiritually healed without being cured. Conventional medical interventions might cure disease temporarily, but unless the necessary healing also happens, patients are likely to get sick again, sometimes from an entirely different disease. Healing, on the other hand, creates the physiological conditions that optimize the body’s chance of reversing disease and preventing the onset of new diseases or recurrences of diseases in remission, but you can be healed and still sick. You can be healed and still die.

As much as we might wish we could, bypassing the psychological, emotional, and spiritual healing process, even if conventional medicine knows how to cure us physically, does not optimize health outcomes. Medications, surgeries, and other conventional medical interventions might alleviate symptoms and lead to remission of disease processes, sometimes resulting in cure. But if you’re cured without addressing the necessary healing, you’re at risk of getting sick all over again.

Likewise, you might temporarily feel better if you engage in spiritual practices or interventions, like meditation, yoga, contemplative prayer, plant medicine journeys, making a pilgrimage to a sacred site, or visiting an energy healer. But you can’t bypass the necessary psychological and emotional healing with spiritual healing alone, and it’s unwise to willfully skip conventional medical treatments that might cure you. Sure, medications, surgeries, and even spiritual interventions might make you feel better temporarily, and it might even look like you’re cured on lab tests or radiology scans. But if you’ve bypassed the secondary work of making sense of what was happening when you got sick, you might wind up falsely reassured by that temporary relief, thereby bypassing going back into the past pain of traumatic memories, which is what true healing sometimes requires.

Trauma survivors tend to be drawn to spiritual seeking, and this can be a blessing for some. Many trauma-supportive practices- meditation, creative practices, being in nature, engaging in rituals, prayer, movement meditation like hiking, yoga, or dancing- can help regulate the nervous system in the short run. And they feel good, so it can be tempting to just focus on doing more and more nervous system regulating practices. But nothing replaces the true trauma treatment that happens when you go back into the past, figure out how you adapted to survive, internally “redo” the past, and complete the neurological rewiring of the “memory reconsolidation” process, which lays down new neural pathways and helps neutralize the emotional charge from the past memory, thereby halting the automatic stress responses generated by those past memories that are stuck in the body.

It doesn’t work to bypass the steps necessary truly treat unhealed trauma: 1) basic safety and survival needs get met 2) psycho-education about things like boundaries, narcissistic abuse, the various trauma healing models (like IFS, Somatic Experiencing, NARM, AIT, etc) and how trauma healing works 3) nurturing resilience, resourcing, and meaning making 4) understanding adaptive strategies so we can have compassion for why we do what we do 5) embodiment practices and somatic mindfulness 6) nervous system regulation 7) metabolizing implicit sensations, emotions, and memories 8) treating negative core beliefs, installing a new identity, and rewriting your story 9) safe, brave communities of healing. For more detail on each of these elements of trauma healing, read this. [Hat tip to Chris Rutgers at The Trauma Foundation for helping me figure this out.]

And…do you know how much it costs to try to hit all these boxes and find practitioners who have availability if you can afford them?

7. Positive Childhood Experiences (PCEs) can protect against the harm caused by Adverse Childhood Experiences (ACEs).

PCEs include positive family experiences in childhood- closeness, support, loyalty, protection, love, importance, and responsiveness to health needs, all of which can increase resilience and function in a dose-dependent way towards protecting against the negative mental and physical health consequences of ACEs. For example, a child might get sexually abused by a neighbor, but if they have loving parents at home this will help offset the ACE. They might have divorced parents or a parent in jail, but if they have loving grandparents who remind them they are lovable, this might also offset some of the trauma. (Learn more about Christina Bethell, PhD’s research on PCEs in JAMA.)

And…some kiddos got loads of ACEs and no PCEs, and that’s not fair. So many spiritual types try to explain this injustice with a spiritual explanation, but I don’t believe there is one. The world is unjust. Some people have easier lives than others, not because they’re superior, but because they won the parenting lottery or the genetic lottery or the status and privilege lottery. You might disagree with me, but I don’t believe people with shit childhoods chose their abusers to grow their soul or are paying off karma from past misdeeds. While it might make some people feel more in. control, it’s generally easier to make peace with the random injustice of life than to believe you did something to cause a horrible childhood or that you somehow earned it or chose it.

8. Let go of healing perfection and go for being “healed enough.”

The bad news is that there’s no perfect human. I don’t believe there’s such thing as an enlightened human who never suffers. If you’ve met as many so called spiritual teachers in person, as I have, you come to realize what an incredible relief it is to give up that magical thinking search for an idealized human. Thank goodness we can give up that ghost.

The good news is that giving up this kind of childlike magical thinking can allow you to stop striving to achieve some unnatural, impossible, idealized standard of enlightenment, perfection, or finally having arrived at complete healing. There’s no such thing as “perfectly healed,” and there’s no “there” there. There’s only here. We can strive for “healed enough,” and recognize that healing is a lifelong practice and that we will die one day still engaged in the healing process.

9. Be proactive about healing but without bullying yourself.

Stressing about healing is counterproductive. If you’re dysregulating your nervous system by trying to bully yourself into healing, you’re defeating the purpose. This is a paradox, because being proactive about healing can help you become a health outlier or Olympian of healing. Being passive will not help you achieve an optimal health outcome any more than being a couch potato will get you an Olympic gold medal athletically. But if you’re obsessively restricting your diet, being a drill sergeant about exercising, pressuring yourself to do more and more trauma work, or otherwise trying to perfect yourself, you’ll impede the healing process.

10. There are no shortcuts to the healing process.

Healing takes the time it takes. While spontaneous healing may sometimes seem to happen instantly, it is often based on all the things you proactively did to create the conditions for that to happen. Because we so want to believe healing can happen rapidly and painlessly, charlatans make millions promising quick fixes. But anyone who promises you a rapid, painless healing journey is probably selling you a scam. Sure, some interventions might speed the healing process more than others, but no matter how effective a particular healing method is, no matter how transformational a medicine might be, no matter how much hype surrounds some healer, no matter how powerful a meditation or plant medicine journey might be, healing is a long, slow, arduous process. It can be softened with humor, pleasurable activities, loving community, and fun healing practices, like art, dancing, singing, and ritual. But don’t believe anyone who hooks you with the false promises of fast, pain-free healing.

