Lifestyle Medicine Paradigm Shift

In an interesting Twitter exchange with @ACLifeMed, during their annual conference in 2019, I made a reference to my article on the paradigm change in medicine, that was published on Bernardo Kastrup’s website. They responded with emphatic endorsement that we should be taught a holistic, idealist paradigm in basic education. Are we ready? Aside from Kastrup, Alexander Marchand has delivered a bunch of excellent videos on the idealist (non-dualist, or monist views of reality).

Alex Marchand offers some good ways to look at why physical reality is virtual.

Meanwhile, I recently attended a virtual non-duality conference, the Pure Presence Summit, which included several teachers of ACIM, such as Gary Renard, Lisa Natoli, Maria Felipe, and others, but also included both Rupert Spira, a non-dualism teacher in the advaita vedanta tradition and Bernardo Kastrup, The famous philosopher of science who teaches a metaphysical idealism that treats consciousness as first cause, and finally delivers a scientific paradigm that befits the world of quantum mechanics. Lots of inspiration there also! It is clear to me that it is the materialistic paradigm that is keeping medicine stuck in a body-centric model and a focus on treating symptoms, not cause. Still there appears now to be a growing awareness in the behavioral sciences that the mind of the patient is decisive in the healthcare paradigm. I would go one step further, saying that the ignorance of this fact inexorably drives the spiraling healthcare inflation we have in the USA, where we use 50% of the worlds prescription drugs, with just 5% of the world’s population, and have a #37 place in terms of health outcomes. Here, I want to explore how Lifestyle Medicine can help or hinder in the transition to a new healthcare paradigm of metaphysical idealism, as Bernardo Kastrup suggests, or do we need more?

Bernardo Kastrup at the Pure Presence Summit

The Pleasure Trap & More

Douglas Lisle, Ph.D. and Alan Goldhamer, D.C. co-wrote this famous book, The Pleasure Trap, which is a bit of a bible for the plant-based and lifestyle medicine community in terms of understanding the temptation of bad food, as in: why does bad food (seem to) taste so good? At least for some time in our lives we might have thought it did. The book deals with the neuropsychological mechanisms that drive our attraction to the wrong foods, and understanding those mechanisms goes a long way to helping us to handle our transition out of these self-destructive behaviors.

In a way a corollary, and a special case, is addressed by Dr. Neal Barnard in his book The Cheese Trap, which is about the specifics of dairy, and cheese in particular, which it turns out is in a class all by itself. Curiously, fully two-thirds of the world population, and indeed of the US population is lactose intolerant, ranging from 33% for caucasians to 95% for chinese people. On its face it makes no sense to consume the breast milk of another species. It turns out, milk contains a mild opioid, the theory being that this provides a pleasurable sensation that makes the calf want to return to its mother. In the process of making cheese, this substance, casomorphine, becomes more concentrated, and it is now thought to be one of the reasons why many people find it tough to give up cheese. And again of course, beginning to understand the mechanism is helpful when you want to give it up. I have to admit that I did not have any problem giving up cheese, even though I was a cheese lover most of my life before that time.

The American College of Lifestyle Medicine has embraced an approach of positive psychology and “happiness science,” in helping to motivate people in making lifestyle changes. I would like to argue that more is needed and we need to look more deeply into the area of spiritual growth when it comes to dealing with such transitions, and we need to be patient with ourselves in this regard. Being kind to yourself in this regard will go along way, though it must come with a willingness to be tough in terms of facing parts of yourself that may not be that attractive.

