Post-graduate Training for Health Practitioners

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Post-graduate Training Program in Narrative and Indigenous Healing for Health Practitioners: a project sponsored by the Center for Narrative Studies of the Coyote Institute

Center for Narrative and Indigenous Studies (of the Coyote Institute):  A Four Year Training Program in Narrative Studies for …(Medicine, Psychiatry, Psychology, Social Work, Counseling, and other human service disciplines).

This page describes the training.  For logistics, please visit the page entitled "Post-graduate Training Logistics".

Goal: To further the development of a body of knowledge which integrates indigenous wisdom and practice with modern science and humanities.  We aim to enrich your life and professional practice with the wisdom, medicine, culture, and spirituality of the indigenous world and provide a means to bridge indigenous culture with the post-modern world through a narrative approach, thereby teaching and honoring the wisdom of the ages and of diverse cultures, and incorporating it into our modern practice of the healing arts.”

Description of the Training:

Year 1: 

A) Narrative Medicine: the role of story in illness,making meaning of illness, and meaning-full illness.

Post-modern philosophy provides a basis for understanding and integrating diverse cultures with equal validity.  Social constructionism provides a way of understanding how we create our methods for healing and curing through our networks of social relationships.  It downplays the role of the expert or the idea of privileged knowledge, and supports the idea of local knowledge developed by particular communities for particular contexts and needs.  The wisdom of any particular culture arises from its context in geography, history, and networks of relationships to other cultures.  That wisdom may not be relevant to other communities and cultures except in the sense of learning how practices arise out of context and need.  Translation is necessary between cultures to consider what elements of one culture can inspire, aid, and inform another culture.  Dialogue is necessary for this to happen.  Through dialogue members of diverse cultures share perspectives and come to understand how local practices have arisen and whether parts or wholes of them can be useful to other cultures.  Narrative practices acknowledge that these powerful cross-cultural dialogues take place through the telling of stories.  Cultures maintain their integrity through their traditional stories.  The passage of stories from generation to generation represents the preservation of culture.  In our post-modern world of contact with multiple cultures, elements of culture pass across previously rigid cultural boundaries to enrich and inform other cultures through the global dialogue.  Applied quantum theory gives us a natural science framework to understand how cultures “in-form” their members how to belong and actually shape members to achieve better fits and to evolve in culturally desired directions.  Concepts of holism, non-locality, non-separability, and connectivity inform our understanding of how change occurs and practices evolve.The wisdom of indigenous cultures represents a radically different view of healing and curing than modern biomedicine.  The biomedical perspective is exclusionary and dismissive in its insistence that it is the most valid and effective paradigm for healing and curing.  Multiple voices are dismissed by this dominant discourse.  A value and belief is emerging among a segment of health care practitioners that the wisdom of indigenous cultures and their practices are needed within modern health care in order to be more effective and compassionate.  We have encountered the limits of the pharmaceutical industry as well as some downsides to the exclusive practice of constructing problems as belonging to individuals and solving them with drugs.  While this method can produce results, we recognize that other ways of conceiving problems may be equally effective and more desirable.

B) Narrative Approaches to Mind and Mental Health:  the stories that guide our concepts of mind, mental health, mental illness, and treatment.     

       1)   What are the stories that guide our thoughts about mind, mental health, and how to treat the accompanying suffering.

       2)  What can we learn from indigenous cultures and their views about mind and mental health?

      
       3
)    How do we help people to identify the stories that guide their suffering and change those stories?  

C) Narrative Healing: Changing story for therapeutic purposes      

       
1)     What is narrative, what is culture, what is healing? What is the relation of healing to medicine and to psychotherapy?      
       
2)     Techniques for changing story.
       
3)     Art, dance, and movement for transformation and change. 
        4)     Novels, plays, and performances for transformation and change.
         

D) Reading and Writing Medical Narratives; medical fiction; the art of the case study.