What do YOU think?

What am I missing so far? I’d love to hear your feedback or questions, to inform my next post.

*If you want to dive deeper into teachings like this, check out a prerecorded online class I co-taught with IFS founder Dick Schwartz Healing The Trauma That Surrounds Medical Illness.

I’ll be continuing this series, so if you don’t want to miss the next installment, make sure to subscribe.

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Share The Body Is A Trailhead by Lissa Rankin, MD

I was (briefly and painfully) dating a polyamorous New Age celebrity shortly after my divorce from my daughter’s father when I first heard the “Get out of your victim story” schtick. When we met at a New Age spirituality conference, where we were both speakers, his frequent “That’s a story” knee jerk response initially landed as inspiring. Sure, it’s not helpful to loop your disempowered, helpless, self-pitying victim narrative for decades. Sure, getting out of the limited narrative of the drama triangle (victim, martyr, persecutor) can shore up poor boundaries and limit boundaryless triangulation. At its best, the “Get out of your victim story” teaching points toward something genuinely liberating. None of us wants to remain imprisoned forever inside an identity organized around learned helplessness, resentment, or powerlessness.

But then I noticed that when I was sharing anything I was genuinely upset about, whether it was something painful from my past, something politically upsetting, something that dinged my conscience, or something mean he had just done, his “That’s a story” dismissal landed as a hurtful justification for a complete lack of empathy.

If I tried defending my story, “Yes, it’s my story and I want you to care about it,” that only made things worse. In a smug, self-righteous, “I’m more spiritual and therefore better than you because at least I don’t raise my voice and lose my cool” way, he’d explain that I can simply change my story if I want to feel better, without acknowledging that there are structural things happening in the world that one individual has very little power to control, or that there was some validity to why I was upset at him. Suggesting that I could just gaslight myself in order to change my story so I could feel better about Trump being elected or Black men being murdered by police or him showing no empathy when I was telling him about my father’s death (“He’s in a better place now”) very quickly fell flat.

Later, I met my New Age lover’s wife, who didn’t seem to know he was polyamorous until I unwittingly broke the news to her. He had introduced the two of us, and as someone brand new to ethical non-monogamy, I assumed she knew about her husband’s poly lifestyle. Turns out she did know about me—because he had just told her—but she had no clue about the dozens of other lovers he’d had since they had gotten married four years earlier. He’d shared the lurid details with me, but apparently, not with her. That’s when I realized he wasn’t poly. He was just a garden variety cheater.

She had an understandable reaction to this news, as any wife who thinks she’s in a monogamous marriage would. But when I asked my New Age lover how his wife responded to finding out he’d been advertising himself as poly while cheating on her, he used the same line to shut down her protest. “She’s stuck in her victim story.”

At first (and I’m not proud to admit this), I validated his response. Sure. Let’s put the blame on her, so I don’t have to feel ashamed of being the “other woman” I didn’t consent to becoming. Sure. Let’s withhold our empathy for her legitimate pain and justify it by making her out to be the less evolved one. Sure. Let’s just cast her as not cool enough or evolved enough or spiritual enough to rise above her low vibe reactivity. Let’s frame it as her being stuck in the Stephen Karpman’s “drama triangle.” As soon as she plays the victim and casts him or me as the persecutor, expressing her understandable and appropriate anger at having her boundaries violated, let’s spin it as she’s now persecuting us.

It’s a total mind fuck and empathy-bypass, but I was buying it for a hot slick minute. I was even parroting that narrative in ways I now see were hurtful to other people, which I wrote about in Outing My Own Spiritual Bypassing Shadow here.

But as karma would have it, he later turned “Get out of your victim story” on me. After hours of discussion between the three of us, he had agreed to a closed throuple with only me and his wife and then slept with one of his sycophantic students at a workshop in Europe without discussing it with either of us or wearing a condom. I was outraged. Now I was the one stuck in my victim story, as was his wife, who was also upset. That’s when I realized that this way of thinking was a very convenient way of shirking accountability, like…Every. Single. Time.

When removed from context and applied indiscriminately, “get out of your victim story” can become one of the most psychologically uninformed and spiritually bypassing messages in contemporary healing culture. What is intended as empowerment can easily become invalidating gaslighting. What is presented as wisdom can become another way of silencing people who are still carrying unbearable pain.

In the throes of the chaos of 2020, it horrified me to hear that people like psychiatrist, conspiritualist, and COVID denier Kelly Brogan MD apparently required as a prerequisite to joining her mental health community a clause that asked clients to promise that they will get out of their victim stories or risk termination from the group. Where is the empathy in a statement like that? While such a teaching is a convenient way to suppress legitimate anger and make sure nobody challenges you for your unempathic treatment of their vulnerability, it’s cruel and lacks both safety and integrity.

There comes a time during trauma healing treatment when you need to have your victim story heard, validated, witnessed, and healed by you or by a therapist, holding Self energy, in order to transform your story into a more empowering, meaningful, soul growth-oriented narrative. This happens naturally as healing progresses over time. It doesn’t happen because someone blended with a narcissistic part who wants to control and dominate you shames and silences you with “Get out of your victim story.”

Telling someone who is hurting to get out of their victim story not only lacks empathy; it’s downright abusive. People can’t get out of their victim story until they’ve had adequate healing, and such healing is often expensive, painful, time consuming, and not accessible to many financially disadvantaged or marginalized communities. The kinds of treatments that actually transform people’s victim narratives are often pricey and not covered by insurance.

If someone tells you to get out of your victim story, what they’re really telling you is a likely to be a combination of shirking accountability for harm they’ve caused, trying to shut you up, or trying to shut you down and bypass your feelings so they don’t have to feel uncomfortable with the intensity of your pained emotions—so they can feel better. Whether the goal is letting themselves off the hook or not getting overwhelmed by how your suffering makes them feel, “Get out of your victim story” is never an empathic response to your pain.

