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“Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?”

T S Eliot, The Rock

The Healers Council provides a safe space for healers to explore the wisdom of their healing traditions. This of course raises the question: “What is wisdom anyway?” More than 20 years ago, I was fortunate enough to be awarded a Kornfeld Fellowship that supported my travels in search of medical wisdom. I soon discovered that wisdom that was not to be found in the prestigious towers of academic allopathic medicine. Yes, there was certainly tremendous scientific genius to be found in the sterilized spaces of science, but no interest in wisdom. In fact, it seemed that any discussion of wisdom was considered to create unnecessary friction on the march of progress towards a utopian mechanistic future. My travels inevitably took me to unexpected places where I discovered wisdom among healers whose traditions date back thousands of years. The “Bird Men of the high Andes, the shamans of the Amazonian Shuar, the Sangomas of Africa, the Daoist healers of China, the Tibetan medicine physicians, and so many other remarkable healers who continue a lineage dating back thousands and thousands of years. Their remarkable insight did not disparage or negate scientific allopathy, it simply helped to place in a larger and wiser context.

The English word wisdom is derived from an Indo-European root wede, which means “to know” or “to see”. Although the word wisdom is employed so frequently in contemporary society (but not much in allopathic medicine), a review of English language dictionaries does not produce a consistent definition for the term. This lack of consensus indicates that wisdom describes a multi-dimensional concept that is best understood as the amalgam of specific components.

These numerous and diverse characteristics subsumed under English (Western) definitions of wisdom share one commonality i.e. They describe wisdom as a deep understanding and application of what is most important to a positive and contented life. This distillation highlights two manifestations of wisdom i.e.:

1. Sophia – The intellectual understanding of what is important.

2. Phronesis – the practical application of this knowledge.

In practical terms, one could argue that Sophia describes the intellectual and objective scaffolding for describing a benevolent world. In contrast phronesis can be understood as the practical application of knowledge in the context of a world complicated by the messy complexities of individual and environmental idiosyncrasies.

The wise practical application (phronesis) of medical knowledge can be very challenging in the complex world of technology, pluralistic societies, professional guilds, and shifting societal trends. Ultimately, the wise healer should have both a deep understanding of ethics (what is important), as well as the ability to apply these principles in the context of the complex and ambiguous situations they encounter in their care of patients. In this regard, deontological (principal-based) approaches that form the basis of contemporary bioethics may provide theoretical guidance but do not guide the clinician in what is the most compassionate or wise action in a particular clinical situation. Unfortunately, working within framework of principle-based ethics, clinicians therefore resort to invoking whatever principle will justify their agenda of what will be most helpful to the patient, or themselves. I have written previously that deontological ethics has been degraded to a mechanism for “cognitively sanitizing anxiety inducing situations”.

The most important determinant of medical wisdom is the ability of the clinician to consciously understand the multiple perspectives shaping their patients’ subjective suffering. Each individual has a completely unique perspective of themselves, and the world they inhabit. The work of the healer begins by understanding this perspective, and how it is shaping the person’s suffering. An inflexible perspective will result in dogmatism, arrogance, insensitivity, inflexibility and devaluing – all of which are contrary to the healing process, and will even create suffering.

“The only thing more dangerous than ignorance is arrogance”.  Albert Einstein

Roger Walsh MD PhD has written extensively on the topic wisdom and has provided a framework for understanding the concept of perspective based on an integral model. He writes:

“Wisdom is a function of the capacity for taking skillful perspectives. Of course, wisdom is also much more than this capacity but will certainly include this capacity. 
I define a perspective or action as skillful to the extent that it minimizes suffering and enhances wellbeing for everyone involved, including oneself. So, the hypothesis that wisdom is a function of the capacity for taking skillful perspectives implies that wisdom involves the capacity for looking at things in ways that lead to reduced suffering and enhanced wellbeing”.

“A perspective is a selective perceptual stance which results when awareness is filtered through and constrained by mental schemas and modes. A perspective therefore functions as a perceptual and interpretive framework which biases and limits perception (as well as subsequent interpretation, understanding, and responses)”. 14

In order to work effectively with each person’s unique perspective (experience of their life), the integral healer must possess the capacity for post-conventional thinking that includes the capacity to assume a perspective that is characterized by:

The wise integral healer exhibits the following characteristics: 

• Open-Mindedness: The ability to simultaneously hold multiple perspectives. The integral healer recognizes that no single perspective possesses a monopoly on truth. Given this, the integral healer recognizes and acknowledges that all perspectives contain some aspect of reality that can bring value and support the healing process.
• Cognitive agility. The integral healer exhibits the ability to generate creative responses and is not straightjacketed by pre-determined algorithms.
• Meta-cognitive capacity: The ability to hold a higher order perspective that creates a space where the healer can make decisions that are flexible. Motivated by their desire to understand any situation from multiple perspectives, the integral healer is always curious and eager to explore new ideas and acquire new skills.
• Integrative capacity: The ability to not only adopt multiple perspectives, but also to recognize relationships between these perspectives, and integrate them into a higher order synthesis. The enables the healer to view things in a larger context, and the ability to move from a micro to a macro perspective i.e., being able to see both the trees and the forest and vice versa. The integral healer is able to move from one domain (i.e., the integral four quadrants) and recognize the importance of addressing not just the patient’s disease (as defined by a scientifically derived pathophysiological model) but also recognizes the importance of addressing the first-person experiential, cultural and ecological aspects of human suffering. The integral healer recognizes that all human suffering is a metaphor for imbalance in systems beyond just the physical domain. This integral perspective is reflected in the shamanistic saying, “First heal, the community, then the person, and then the disease”.
• Trans-perspectival awareness: This describes the capacity of the integral healer to work effectively with intuitive insight.

Each of these characteristics demand a rigorous training garnered through their relationship with a teacher whose own experience has opened her to a wider perspective of what it means to be a human. A teacher who is a pilgrim along the pathway to wisdom, and one who stops to show us the way through to the other shore. We owe a deep gratitude and reverence to our teachers, including our patients who are often our most powerful journeyman along the healer’s path.

“And yet we only knew how each loss of one’s viewpoint is a progress and how life changes when one passes from the stage of the closed truth to the stage of because it embraces every point of view…a truth great enough to deny itself and the open truth— a truth like life itself, too great to be trapped by points of view, pass endlessly into a higher truth”.

Sri Aurobindo

(This blog has been extracted in part form an article; The Integral Healer by James Duffy MD published in the journal Glabal Advances in Health and Medicine, 2020.)