The Dialogue on Overeating & beyond

There is a small book by Ken Wapnick, Ph.D. titled Overeating: A Dialogue. It was based on a workshop at the Foundation for A Course in Miracles, in the nineties, when it was located in Roscoe, NY. I would highly recommend this book for anyone interested in the nexus of lifestyle and health, with one cautionary note: the conversation pertains to more to “dieting” within the old nutritional paradigm where you are counting calories and attempting (mostly in vain) to avoid certain foods – the proverbial “chocolate ice cream sunday” in the dialogue. What we are discussing in the context of the Whole Foods, Plant-Based diet and Lifestyle Medicine is about changing of the nutritional paradigm altogether, and within the new paradigm you can eat as much as you like, since all of the food is healthy. In other words, the sense of quantitative limitation, and calorie counting is out. This shifts the picture a bit.

The difference is not as great as you think. Indeed, the old style dieting is a losing battle, since the underlying bad nutrition sets up a craving for junk. Compared to that the transition to a whole foods, plant-based diet is more drastic initially, but even a 10-day program or a 21-day program can be sufficient to put people on the right track, as they start to feel noticeably better, which is great for motivation. Three to six months is usually enough to instill a permanent change. Famously, Dean Ornish, in his book Undo It! claims very high rates of compliance with his regime for heart patients, far higher than for statins after six months. In any other area of business the low rates of compliance would lead to considering statins a failed product. Ornish considers that the unpleasant side effects of statins are responsible for patients declining observance of their prescriptions, while the side effects of a healthy lifestyle, including a whole foods, plant-based diet are strongly pleasant, resulting in high compliance.

Still, people on a whole foods, plant-based diet may have relapses also. The society around us, including significant others are not always as supportive as might seem desirable, although that is slowly changing. All the material referred to earlier all helps, but it is the Overeating dialog which makes clear the inner conflict that often causes our struggles in this area. It is a driver behind the neuropsychological and physiological drivers, which are simply the proximate causes. It helps to understand those mechanisms, but what we really need to do eventually is to address the conflict that provides the energy for these struggles. That inner conflict says we lover our struggles, we identify with our struggles, and, after all, who would I be without my problems?

The Separation Thought

I positively admire Bernardo Kastrup for the work he is doing as a philosopher of science in terms of educating the scientific community about why Materialism is baloney, as per the title of one of his books. And, as my article on the healthcare/medical paradigm that was published on his site points out, treating matter as primary cause, which is what materialism does, has led to the development of medicine in a model that often causes more problems than it solves, for often times we are spending our resources on moving the deckchairs on the Titanic, and treating symptoms while the underlying disease rages on.

This pattern is very clear in areas like diabetes, heart disease, many gastro-intestinal problems and cancer. When the doctor brings out the Metformin, because you are “prediabetic,” he services pharmageddon, not his patients, for it is a seeming treatment of the symptoms, that allows the underlying condition to continue to deteriorate, and we now know that a whole foods, plant-based diet can prevent or reverse the problem. The relentless progression of the disease will make you a patient for life. Once we realize that the choice manifests at the end of my fork and has everything to do with our health, we find ourselves with a new found responsibility that can be either very empowering or very threatening. This gets us to the real issue, which is that it all starts with a decision in the mind to choose wholeness and healing over sickness. And inevitably, this means we will also have run-ins with the mechanisms that tempt us to eat stuff that is eventually self-destructive. Twinkies can seem very appealing. Worse, for generations we were told that milk was nature’s perfect food, but now we know that fully two-thirds of the population are lactose intolerant, so that we should stop eating dairy and quit using pharmaceuticals to try to overcome our lactose intolerance, as if it were a disease. There go the sales of Tums, Rolaids, Lactaid, and loads of prescription medicines that all deal with the symptoms of lactose intolerance, and associated conditions, like IBS and Crohn’s Disease.

Kastrup and Spira represent two avenues one philosophical and the other experiential, to lead us to an understanding that the body, and the physical universe, all of the manifest world all exist within the mind. Kastrup argues his case strongly based on Occam’s razor, namely that this view is ultimately simpler than the convoluted idea that the mind, consciousness, is an epiphenomenon of the body. However, that still does not get us there. As spiritualities go, it is A Course in Miracles which, in the Western tradition most clearly expresses how the ultimate ontological “problem” is the guilt over thinking that we could be separate, separate individuals, living in this upside down world where we think we are a body, a body that has a mind. It’s the other way around, and the minute you realize that, you will also realize this solves the seemingly difficult problem of reincarnation. There is no such thing, but rather, the entire dimension of time is the expression of the separation thought, in which the individual experience is the basis of a reality in which there is a past, present and future. In Einstein’s words: we are non-local beings having a local experience.