When we’re in pain, what most of us need is some version of “I hear you and I believe you” or “I’m so sorry that I hurt you and I want to understand more” or “I don’t even know what to say but I’m with you and you won’t be alone through this” or “It makes sense that you’re hurting.” “Get out of your victim story“ is the opposite of empathy and a giant red flag for outright sociopathy.

So…let’s deconstruct this baby and parse out what’s helpful about the “drama triangle” or the “Get out of your victim story” teaching, peeling the useful bits apart from the muddy ass bathwater of New Age bullshit. I’ll use my New Age celebrity lover’s accountability shirking tactics as a road map of 9 red flags to look out for, so you can protect yourself from people in positions of power who weaponize the drama triangle.

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To those of you who are new to my work, you might not know that I wrote a New York Times bestselling book called Mind Over Medicine back in 2013, which led to two PBS specials, four TEDx talks, and a training program for medical doctors in the principles from that book. That got me swept into the wellness world that I’ve lately been calling out, because of the rampant corruption, lack of trauma-informed sensitivity, destructive spiritual bypassing tendencies, spiritual narcissism in its leaders, blindness to social determinants of health and social justice issues, and over-reliance on self help when it’s systems change that we often need. All of this puts too much pressure on individuals to heal themselves, when we, as tiny selves, only have so much power to control things that need to be addressed politically, like access to women’s health, medical insurance for everyone, deconstructing white supremacy and patriarchy, and other such enormously overwhelming social health and justice needs.

With that disclaimer, many of you have been asking me where I stand now. What do I still believe about health and wellness after calling out and deconstructing both conventional and alternative medicine, in addition to some worrisome tendencies in the trauma healing spaces? Are there ways people who are struggling with medical conditions can improve their outcomes without spinning their wheels or paying a fortune for expensive wellness products? Are there any babies in this bathwater? Or should everyone just throw their hands up, go to the doctor, ignore the wellness industry’s “rugged individualism” capitalistic messages altogether, and throw out all the muddy bathwater?

Since this Substack is called The Body Is A Trailhead, using that Internal Family Systems term to apply to health, I thought I’d take a stab at a series of essays, of which this is the first. But first, let me just give you a little back story and then a few summaries of where I stand now, in case it’s helpful.

“The Northwestern Way”

When I was an arrogant young whippersnapper indoctrinated into the brainwashing of academic medicine, I honestly believed that as a Northwestern-trained OB/GYN educated in “The Northwestern Way,” I knew how to save lives. My training program was rigorously evidence-based, with weekly journal clubs and tons of training about how to interpret statistics and evaluate a medical journal article for how credible it was. Anything health-related that fell outside the rigors of evidence-based medicine was worthy of contempt and mockery.

Within ten years of finishing my twelve years of indoctrinating training, I would wind up shattered and disillusioned, morally injured and confused, and I would leave the hospital, never to return as a practicing doctor. Unlike some, I wasn’t so disillusioned that I turned my back on conventional medicine. I still believe it saves lives and I would still use it myself and recommend it to patients for many health conditions. I’m still a fan of science and I roll my eyes at the science-deniers who justify reckless disregard for health care, public health measures, and treatments that might save lives if they are implemented.

But I no longer believe that what I learned in medical school is the whole enchilada. My medical training failed to even recognize, much less appreciate, all the aspects of healing that fall more into the “subjective” category, things like bedside manner, the quality of the therapeutic relationship, the mind-body-spirit aspects of healing, trauma-informed medical approaches to disease recovery, the impact of toxic, exploitative, or narcissistic relationships on the physical body, the effect of loving relationships on health, and other hard-to-quantify aspects of healing.

I also no longer believe a lot of the nonsense people in the wellness and spirituality world tried to imprint upon me, which I’ve been actively deconstructing here on Substack with essays like this one about Deepak Chopra in the Epstein files, this one about how destructive Byron Katie’s teachings are, and this one about how I don’t believe your soul chose your cancer (or your childhood sexual abuse or the death of your child or the natural disaster that destroyed your life.)

Leaving the hospital and landing in the wellness industry left me twice disillusioned. If the Northwestern Way wasn’t the end all/ be all, and if the wellness industry is more corrupt than healing, what support can we ethically provide for those facing medical issues and wanting to do what is within our power to optimize our health outcomes? Is there grounded ethical hope that isn’t false or manipulative hope? Are there interventions sick people might not have tried, interventions that might actually make a difference if someone is chronically or life-threateningly ill? Are there any ways we do have some power to impact our health that are free of the ills of conventional medicine and the wellness world?

To suggest that I know the answer would be the very hubris I’m pointing out here. But if you’ll humor me, there are a few conclusions I’ve landed on that I think still get too little attention in the dominant narrative of health and disease recovery.

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1. Bodies are naturally equipped for self-repair.

The body is designed to heal what breaks inside, at least until we naturally begin to age and those mechanisms work less effectively. What fueled much of my career since the hospital was my curiosity about why some people get sick so young, in their twenties and thirties, in their forties and fifties. We’re all statistically likely to start having some health issues in our seventies, eighties, and nineties, because that’s just what happens to human bodies, no matter how perfectly you care for your health.

But some people’s natural self repair mechanisms seem to break down far too young. Why is that so? And some people seem to have clusters of medical symptoms that doctors can’t even really pinpoint or explain. How come? And is there any way to solve these medical mysteries?

One thing we’ve learned in the field of traumatology is that those self-repair mechanisms only operate optimally if your nervous system is in the “tend and befriend” ventral vagal parasympathetic state or the resting sleep version of the vagal state. In other words, if you’ve experienced a lot of trauma, and it’s still unhealed and unresolved, it’s practically guaranteed to cause either mental health or physical health problems if it stays untreated. So ignoring trauma in the conversation about health and wellness is ludicrous. Bypassing trauma in the conversation about healthy and spirituality is even more ridiculous. You can’t get well with magical thinking if the trauma that is dysregulating your nervous system is still underground, destroying your body’s ability to self repair.