Year 2: 

A)  Narrative approaches to imagery and visualization/use of imagery in narratives           

We will learn how indigenous cultures use storytelling, imagery, and visualization as part of the healing and curing process.  One tribe, for example, uses a practice that translates literally as “putting them to sleep so that they dream like they’re asleep, but they’re really awake.”  Stories are crucial to indigenous cultures.  Some scholars have argued that our modern culture suffers in its loss of traditional stories.  We will explore how stories inspire people to believe that they can be healed or cured.  Stories revision people’s sense of what healing and curing means and how it comes to pass.  Within the modern world, Alcoholics Anonymous provides an example of the healing power of stories.  Through testimonials, other alcoholics learn to believe that they can stay sober also.  The Native American Church and other cultural practices also use stories to inspire transformation.  Storytelling requires the use of language as rhetoric, including the power of persuasion (often called hypnosis in the modern European-American world).  Evocative visual images make the story more powerful.             

B)  Narrative approaches to hypnotherapy/hypnosis and storytelling      Words have served healers, doctors, priests and politicians from time immemorial.  In this three day workshop we will learn the art of speaking the language of healing.  We will consider how words affect attitudes, change beliefs, and nurture faith.  Through our words, deep inner resources for self-love are kindled which become physiological changes. In at least one Creation story, the Word was sufficiently powerful to create the world.  We do maintain our identities with the
words of our stories about ourselves and perhaps our stories also maintain the integrity of our body, for words are physical events, spoken by people through bodies with vibrational energy and the capacity to change those who hear these words.

Hypnosis is the art of speaking persuasively.  In hypnotherapy we aim to facilitate a movement toward greater health and the reduction of suffering and pain.  We persuade people to relinquish old self- deleterious stories in order to embrace those that are more life affirming.  

In North America many indigenous cultures use storytelling, imagery, and visualization as part of the healing and curing process.  One tribe, for example, uses a practice that translates literally as “putting them to sleep so that they dream like they’re asleep, but they’re really awake.”  Stories are crucial to indigenous cultures. Some scholars have argued that our modern culture suffers in its loss of traditional stories.  We will explore how stories inspire people to believe that they can be healed or cured.  Stories revision people’s sense of what healing and curing means and how it comes to pass. Storytelling requires the use of language as rhetoric, including the power of persuasion (hypnosis).  Evocative visual images make the story more powerful. 

With voice, tonality, phrasing, and words we can change our body reality, transforming sickness to health; despair to hope; and misery to happiness. Our words flow with pictures of mountain streams, armies of blood cells, and the eternal peace of the soul. What words do we choose?  How do we breathe these words?  How do we learn to speak the poetry of the spirit? With this attitude, we will flow between the analytic side of technique and the experiential side of storytelling and poetry, striking a balance that will aid in the restoration of wellness for ourselves and our clients.  This workshop will aim at professional development through personal experience, combining self-healing opportunities with consideration of technique and method.
       Contemporary practitioners of hypnotherapy, particularly those influenced by Dr. Milton H. Erickson, depend to a large extent on their ability to a) enter into trance along with their clients, and b) invoke trance and powerful changes in trance, through ‘special linguistic circumstances’. Hypnotic language patterns encourage us to ‘invent’ our own grammar. Our minds are conditioned to receive verbal communication in certain ‘grammatically correct’ patterns. When we receive communications that have been coded differently, it creates confusion and opens the door for new and creative ways of thinking. Successful and creative hypnotherapists put more poetry into their inductions. They may even experiment with singing, chanting, or whispering to their clients while they are in trance.
       Beside the words comes the music of delivery. A certain rhythm and cadence develops, seemingly by itself, as our conscious mind withdraws into the background. We begin to supply a surprising thread of images and metaphors… often with internal rhyme and rhythm! Having collected information during the intake and pre-talk with the client,
we can weave a story with this thread of images and metaphors.
       The use of hypnotic fables and storytelling is another overlap between traditional healing practices and the work of Dr. Erickson (who studied with the local Chippewa) and those who followed in his footsteps.

“[Traditional] healers lacking in any formal education often
demonstrate a masterful command of language in telling stories. With
their stories, they communicate complex ideas about love, forgiveness,
faith, hope, and self-transformation. They practice the sophisticated
art of a master hypnotherapist without ever demonstrating any
awareness of the techniques they are using. They use the ancient art
of storytelling – a masterful tool of persuasion and, no doubt, the
mother of hypnosis.” — Coyote Wisdom


The techniques of the imaginative hypnotherapist, like those of the traditional healer, may utilize unusual objects or artifacts in the treatment room: sound and light machines to induce alpha-theta brainwave states;  burning of sage, incense, or aromatherapy with essential oils to anchor state-dependent learning in the limbic system; playing of special trance-inducing musical sounds (repetitive drumming, harmonic chanting, singing bowls, etc) which are outside of the client’s normal reality.