A recent book. titled i didn’t do it, I did, that strongly references A Course in Miracles, but was primarily inspired by the work of Joel Goldsmith, the author, Susan Pearson, gives a particularly vivid description of why the ego is at war with itself, how it is this thought of separation which wants to maintain itself at the expense of the whole, even though it can live only by accepting wholeness. It is the thought that we could be separate and independent of the whole of which we are a part, or in the words of A Course in Miracles, we are “At home in God, dreaming of exile,” (ACIM:T-10.I.2). The thought of separation is referenced in the Course as the ego. This provides a clearer explanation than advaita vedanta does, where it is recognized that the world is Maya, an illusion, but the cause of it is variously described as Brahman playing a game, or engaging in some form of self-discovery. Such explanations grant objective reality to the manifest world that it does not have. The explanation you’ll find with the Course or in i didn’t do it, I did is more satisfactory in that regard, for if our choice for the separation, for the ego, is the core problem and the driver of the ontological guilt that keeps us chasing our tail in the world, then it is also up to us to change our mind. In that context it is helpful to realize that this is what Jesus always talked about, but which was obfuscated by the tradition about him.

The New Testament word that was translated as repentance or conversion, was metanoia in Greek, and simply means a change of mind. This mis-translation and corruption of Jesus’ teaching is attributable to Paul, who transformed Jesus’ teachings into Christian theology – a story you had to believe and pay allegiance to. The Greek term however, refers to the simple change of mind, the spiritual awakening, or enlightenment in which we realize that we’re the whole and not the separated self. In the words of Lesson 188 in A Course in Miracles:

Why wait for Heaven? Those who seek the light are merely covering their eyes. The light is in them now. Enlightenment is but a recognition, not a change at all. Light is not of the world, yet you who bear the light in you are alien here as well. The light came with you from your native home, and stayed with you because it is your own. It is the only thing you bring with you from Him Who is your Source. It shines in you because it lights your home, and leads you back to where it came from and you are at home.

ACIM:W-188.1

The Stages of Spiritual Development

Besides appreciating the importance of the separation thought, we need to take a look at the stages of spiritual development and the mythologies and beliefs that accompany them. For this conversation, note that it makes no difference whether you believe in God or not. If you believe in an objective reality outside of you, caused by something external to you (God, evolution, the big bang, etc.), that is dualism and the most common mental attitude that prevails in the world. The most lucid presentation of the stages of human spiritual development I know is found in Gary Renard’s The Disappearance of the Universe. Understanding this helps us grow, but it is also critically important to our effectiveness as healers, so we can address people where they are. I will use the definitions from the book here:

Dualism is the condition of almost all the universe. The mind believes in the domain of subject and object. Conceptually, it would appear to those who believer in God that there are two worlds: The world of God and the World of man. In the world of man you believe, very practically and objectively, that there is in fact a subject – you – and an object, namely anything else. This attitude was well expressed through the model of Newtonian physics. (DU, p. 29).