Here’s the brass tacks. We’re all exposed to all kinds of pathogens every day, but if our bodies are working as they should, our bodies know how to protect us from being infected all the time (as long as we’re optimizing conventional medicine, getting our vaccines, and using medical science to protect us from the infections we know how to avoid.) That doesn’t mean we won’t get a sinus infection or a cold or strep throat or Covid from time to time. And it doesn’t mean we’re doing anything wrong if we do get a mild infection. But if we get infections we can no longer fight off successfully, there may be something underground making that so.

We also all make cancer cells regularly and our immune systems kill them. Autopsies have proven that 11-44% of people who die for other reasons often have undiagnosed cancers at the microscopic or macroscopic level. Most of us, at some point or another, have had cancer cells growing in our bodies and we never even know about it. (The book Overdiagnosed: Making People Sick In The Pursuit Of Health talks about this phenomenon in its argument that screening tests, while beneficial and life saving in many ways, also increase the likelihood that a cancer will get diagnosed and treated when it might have gone away on its own.) Suffice it to say, cancers come, cancers go, and if cancer stays, something has allowed that to happen, whether a genetic predisposition, the toxic waste dump next door, or a weakened immune system related to chronic nervous system dysregulation.

Also, we all have this amazing microbiome in our gut that helps keep things running smoothly. And because of psychoneuroimmunology and epigenetics, our thoughts, beliefs, and feelings affect the hormonal milieu of our bloodstream and organ function and genetic expression on a moment-by-moment basis. The human organism is a miraculous creation in this way!

But our bodies aren’t made to stay well when our nervous systems are jacked up in chronic repetitive stress responses. Anytime you’re in a “fight, flight, freeze, or fawn” state of the sympathetic or dorsal vagal parasympathetic nervous system, your body is thwarted from fixing anything that might have broken down. These powerful stress responses, which bolster survival in a real emergency but which destroy the body if firing chronically, override the body’s ability to repair what breaks, allowing chronic and life-threatening diseases to take hold and flourish, often at way too young an age.

That’s not meant to scare you or blame you, but to inspire you to care for your nervous system and its relationship to the body’s repair mechanisms with as much rigor as you might care for your body with nutrient dense foods, regular exercise, getting enough sleep, or taking vitamins.

2. Spontaneous remissions are real, but they’re not “spontaneous.”

It’s well known in conventional medicine tthat “incurable” diseases can disappear. The medical literature is full of proof that people have been cured without medical treatment from diseases as deadly and severe as almost every type of cancer, including Stage 4 pancreatic cancer and Glioblastoma multiforme. They’ve been cured from life-threatening diseases like HIV, end stage heart failure, aneurysms, heart defects, abscesses, hydrocephalus, and liver and kidney failure. They have also been cured from common chronic diseases like asthma, hypothyroidism, rheumatoid arthritis, ulcers, gallstones, diabetes mellitus, high blood pressure, ischemic heart disease, cataracts, herniated discs, and epilepsy.

The medical establishment labels these unexpected cures “spontaneous remissions,” and doctors write them up in medical journals as curious flukes. But if you actually study these people, as me and my partner in writing RELATIONSICK Jeffrey Rediger, MD, MDiv have done, you’ll realize these remissions are anything but “spontaneous.” These people work so hard for their mysterious cures that we’ve come to call them “Olympians of healing’- or more simply, “health outliers.”

The sickening reality of this research is that spontaneous remission may happen more often in those with unearned privileges. If you’re a white person with class privilege and you’re able to take time off work to get well, to pay for trauma therapy, to get away from the stressors of life to go to a healing retreat center where they feed you fresh farm to table produce and you meditate for hours every day, you might have a better health outcome than an essential worker who can’t take time off work to prioritize recovery, can’t afford trauma therapy, and lives in a food desert.

And that’s not fair. It’s just not.

3. Treat causes, not just symptoms.

Conventional medicine focuses on alleviating symptoms but stops short when it comes to helping patients figure out why their bodies broke down and why self-repair failed. Treating symptoms is important: if you’re in pain, by all means take a pill or get a surgery to relieve your pain. If a vital organ stops working, by all means take a pill or submit to an intervention that will help your organ work better or replace your organ. If you get cancer, see an oncologist.

But conventional medicine does nothing to help patients enter into a period of self-inquiry after the initiating symptoms are addressed, worked up, treated, or relieved. Once the acute intervention happens and the symptoms are allayed, a secondary part of the healing process must be facilitated, and this is where conventional medicine falls short and alternative healing modalities do a better job. Good healers, who are often expensive and don’t usually accept insurance, listen. They ask about what was happening in your life when your symptoms started. They care about how your relationships might be impacting your body or whether you’re in a cult that is making you sick or whether you’re being oppressed by an abusive boss or a tyrannical political regime or an oppressive caste system or racial injustice. They look at the whole picture, not just a body part.

Good healers know that if you fix the symptom but ignore what might be underlying it, you’re likely to get sick again. Maybe it will be a different diagnosis, or maybe it will be a recurrence or exacerbation of a current diagnosis. But those underlying issues rarely go away just because someone cut out an organ or prescribed a drug.

4. Trust your intuition, but don’t believe everything you think it says.

Experts might know what’s best for a population of statistics or for public health, but you are not a statistic, so no expert knows what’s best for your individual body better than you do. Expertise is awesome. We need our experts to offer what they offer in their respective medicine bags. But someone else’s expertise does not make them the expert of how your very personal healing journey should go. Conventional medicine undermines patient intuition, and it’s understandable why they do. Intuition is imprecise and hard to validate, and fear (of a lifesaving medical intervention, for example) can masquerade as intuition and lead you astray.

But if you’re on a healing journey, your intuition- which is a somatic experience- can help, along with critical thinking and logic, guide you to making the right choices—for you, as a unique individual who is not a statistic. Mixing your own intuition with doing your own research and also trusting the opinions of trustworthy experts- and weighing that feedback in a measured way- will get you the best health outcome. Just make sure you’re not “doing your research” with pseudoscience, medical disinformation, and corrupt wellness industry con artists who make money off you believing their fake research. If you’re not trained to study journal articles and understand statistics and evidence based medicine in peer reviewed journals, it can be very hard to do your own research and interpret it accurately.