In Imagery In Healing: Shamanism and Modern Medicine, in describingthe healings performed by Navaho medicine men, Jeanne Achterberg says “there is emphasis on song, prayer, body painting, sweating and emetic (the purification), and vigil for concentration and clarity of thought… Throughout the long ritual, the patient is involved in symbolic drama, especially as he is encouraged to continuously develop and sustain images of the personal healing process.” Later, in the same chapter, Achterberg mentions Dr. Bergman, a physician who studied in a Navaho school for ‘medicine men’. “Bergman conducted an hypnosis demonstration for those healers with whom he was studying. He said that instead of looking half asleep, as they usually did during their meetings, they watched in wide-eyed wonder (although he noted that they scarcefly seemed to be breathing). Thomas Largewhiskers, a venerated 100-year-old medicine man, said he was surprised to see that white men knew anything so worthwhile!”

Outline of Three Day Face-to-Face course:

       On the first day, we will demonstrate hypnotic technique from our respective standpoints which integrate much from indigenous perspectives, both Native American and Tibetan.  We wil consider briefly some theory -- namely the neuroscience behind hypnosis and trance and will reflect upon the nature of the trance
state, upon absorption, flow, immersion, inter-connectedness, and those aspects of consciousness which are compatible with accelerated learning.  We will videorecord our demonstration and will discuscs the
elements of technique with participants who will then practice technique with our guidance.  In the afternoon, we will further elaborate upon hypnotic technique with an indigenous flavor and will focus upon how hypnosis can be used to change the body, to modify physical illness, and to reduce pain that Is considered in biomedicine
to be physical. We will look at the power of suggestion upon physiology. We will this time do a group hypnotic exercise and will review technique and motivations.  We will practice together with guidance.

       On the second day, we will add storytelling into our mix, considering what makes a good story, a healing story, and a powerful story, asking how we tell these stories as part of our therapeutic work.  We will look at storytelling as the original hypnosis from time immemorial and reflect upon how a story maintains audience attention and how stories elicit trance states. There can be deeply encoded messages for change in story that bypass conscious resistance – these may consist of universally shared myths, or fables, both ancient and modern; or of client specific stories, constructed with that particular client’s situation in mind. Or of anecdotal stories, meant to convey an underlying (hidden) message to the client’s unconscious mind. We will see how the elements of technique that we reviewed on Saturday are also the elements of good storytelling and will see how indigenous elders, healers, and storytellers have used these techniques long before there were hypnosis training courses, as these techniques naturally arise from the intuitive understanding of language and its effect on the body.  We will practice telling stories as part of our hypnotic work, both as a stand alone event and within a larger hypnosis sesssion.

       On the third day, we will continue to demonstrate and practice, including now the use of guided imagery In hypnosis, exploring how to utilize the resources of memories of one’s personal experiences to choose metaphoric images – primarily from the natural world.  We will review ideomotor technique, signaling methods, and enactments with the body that aid in trance induction and symptom relief. This includes various arm lift techniques, post-hypnotic suggestions, walking hypnosis, and body positioning. We will work with a participant who has a particular afflication to demonstrate how hypnosis can be used for that person/purpose and will continue to provide supervised practice time to integrate what is being learned people's ongoing practice.

       The remainder of the course will take place on-line.

C) Narrative as Performance: drama, ceremony and ritual                  
       
      
1) Enacting ceremony and ritual.  Why are ceremonies and rituals important?  How does using dramatic (in the sense of acting physically) practices affect our conception of what we are doing.  We will consider the common elements of rituals and ceremonies from multiple cultures and will consider the usefulness in health practice of daily ceremonies.  These can include welcoming the dawn, greeting the twilight, removing adverse energy or entities, purification ceremonies, vision quests, and other specific practices of local tribes or groups.  We will explore the concept of spiritual entities and various concepts of how they interact with humans, especially in reference to health and disease.
                       

      
2) Enacting the story of the illness.       