Semi-dualism: The next attitude of learning you will go through during your return to God is sometimes referred to as semi-dualism. This could be described as a kinder, gentler form of dualism because certain true ideas have begun to be accepted by the mind. Once again, it makes no difference what your religion is, which is just one reason why all religions have some very nice, gentle and relatively non-judgmental people. One such idea that the mind would be accepting at this time is the simple concept that God is Love. (DU, p.29)

Non-dualism: The concept of oneness is hardly an original one. However, the question few people ever ask is: What am I really one with? Although most of those who do ask this question would say the answer is God, they then make the error of assuming they and this universe were created in their present form by the Divine. That is not true, and it leaves the seeker in the position where ven if he masters the mind, as Buddha certainly did, he will still not reach God in a permanent way. Yes, he will achieve oneness with the mind that made the duality waves. This mind, in a non-place that transcends all of your dimensions, is completely outside of time, space and form. This is the logical and proper extension of non-duality, yet it is still not God. It is, in fact, a dead end. Or better yet, a dead beginning. This explains why Buddhism, which is obviously the world’s most psychologically sophisticated religion, does not handle the issue of God. It’s because Buddha did not handle the issue of God while he was still in the body you call Buddha. It’s also the reason we’ll be making distinctions between non-dualism and pure non-dualism. When Buddha said, “I am awake,” he meant he realized that he was not actually a participant in the illusion, but the maker of the entire illusion.
Still, there is another step required, where the mind that is the maker of the illusion chooses completely against itself in favor of God. (DU, p. 31)

Pure non-dualism: Pure non-dualism recognizes the authority of God so completely that it relinquishes all psychological attachments to anything that is not God. This attitude also recognizes what some people have called the “like from like” principle, which says that anything coming from God must be like Him. Pure non-dualism is not willing to compromise on this principle either. Rather, it says that anything that comes from God must be exactly like Him. (DU, p. 39)

Gary Renard, The Disappearance of the Universe

Again, in the above it makes no difference if you call the creator ” God” or “evolution” and the “big bang,” psychologically/spiritually at that stage we give the world objective reality, and we forget we have a mind. As we wake up to the fact that we are mind, the perception shifts to a realization that everything starts in the mind before it is expressed/manifested in form. And individual consciousness, born of the “tiny, mad idea” (the separation thought in the language of the Course). is not reality but a point of view, based on that thought of separation. As individuals, we tend to think in debit and credit in our own personal ledger, which is entirely illusory in as far as “you can’t take it with you.” However, we do have the capability of tuning into our deeper reality, and take our guidance from there – call it what you want, Jesus, the Holy Spirit, the better angels of our nature, the higher self, Quan Yin, Avalokiteshvara, Mary, – use whatever suits you best. This requires practice and willingness, for we tend to default to an ego-centric, individualistic attitude and we only become willing to question it when the pain is too much. But also, we may stumble on to the reality of the mind, which is a constant, the primary reality, really, when we have experiences of déjà vu. This is when we realize that the mind, the observer is a constant.

The Healing Moment

Say thou:

“When I am led astray,
I am only myself to blame,
But when I am guided right
it is my Lord
who hath inspired me.
He heareth all,
He is always close!”

The Message of the Qur’an, XXXIV:50

The process of healing first of all is the process of listening to the still, small voice that speaks for Love, Oneness, Peace, and not to what A Course in Miracles calls the “raucous shrieking” of the ego. It is first and foremost a spiritual process. One of the consequences of these observations is that we realize that healing is of the mind, and that just like we change channels on the TV, healing means changing channels. The ego is the channel of conflict, with God, with the world, but also within itself – as the Qur’an quote above suggests, it leads us astray. In fact conflict makes us feel so alive, or… so we tell ourselves. In other words, engaging in a fight with the ego, is a recipe for disaster, for with the ego, it’s always lose/lose. For you are reaffirming your individuality, which was the source of your unhappiness to begin with. But there is the still, small voice within, that brings us peace, and leads us back to wholeness. This voice leads us to inner peace and happiness, and happiness means in practice that you no longer have an argument with reality. The individual self is all about self-assertion, and does everything it can to validate itself, at the expense of everyone and everything else.