And just make sure that you can tell the difference between the genuine intuition of Self, or your wisest inner healer, and a part of you that might have an agenda, that is scared of getting medical treatment, or doesn’t want to feel out of control, or doesn’t trust authority figures and wants to ignore experts. Parts can very effectively pretend to be intuition, and they can be very convincing! Discerning the difference is one of the hardest parts of a recovery journey. Internal Family Systems offers us a way to become intimate with our “parts” so we can “unblend” and benefit from the clarity of Self.

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5. All aspects of your life can be medicine or poison. You have the power to choose to turn poison into medicine.

Every aspect of your life (your relationships, your work, your creativity, your sexuality, your spirituality, your relationship to money, your environment, your food, how you move your body, etc) has the opportunity to be either poison or medicine, depending on whether these aspects of your life stressfully activate or calmingly relax your nervous system. As I explain in great detail in the description of the Whole Health Cairn in Mind Over Medicine, what I call “whole health” requires lifestyle modifications that transform what might be poison into what can be medicine.

For example, your work can be poisonous to your health if you’re sucking up to a narcissistic boss every day or selling out your integrity to earn a paycheck. Or your work can be medicine as you express yourself creatively and fulfill your calling in a way that helps you (and others) heal.

But notice the privilege in that arguably true statement. The world is full of people who have to choose between sucking up to a narcissistic boss or not feeding their children. If I had to choose between fawning a boss or drilling in the rain forest and feeding my children, I would do whatever I had to do to feed my children.

But those of us with more unearned privileges often have more choice than that. I could have stayed in the hospital working as a doctor, where I was getting increasingly sick in my twenties. But as a person with a lot of unearned privileges, I was able to choose to leave that career—for mental and physical health reasons. It took me five years to figure out how to earn a living again, but the impact on my health was enormous. Not everyone has the luxury of taking those kinds of arguably reckless risks. But if you can, it could impact your health. And if you can’t, again, it’s not fair. And I struggle with that injustice every time I talk about such things.

So yes, it’s true that when we live authentically from the life force of our Self/ Inner Pilot Light, in our relationships, our work, our spirituality, our creativity, our sexuality, our relationship to money, our mental and physical health behaviors, we have the potential to make work our medicine, make relationships our medicine, make creativity our medicine, and so forth. We can sometimes convert what is potentially toxic into what is healing, and that’s an empowering kind of agency.

And…again, that’s a privilege, to have the capacity to make those choices from a place of true authenticity and integrity. It’s easier to do this when you have more privileges and less marginalizations, and that’s not fair either.

6. Almost all diseases are caused or exacerbated by chronic inflammation.

Inflammation is a normal part of fighting off infections. When the body spots a pathogen, it mounts an immune response- with fever, redness, swelling, pain, and recruitment of immune cell activation. But metabolic diseases result when there’s too much inflammation, unrelated to infection, and the inflammatory process gets stuck in a permanent “on” position.

Harvard magazine published an article that states:

Inflammatory diseases tend to cluster together as chronic metabolic diseases- such as diabetes, cardiovascular disease, stroke, Alzheimer’s, nerve degeneration, and cancer. Because chronic inflammation underlies these metabolic diseases, if a person gets one of these diseases, they’re much more likely to develop others.

And…if you’re an undocumented immigrant in the United States right now or a BIPOC young man getting stopped by a cop or a queer Black woman just trying to get by with so many strikes against her, it’s not easy to prevent chronic inflammation, because all that outer stress is going to impact the physical body, no matter how perfectly you engage in healthy behaviors. And that’s not fair either.

7. Chronic inflammation is an auto-immune process.

In medical school, I was taught that auto-immune diseases include diseases like rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, multiple sclerosis, scleroderma, psoriasis, inflammatory bowel disease, Type 1 diabetes, and celiac disease. But nobody taught me that diseases like the #1 and #2 killer in the US- coronary artery disease and cancer- are also autoimmune diseases. Long Covid also appears to be an autoimmune disease. All of these autoimmune diseases are the long term side effects of an inflammatory process that gets stuck in the “on” position, even when there’s no infection that needs to be fought off.

As Harvard magazine asserts here:

In medical school, I was taught that, if anything, inflammation was a beneficial response to invading pathogens, recruiting granulocytes, T-cells, B-cells, macrophages, fibrocytes, antibodies, cytokines, and complement, an array of circulating proteins produced in a cascade of enzymatic activity in the presence of microbes. Once the pathogens is eliminated, suppressor T-cells are supposed to turn inflammation off.

But that’s not what happens with chronic inflammation, which is different than acute inflammation, which is easier to spot because of the Latin pneumonic we did learn in medical school- calor (heat), dolor (pain), rubor (redness), and tumor (swelling). But when the acute inflammatory response fails to eliminate the offending invader agent completely, suppressor T cells don’t call off the immune system- and chronic inflammation takes hold, often without the obvious fever, pain, redness and swelling. When this happens, the immune system goes on to slowly, gradually turn on its host and attack your body, rather than protecting it. This is what we call “auto-immunity.”

As we age, we all have some degree of chronic inflammation, which is associated with degeneration of the body. But if chronic inflammation, marked by high levels of CRP (C-reactive protein) and other inflammatory biomarkers, get high, they’re associated with all kinds of diseases, most notably coronary artery disease, cancer, diabetes, and Alzheimer’s.

So trauma causes nervous system dysregulation, and chronic nervous system dysregulation causes chronic inflammation, and chronic inflammation leads to auto-immune dysfunction, which increases the risk of almost every chronic disease process. So in effect, trauma causes inflammation-related diseases, proving that there’s no such thing as “mind-body” because the nervous system impact of psychological, emotional, and spiritual trauma is 100% in the body- as nervous system dysregulation and chronic inflammation. We should be calling it “nervous system-body” rather than mind-body, if we want to be precise.