      
3) Family and historical reconstruction/Resurrecting the story.

D)    Working with Psyche and Substance:

In this course we will explore plant spirit medicine, nutrition and herbs.  Indigenous cultures have different views of plants and natural therapies than the natural products biochemical point of view of European-American cultures.  We wish to explore and preserve these alternative points of view regarding herbs and plants and animals and their use in healing and curing.  These points of view include the idea of communicating with the spirit of plants to learn what the plants want to heal.

Year 3:

A) Narrative and the Body: The Physical Story; Indigenous bodywork/osteopathy

Every culture provides hands-on therapies.  On Zuni pueblo, in New Mexico, for example, high velocity adjustment practices developed parallel to and preceding the development of chiropractic medicine in Iowa.  Stories exist about chiropractic arising from the study of existing Native American methods.  Hawai’ians have lomilomi, Cherokee have a well-developed style of bodywork, as did Apaches.  In this module, we will learn one type of manual therapy from an indigenous culture, aimed at incorporation into local practices and also preservation of particular styles of practice that are in danger of extinction.  We will explore the use of dialogue during touch therapies.

B) Energy Medicine

Energy healing is a common aspect of the indigenous world, largely dropped by modern biomedicine.  Multiple types of energy healing practices exist.  Cherokee culture, for example, uses hands on the body, hands over the body, the shaking of rattles, burning of herbs, use of crystals, and the use of feathers and feather fans to move energy.  Cherokee also practices an acupuncture-like process of inserting needles (thorns, porcupine quills) into specific points along meridians to remove energy blockages.  In this module, we will consider the concept of energy – what is it, how does it work, how do we work with it, what happens when we work with energy.  We recognize that these are constructions to guide us and not necessarily absolutely true, but rather models to guide our practices.  Energy healing is used to clear energy from ourselves, our sacred objects, and our dwelling places.

C)            Narrative approaches to family and community, including large group work

         1)         Family

         2)             Community        

        
3)             Healing Circles, Round Table of Healing, Large Group Consultation.

Within a narrative stance and a post-modern framework, and entirely compatible with the practices of indigenous cultures, is the idea that groups best solve their own problems.  Groups decide what constitute problems and what comprise acceptable methods for solving these problems.  We will consider the practices of healing circles, large group meetings to bring social networks together to discuss their constitution of a problem and to brainstorm about solutions.  We will consider the healing power of large group ceremonies for healing communities.

D) Narrative Research Methods

Year 4: 