The important part of the healing process then is the decision in the mind of the patient to choose healing, and from that, the choice of the tools, the practical means will become obvious. Thus forcing ourselves to change our diet and lifestyle with sheer willpower will not work, not ever. This inner resolve to choose healing over conflict is the only way to change naturally, and easily. And, when temptation shows up, we know not to fight it, for that leads to escalation and it makes the problem bigger, not smaller. Instead, if we find ourselves indulging in some bad old-style food, we try not to feel guilty, but as Ken Wapnick puts it in the overeating dialogue: ask Jesus to join you and enjoy the chocolate hot fudge sunday with you. The point is this; the ego thrives on guilt – that way, it’s got you by the short ones. It thrives on the addictive power of your secret, guilty pleasures. But the choice for the Higher Self, the Holy Spirit or Jesus, makes it possible to look at the ego without guilt, which gently releases the attraction of those guilty pleasures and gradually we can let them go if the pay-off is no longer there.

Dr. Dean Ornish describes about his professional development, how he always knew enough to be still and ask for that inner guidance to show him the way to the next stage in his work. Most of us forget to ask. We know we know, but we still forget to ask. That is the ego asserting itself and keeping the Holy Spirit safely outside, until we realize we are suffocating to death in the ego’s prison and we ask for help. In short, it is not one thing or another that makes the difference, it is the sincerity of that inner choice for healing and wholeness, which gains strength as we begin to see more and more how our ego is our worst enemy and keeps us in conflict. It is truly addictive. One of the manifestations of that addictive mindset is addictive foods, sugar, and refined flour, on and on, until we realize we don’t want the conflict any more and begin choosing against them.

Yet another way of looking at it

Author Jed McKenna, of The Enlightenment Trilogy, uses different terms, more palatable perhaps to some, he speaks of being in tune with the universe, as opposed to the illusory world of the ego (Maya). And, as he puts it. human adulthood does not even start until we make that shift from ego-centric thinking and constantly swipping up stream to going with the flow and getting in tune with the universe. It is yet another approach to the process of becoming more spiritually mature, which is a lifelong process in most cases. I am mentioning this material here simply to show that there are many ways to approach the same thing.

The practicalities of Lifestyle Medicine

A Whole Foods, Plant-Based diet is very different from traditional dieting which stays within the boundaries of the old nutritional paradigm that is now on its way out. The crisis in obesity, diabetes, heart disease is so massive, we cannot afford our healthcare system any longer. The plant-based diet is a new paradigm, but again in and of itself it is not a mechanistic answer – as if it were just an alternative to popping pills. Making the transition is truly easy, once we tap into that inner drive, intuition that wants to guide us to wholeness, health and healing. The material part of the healing process is that inner commitment in the mind of the patient.

So, as it is said in the Lifestyle Medicine community, there’s no use mopping up the floor, if we do not first turn of the faucet that caused the flooding. And diet and lifestyle are indeed the proximate causes of the majority of chronic diseases of our time. But that realization alone takes us to the process in the mind that makes our self-destructive choices and that process is the ego. The critical point now is to realize that we are doing it to ourselves.

Healing occurs as a patient begins to hear the dirge he sings, and questions its validity. Until he hears it, he cannot understand that it is he who sings it to himself. To hear it is the first step in recovery. To question it must then become his choice.

ACIM: P-2.VI.1:5-8

There you have it: healing begins with owning the process, and questioning your own judgement. Nobody in their right mind really believed that ketchup was a vegetable, or that it was healthy to live on hamburgers on soggy white buns. Admitting that is a necessary first step to wanting to heal. Calong those lines Carl Jung said: ” Everything that does not rise into consciousness comes back as destiny,” and also: “… we aren’ t hear to heal our illnesses: our illnesses are here to heal us.” Or, to unbundle that a bit: a disease a disease is an opportunity to address a dysfunction that merely manifests as disease. This is also the reason why fighting the symptoms alone is not enough and medicine tends to stop there. The healing process is the inner process of listening to the disease and accepting the possibility we were wrong before and now we need to live differently. That is the beginning of healing and of wisdom. The details will be different for everyone.

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