And…the ability to get help for treating a dysregulated nervous system is a massive privilege. Many of us simply don’t have affordability or access, and that’s not fair.

7. Reducing chronic inflammation can reverse autoimmune-related disease.

Acute inflammation typically results because of infection or a neoplastic process like cancer. But chronic inflammation is different. It tends to show up in the body for three primary reasons- an inflammatory diet (metabolic inflammation), immobility, and the physiological impact of psychological trauma. Overeating or eating nutrient-free foods stimulates an inflammatory response that kicks off a whole cascade of physiological auto-immune activity. Exercise can reverse some of this, but if your diet is poor and you’re not exercising much, the effect is amplified. Complex PTSD also increases inflammatory biomarkers (read more here and here), largely related to the excess cortisol stimulated by chronic repetitive stress responses.

The good news is that diseases caused by chronic inflammation can be reversed by reducing inflammation, although this is easier said than done. Gökhan S. Hotamisligil, Simmons professor of genetics and metabolism at the Harvard T.H. Chan School of Public Health, said:

Diet-related inflammation can be reduced by limiting overconsumption and eating an anti-inflammatory Mediterranean diet. Immobility-related inflammation can be treated with exercise, when that’s possible. And of course, trauma-related chronic inflammation requires healing and treating the underlying trauma, which is expensive, time consuming, and often inaccessible to the majority of humans who need it. (And that’s not fair.)

As is typical in the conventional medical mindset, scientists have investigated whether anti-inflammatory drugs can reverse chronic inflammation, but the body outsmarts the drugs. If you block on inflammatory pathway, the body tends to switch pathways. If you block too many pathways, you create dangerous immunosuppression. The obvious answer is to reverse chronic inflammation not by using anti-inflammatory drugs, but by treating the sources of the problem- diet, exercise, and psychological trauma.

But all of that requires not just personal buy in, but also money, access, and an awareness of social stressors that can’t be treated with an diet, exercise, or therapy.

8. Sleep is medicine.

In medical school, I was taught to work 36 hour shifts without any sleep. By the time I was a practicing physician, I was expected to work 72 hour shifts without sleep- even when I was pregnant. But optimal health requires the opposite. To achieve the best health outcomes, most people need about 9 hours of solid nighttime sleep (naps don’t make up for lack of nighttime sleep.) Our bodies need our nervous systems to spend many hours in the healthy dorsal vagal parasympathetic sleep state in order to repair what breaks down during the day.

Western culture prioritizes productivity at the expense of sleep and optimal health. But especially if you’re sick and in recovery, or if you’re interested in disease prevention, sleep is essential.

And…getting that much sleep is often a privilege many people don’t have access to. And that’s not fair.

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9. Nutrient-dense foods are potent medicine.

I didn’t get one single class on nutrition in medical school. Not one. I learned more about nutrition in elementary school, when they taught us about the USDA food pyramid (bread, cereal, rice and pasta at the bottom as what you should fill up on most, then fruits and vegetables next, then milk, yogurt and cheese, with fats, oils, and sweets used sparingly at the top. This pyramid has now been officially discredited, since we now know that a high carb, high glycemic index diet is not good for anyone- and that a low fat diet is not the answer, especially since products branded as “low fat” are usually loaded with refined sugars.

But they didn’t even teach us about the food pyramid in medical school. If anything, we were taught that disease is the result of obesity, of over-nutrition from too much eating. There was no distinction between empty calories and dense nutrition. I now know that the opposite is true. The hunger mechanism is repetitively triggered when people are not getting the vitamins, minerals, fats, proteins, enzymes, and phyto-chemicals the body needs in order to operate physiological processes.

The truth is that people eating a standard Western diet are not over-nourished; they’re malnourished. It’s not just that you’re eating the wrong things that can poison you, like junk food, processed foods, trans fats, and sugar. It’s that if you’re filling up on non-nutritious food, you’re starving yourself of the nutrition the body needs in order to prevent and recover from disease.

The average American over 100 years ago consumed two pounds of sugar per year. No big deal. Now the average American consumes 152 pounds of sugar per year. Our bodies were not made to handle that kind of load, because sugar is highly inflammatory. Such a high load of sugar in the bloodstream means that these sharp-edged little sugar crystals go coursing through our blood vessels and cause little cuts in the arteries, which then marshall your immune cells to come in and repair the micro-cuts. When you’re consuming a high load of sugar, year after year, this means you’re repairing cuts on top of scars, and you wind up with scars that we doctors call “atherosclerosis.”

There’s no single healing diet that works for everyone, but in general, high density, mostly plant-based nutrition that includes a broad range of nutritional value and includes low glycemic-index carbohydrates is your best bet. Think Mediterranean diet with loads of vegetables, fruits, legumes, nuts, olive oil, seafood, and chicken, minus red meat, sugar, and filler foods that are nutrient-free.

[NOTE: The Public Health Nutrition Department at Harvard and the professor at Harvard who became the head of the FDA were paid by the sugar industry to say that fat is the problem and “low fat” is the solution, but it was the sugar industry funding that to divert attention away from the research showing that sugar was the problem. Learn about that scandal here.]

And…eating this kind of nutrient dense diet is a massive privilege. Most of the world simply doesn’t have that option. Even most people in the US don’t have that option. I’m growing my own vegetables now, but even that is time consuming, requires the good weather we have in Sonoma County, and costs money to get started. We’re lucky in West Sonoma County that we have a farm swap at the Sebastopol Grange where the food insecure are invited to enjoy excess produce from some of our gardens—at no charge. But that still requires enough privilege to afford to live near Sebastopol, which is a far more expensive place to live than much of the rest of the world. If you have to buy your organic groceries at health food stores or CSA’s or farmer’s markets, it’s even more of a luxury good. And that’s not fair.