A) Narrative Philosophy: Bakhtin, Vygotsky, Volosinov, Harre, Shotter, Gergen, and more.      B)  Conceptualizations of mind, mental health, health, and healing from non-European perspectives.       Class 1  Introduction to the course and its modules.  The class will use examples from the instructor’s own experiences working in communities to facilitate the exploration of how to understand people’s models or stories about what is mind, what is health, what is illness, and how to people transition between health and illness.         Class 2:  The chief text for this and the next two classes will be Medicine that Walks by Maureen Lux.  We will use the Plains people of Canada as our example for how history shapes contemporary health problems and will use Lux to explore culture change and persistence of cultural practices in response to colonization and social injustices.  Through her writings and the history, we will explore the interactive, inter-relationship among culture and human pain and suffering.  We will define culture and explore readings from other cultures to supplement Lux on the relation of culture to pain and suffering.  This will help us explore the various ways in which different cultures conceptualize and categorize suffering.  We will use the activity to create a framework or template for students to use in their exploration of concepts of mind, illness, health, and wellness in their communities of interest.  Class 2 will focus primarily on the making of Treaties in Prairie Canada and how the introduction of the reserve system affecting people’s health and wellbeing.          Class 3: Using Lux, this class will explore the residential school phenomenon in Prairie Canada, making international comparisons, and leading students to search for similar phenomenon within their communities of interest.  Narrative concepts for cross-cultural understanding will be introduced in supplemental readings along with the systems theory concept of emergent properties and the non-linear nature of change.  We will use Lux’s examples to see how people instantiation internalized story to guide interpretive thought.  We will collect and read the stories that emerge to shape views of self and other during periods of culture change and disruptment.  Students will be expected to continually refer the readings to their own communities of interest.         Class 4: We will explore the Indian Act of Canada and use Lux to learn how about the long-term effects of colonizing policies on health and well-being.  Our goal is to see how contemporary health disparities arise through “Indian policy” and how such policies from over 100 years ago are still having health impact.  Students will use this reading as inspiration to look at similar laws and policies which come to impact the communities in which they work.  We will explore concepts of institutional violence, including some readings from the South African experience.  We will read and discuss excerpts from Goffman (1961) on authoritarianism, degradation ceremonies, the induction and perpetuation of powerlessness, unnecessary dependency, labeling, and the primacy of institutional needs over those of the persons it is ostensibly serving. We will explore how politics and policy affect health and illness and pain and suffering.          Class 5: The chief text for classes 5, 6, and 7 is O’Nell’s book, Disciplined Hearts.  O’Nell introduces us to reflexive methodology as we read how she and her views change when she begins to do her field research within a Flathead community in Montana.  She raises important points for discussion about the lack of correspondence between the Salish language and the English language concepts about mind and well-being, and how the Flathead people picked English words to map onto their concepts that actually had consensual meaning for them but did not match the general meaning that English speakers place on the word, her example being the word “depression.”  We will use O’Nell to explore aboriginal concepts of mind and mental health, and, more broadly, what constitutes a good life.  We will review historical changes in these concepts as culture evolved through contact with other groups.           Class 6:  We will continue to review how O’Nell approached the community in which she studied and how she built relationships within those communities.  We will look at the reflexive nature of her work and review some of the literature on intuitive inquiry and community based participatory action research.           Class 7:  We will aim for live interaction through videocast or podcast with a traditional healer for group discussion of mind and mental health.  Students will present their work in progress for their paper on their own communities of interest. ‘          Class 8:  This class and the final two will be based upon Narrative Medicine by Mehl-Madrona as a text.  In this class we will consider the nature of story and discuss how narratives can be used to describe cultures.          Class 9:  We will explore “talking in order to listen” or how dialogue produces understanding and change among its participants – change that could not have been anticipated prior to the dialogue.  In continuing to develop a narrative methodology, we will see how cultures can be conceptualized as a dynamic narrative of affiliation and belonging, ever changing, and consisting of smaller units (communities, kinships, families, individuals), all of whom can be defined as syncretic totalizations of all the stories they have ever heard and especially the portions they have internalized and instantiated as performance.          Class 10:   We will review non-linear methods of communication and learning, including talking circles, round tables, and focus groups.  We will practice how to create non-hierarchical discussions and how to even engage in professional practice from non-hierarchical models.  We will see how the concepts of compliance and non-compliance; adherence and non-adherence, resistance, and more, disappear within this alternative models. The focus of students’ time outside of class will be to interact with the knowledge holders of their selected community  Students are encouraged to attend community meetings and events, ceremonies, and to talk with community members as much as possible. Course Requirements:   1.  Students will make at least two responsive posts each week on the class discussion group.          2.  Students will attend at least two community events (for example, sweat lodge ceremony, powwow, Tribal Council Meeting) in their communities of interest and will interview at least one knowledge holder of that community (this portion of the requirements is probably essential for the required paper).         

3.  Students will write a paper describing the views about health, mind, well-being, and illness prevalent in their communities, tracing as much of the history of those views as possible. 

This project will require students to interact with community members and knowledge keepers as well as reading texts and journals.  Potential areas of interest include how colonization, migration, or immigration was associated with changing views from those found among historical members of this group or members of this group from other locales.  As this is the major class project, we will expect 4000 to 5000 words.  The instructor will work with students to potentially publish papers and will have an overarching project for exploration of community views about health and healing with Ethics Committee approval for students to talk with community members.  We hope that many if not all of these papers can eventually be published often with community members as co-authors.

C)  Indigenous Friendly Therapies
D) Indigenous Ethics

Each Year:  Supervised clinical practice with mentorship. 

One week in-residence together:  Integrated Practice:  Putting it all Together. 
Besides having time to revisit how our theories and ideas have changed over the course of the training, we will visit some modern practices that seem to build upon indigenous understanding of the world.  These include practices like hypnosis, biofeedback, neurofeedback, magnetic therapies, and electrical stimulation.  We will take time to explore some of these tools to wonder how they might be integrated with indigenous practices.  We will revisit the world of applied quantum theory to talk about the theoretical basis for our being connected with each other and being influenced by each other, sometimes in unexpected ways.                 