10. There’s no guarantee and no panacea.

Nutrition as medicine, exercise, getting enough sleep, following doctor’s orders, and other traditional wellness behaviors are essential building blocks of whole health, but on their own, they’re insufficient for optimal health outcomes. You can eat the world’s most pristine anti-inflammatory diet, work out every day, sleep 9 hours per night, take 100 supplements, and get the best conventional, alternative, or integrative medical treatment in the world. But if there’s untreated trauma impacting your nervous system, or if you’re making lifestyle choices that continuously retraumatize you- like staying close to an abusive narcissist or living under the influence of coercive control, you’re unlikely to be permanently cured from any chronic or life-threatening illness.

If you have poor boundaries and stay in toxic relationships, you’re effectively marinating the cells of your body in the stress hormones of epinephrine, norepinephrine, and cortisol, rather than the healing hormones of endorphins, oxytocin, dopamine, and serotonin. This ultimately causes your cells to misfire, break down, malfunction, and fail to do their jobs of self-repair. Instead, they will begin to attack the body that they are sworn to protect.

Not everyone can leave an abusive marriage, find a better job, get enough sleep, get the right trauma therapy, and create a life your body will live. If you can, by all means, see what happens if you practice nervous system hygiene, if you create the conditions for optimal self repair. At least anecdotally, this approach has optimized outcomes for many of the people Jeff and I have studied, and many people who have put the principles of my books Mind Over Medicine and Sacred Medicine and Jeff’s book CURED into practice.

If You Think You Might Be “Relationsick”…

With all my previous disclaimers, I still want to encourage you to read RELATIONSICK if you think your physical health condition might be related to relational trauma, past or current. With health equity and accessibility in mind, we did our best to boil down the best advice the two of us can come up with into an actionable treatment plan for anybody who can afford the cost of a book. We know it doesn’t replace the best trauma therapies, and we won’t make any grand promises.

But if that’s one aspect of improving your health you haven’t tried, I encourage you to at least consider reading our point of view on this overlooked aspect of health that few doctors or wellness industry providers are talking about.

And if you are a doctor, therapist, or health care provider yourself, please consider reading it in case it might help your patients, as a way to get them started and as an adjunctive supplement to the kind of treatment you provide. You can preorder anywhere you get books and learn more about the book here.

Contribute To The Conversation!

What does all this bring up for you? What lingering questions do you have? In what ways do you agree or disagree with me? I learn so much from this community and all the wisdom here, so feel free to push back, challenge me, ask good questions, or otherwise crowd source this conversation. I have pages and pages more notes on this, but I’ll start here and continue the conversation in coming posts. If you want to make sure to get them in your inbox, please subscribe (free or paid) to make sure you don’t miss anything.

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*Photo credit Monique Feil

*Image credit Getty Images

When my mother died in 2017 and I got into some of the hardest and deepest therapy of my life, my therapist started by giving me some psychoeducation about narcissism and high-functioning codependency/ over-functioning. I had the sense that she had pity on me because she could see that I kept getting hurt by people who claimed to love me, who then abandoned me if I thwarted their attempts to exploit me.

I’d get love bombed by these so-called “friends,” and after my divorce and losing my parents, and because my wonderful family all moved to Ohio when I’m in California, I was starved for chosen family. So a part of me was looking for chosen mothers, fathers, sisters, and brothers. I’d think I’d found one, a replacement father figure or mommy, a soul sister or chosen brother. But then things would get hard when I tried to have boundaries, say no, or avoid dual relationships. I kept thinking I’d finally gotten my discernment right, but then one of my best friends ditched me after my editor cut the chapter about him for my book Sacred Medicine, and I realized he only wanted to be my friend if I was promoting his work and helping him make money.

It was a hard reality check.

In therapy, I learned to spot the red flags of narcissism early. I learned to catch myself early if I was selling what I can do to help someone as a bid for connection, because of an underlying lack of self worth or trust that what I offer in friend connections is good enough, even if I’m not over-functioning. My therapist taught me what she called “ruthless lessons.” She said I had too much “ruth” (I didn’t know it was a word, but it is. It means “compassion for the misery of another.”) She said my abundance of ruth made me blind to ruthless people, so I didn’t notice how they targeted me for exploitation. She said I needed to spot ruthlessness in other people so I could better protect my parts.

Which made me so confused. Because when I looked at some of my friendships, I realized they had many of the red flags of narcissism, but then, so did I. In some relationships, I was the “one down” fawning someone highly self-absorbed, someone I judged as more special than me, someone smart, talented, rich, powerful, or beautiful who expected “yes” people to surround them and do their bidding, someone emotionally fragile and lacking in empathy, someone with shaky self-esteem and a lack of shame resilience that caused them to use the DARVO defense (deny, attack, reverse victim and offender) whenever they hurt me and I tried to stand up for myself and hold them accountable. With these folks, I gave more than I received and I usually didn’t protest that lack of mutuality.

In other relationships, I was the “one up” with someone else fawning me, putting me on a pedestal, buttering me up, giving their power away to me and allowing me to control them more than either of us should have allowed, often in the name of rescuing someone who was down on their luck. Sometimes I was the one without enough empathy, mutuality, or generosity towards the other person.

In some relationships I was needy, clingy, insecure, and graspy, reaching for someone avoidant, who felt put upon when I expressed needs. In others, I was intrusive, controlling, meddling in the name of being helpful, and selling my value to the other person in the terms of my usefulness, all while hiding my own needs, failing to make requests, and then feeling resentful and upset about the unfairness of the arrangement. It was painful to examine, to look at square in the eye and admit to my own vulnerabilities and weaknesses.

IFS helped because it gave me a compassionate lens, a way to love my parts in spite of the harm they caused me or others. But ultimately, I had to face the truth about my friendships, which meant letting some of them go completely, while others chose to do their own healing work alongside me, and we grew closer and healthier, breaking old patterns and choosing to recommit under different relational agreements.

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Friendship After Therapy

In the beginning of my treatment, my therapist tried to put an emergency plug in the gaping hole of my boundaries by suggesting that I generally avoid dual relationships. Keep relationships in only one category. Don’t befriend your clients or business colleagues. Don’t date your friends. Don’t do business with friends, family, or lovers. Keep things very separate.

But my life was a shit show of dual relationships, narcissism and codependence, control and being controlled, and other unhealthy ways of relating. During therapy, I kept saying to my therapist, “If I take your advice, I’m not going to have any friends.”

And she’d say, “Maybe. Maybe not. We’ll have to see.” Which always scared the crap out of me.

I tried to comfort myself with the old Taoist fable about the farmer whose horse ran away. His neighbors came to console him. “What terrible luck,” they said.

The farmer shrugged. “Maybe.”

A few days later, the horse returned, bringing with it several wild horses. The neighbors rushed over. “What wonderful luck!”

The farmer smiled. “Maybe.”

Soon after, the farmer’s son was trying to tame one of the wild horses when he was thrown off the horse’s back and broke his leg. “How terrible,” the neighbors said.

“Maybe,” replied the farmer.

Then war broke out, and every able-bodied young man in the village was drafted. Because of his broken leg, the farmer’s son was left behind. “What good fortune!”

“Maybe.”

The story goes on, reminding us that we rarely know, in the moment, whether something is a blessing or a curse. We tell ourselves stories about what events mean, but life keeps unfolding, revealing consequences we could never have predicted.

So when I would ask my therapist, “If I heal my trauma, am I going to lose friends?”

She said maybe. And she was right. Maybe, maybe not. I did lose some friends, and that turned out to be a blessing. I kept others, and that turned out to be a curse sometimes. It took the distance of a pandemic and a lot more psychoeducation, therapy, and relational recovery skill-building to get to the point where I felt like my friendships were solid.

And then I was forced to move, and suddenly, all those friendships and chosen family and community that I’d worked so hard to cultivate lived three hours away. So now I’m in the process of rebuilding, meeting new people, and going on meet ups with new people to see if we want to be friends with each other. It’s so sweet, and so awkward, to approach new people like a shy kid on the schoolyard to say “I like you. Do you want to be my friend?”

I happen to be new in town, so I have a good excuse to start over again with friendships. But many of my clients still live in the same town, near the same friends, but after therapy, they realize that many older friendships aren’t going to survive the healing work. The truth is that you might lose some friends after trauma healing and relational recovery work. When you stop fawning and people-pleasing, those who benefited from your lack of boundaries may not appreciate the new you. When you stop overfunctioning, some people may resent having to carry their own weight or show up with mutuality. When you stop abandoning yourself to maintain connection, relationships built on your self-abandonment may wobble, strain, or even fall apart.

That can feel like terrible luck. Maybe…

When Friendships Depend On You Being Unhealthy

Sometimes friendship are built upon unspoken contracts that you might not realize you’ve unconsciously agreed to, like “I’ll let you suck me dry energetically, and I don’t get to expect any reciprocity if I’m the one needing attention, help, support, or the right to take up space.” Or “I’ll be your friend as long as things are always on my terms, and if you expect me to put myself out to do things your way, I’m going to have a tantrum or reject you.” Or “If you’ll rescue me and help me get out of my bind, I won’t call you out when you treat me badly.” Or other unhealthy trauma bonded patterns.

Because what if those friendships are held together by trauma responses rather than genuine intimacy? What if your role was to rescue, accommodate, perform, stay small, stay agreeable, never have needs, never rock the boat, or sacrifice yourself to be someone else’s narcissistic supply? What if the relationship depended on versions of you that were never truly free? Losing those relationships can feel devastating. It can trigger grief, loneliness, and fear. It can make you wonder whether healing was a mistake.

But what if the space left behind becomes fertile ground for something healthier, something fresh, something new? What if the people who disappear create room for those who can actually meet you as equals, eye to eye and heart to heart, without one person leading and the other following, without one giving and the other receiving, without one martyring and the other benefitting from your martyrdom? What if the exhaustion of maintaining relationships built on self-betrayal gives way to the relief of being loved as you really are?

The trouble is that we want certainty. We want guarantees. We want someone to tell us that if we do the brave work of healing, we’ll only gain and never lose. But healing doesn’t work that way. Healing may cost you some relationships. It may deepen and improve some, it may reveal that some people were never your people, and it may attract entirely new people who recognize you because you finally recognize yourself.

When trauma runs our relationships, we tend to choose relationships based on familiarity rather than health. We tolerate what hurts because it feels normal. We cling to connections because losing them feels more frightening than losing ourselves. But healing invites a different question, not, “Will I lose friends?” but “Who will I become if I stop losing myself in order to maintain connection?”

In my new book RELATIONSICK, co-written with Jeffrey Rediger, we acknowledge that some cases of “relationsickness” are caused by friendships gone awry. Which is sad. Because friends are the relationships we should be most able to count on to help us heal, to build us up, to give us confidence, told hold us accountable when we mess up, to teach us how to repair when we do, to make us better people, to enjoy safe enough intimacy, to praise us for our boundaries, to support us when we’re in therapy and learning to show up differently. Good friends do this! But sometimes, others don’t want us to change…because unbalanced relationships are working for them, and they don’t want to grow with us.

Preorder RELATIONSICK here.

Building Chosen Family & Healthy Friendships

Now that Jeff and I have relocated, my daughter is in NYC in art school (and in Ohio for the summer on an art internship), my beloved housemate Téa has moved to the East Coast because we had to move, and my wonderful post-therapy friends are far enough away to need a weekend or a vacation to see each other, I’m committing to a personal quest to rebuild a community of new friends and chosen family. I know this will take effort, require energy and effort, and give me opportunities to practice my discernment and put my therapy learning into practice.

I’ve already learned a lot, just from meeting two new people who didn’t make the cut, two new people who, so far, are connections I’m actively pursuing, and a few more that still ie in the “I don’t know yet” category.

What about you? How have y’all navigated friendships after healing relational trauma? Are you satisfied with the quality of your current friend network? What is hardest for you right now regarding friendships and chosen family- meeting new people, trusting people, avoiding old painful patterns, knowing who is safe, moving from acquaintance to real friendship, feeling lonely after boundaries/healing work, repairing older friendships that have gotten strained, or something else? I’d love to hear from you!

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