Proposal to create a Center for Narrative Studies and a Master's program in Narrative Studies for Health Praactitioners

Narrative is becoming increasing recognized as “more than just story.”  Narratives appear to be the building blocks of culture, human communication, and even appear to represent how the brain functions in its optimal state.  Academic centers around the world, including Columbia University in New York City, St. Thomas University in New Brunswick, and Massey University in New Zealand, to mention only a few, have active, vibrant centers for narrative study.  Columbia University offers a Master's degree in Narrative Studies for Health Practitioners and Massey University offers a Master's degree in “discursive practices” that lies within the psychology department.  At York University in Toronto, Richard Mar's research group uses brain imaging techniques to explore the areas of the brain that produce, tell, comprehend, and store narratives, finding that virtually the entire brain is engaged by a good story, unlike other activities that are more specialized.  His group has created a Journal of Studies of Fiction.  Lewis Mehl-Madorna and Daniel Janik have recently launched the Journal of Narrative Neurosciene in collaboration with the Neurobiological Learning Society and the Coyote Institute for the Study of Change and Transformation.

 

This proposal arises from the desire to find an academic home for a Center for Narrative Studies that is steeped in both the neuroscience of narrative and the narratives and the developing narrative understanding of indigenous cultures.  Our aim is toward enriching and improving human services, especially medicine and psychology, though we envision scholars pursuing a multitude of independent directions that overlap in the focus on narrative.  We also propose to house the Journal of Narrative Neuroscience within this Center and to explore further the nature of narrative research in its various manifestations as appreciative inquiry, narrative inquiry, reflexive methodologies, and other qualitative research approaches that may occasionally become quantitative as well.

 

The steps of creating a center are to

1)      begin offering interdisciplinary classes, both local and distant.

2)      Develop a Master's program in Narrative Studies for Health Professionals

3)      Seek research, educational, and developmental funding from foundations and government.

4)      Stimulate and encourage graduate student research and provide a venue for faculty from a variety of disciplines to dialogue about narrative research.

5)      Publish the Journal of Narrative Neuroscience.

 We propose a core of five courses for 16 units total, encompassing: 

1)      Narrative Medicine: the role of story in illness, making meaning of illness, and meaning-full illness.

2)      Narrative Psychiatry:  the stories that guide our concepts of mind, mental health, mental illness, and treatment.

3)      Narrative Healing: Changing story for therapeutic purposes

4)      Writing and Reading Medical Narratives (4 units)

5)      Narrative Research Methods

 

We also propose a practicum that would last two semesters (6 units) and then would propose that students sample a number of electives from the broader academic environment that relate to the narrative concept.  We would propose to offer several courses for the larger academic community that would also serve health practitioners working in rural and remote environments.  Conceived electives that Mehl-Madrona has already taught include the following:

 

1)      Narrative Neuropsychology

2)      Indigenous models (stories) of mind and mental health

3)      Ethical narratives

4)      Creating genuine cross-cultural dialogue through the appreciation of story

5)      Narratives of healers and healing.

6)      And others that faculty may offer from time to time.

Narrative Medicine: the role of story in illness, making meaning of illness, and meaning-full illness.  In this course, we will consider how people's personal stories influence their health.  We will explore potential biomedical mechanism, consider explanatory pleuralism, find how people make meaning out of illness, and consider Broom's concept of the Meaning-full Illness.  We will consider how narrative approaches can be integrated into medical practice.  We will discuss case examples from each others' practices.

Real Time Class via Dimdim, Tuesdays, 1 pm to 2:30 pm

Online discussions anytime.

Cost: $250 for 15 weeks

Register by emailing mehlmadrona@gmail.com or calling 808-772-1099.

Onoing clinical supervision/mentorship via webcam and Dimdim with Dr. Lewis Mehl-Madrona

1 pm Hawaiian Time (7 pm Eastern time) on Tuesdays. (After daylight savings time change, 2pm Hawai'ian Time and 7 pm Eastern).

Cost: $25 per week.

To register, email mehlmadrona@gmail.com or call 808-772-1099

Photo by Sheryl Eaglewoman