Physician Heal Thyself:
Finding Balance, Both Heart and Soul
An interview with Lee Lipsenthal, M.D.
by Ellie Weiser
 Lee
Lipsenthal, M.D., ABHM, is past president of the American
Board of Holistic Medicine and the founder and director of the
Finding
Balance in a Medical Life program. He consults with major medical
centers and medical groups in the area of physician health, and
delivers lectures and workshops in this area throughout the world.
Dr. Lipsenthal recently joined the Hoffman Institute‘s
Advisory Council.
Ellie: You’re a board-certified physician,
an internist with post-graduate training in cholesterol disorders,
and you focus your career on helping people modify their lifestyles,
on teaching physicians to find balance in their lives, and on how
depression affects heart health. How did you choose this unique
path?
Lee: My interest in heart health, physiology,
and function was predominant early in my medical training. As I
continued training, I couldn’t help but feel that there was
something missing in mainstream medicine — especially around
heart disease and its relationship to our emotional lives. I very
much wanted to tie the two together.
Ellie: Was there a particular incident that heightened
your interest?
Lee: When I was a resident, I admitted a 49 year-old-man
who was having a heart attack. I spent the night beside him, learning
about his life from his family. He exercised, ate well, and took
care of himself. So why was he dying at 49? What it ultimately came
down to was that he was a Type A, very driven, stressed-out person.
That was the only reason we could find why someone who did everything
“right” died that night. As I developed a cardiac rehab
program in the hospital I was attending, I realized that what was
missing was the psycho-social aspects of health, the psycho-spiritual
aspects of health, and I made this my focus.
Ellie: When was this? It sounds like you were
ahead of your time.
Lee: Around 1988 I teamed up with a psychologist
who helped me work with heart patients in cardiac rehab. The more
I learned about stress, depression, and other negative emotions,
the more I saw their relationship to heart disease. I started talking
to a fellow named Dean Ornish, whom I presume some readers will
know by name.
Ellie: The well-known cardiologist and best-selling
author.
Lee: Yes. Dean and I joined forces, doing research
on heart disease and behavior change. It always boiled down to the
hardest and most significant part to change was a person’s
psycho-spiritual, psycho-social aspects.
Ellie: Was the medical community open to your
“non-traditional” findings?
Lee: No. In the mid ‘90s we looked at data
on why physicians had trouble recommending heart-healthy programs
to their patients, and we found that doctors themselves didn’t
believe they could do it. That’s when I realized the importance
of working with physicians on physician health. The other, deeper,
reason I’m on this path is because for many years, through
my meditation practice, I have been led to work in this area.
Ellie: You’re the past president of the
American Board of Holistic Medicine. What is holistic medicine and
how does it differ from traditional medicine?
Lee: Holistic means that you’re meeting
a fellow human being, looking at their entire life system, including
their nutrition, exercise, physical environment they live and work
in, their psycho emotional health, depression, anxiety, hostility,
love, peacefulness, gratitude. It also includes their spiritual
lives. The holistic practitioner looks at these factors and decides
what tools would be best not to fix this person’s disease,
but to optimize their health.
Ellie: What are some of the tools you might use?
Lee: An assortment of herbal medicine, acupuncture,
energy medicine, supplements, homeopathy, and much more. And the
philosophy is that when the person is well, they then can manage
any disease process better, that there’s an innate ability
within the body to heal itself. And what we’re trying to do
is help a person get out of their way so the body can do its work.
Ellie: What if the medical problem is more serious?
Lee: If more invasive treatments, like an angioplasty
or bypass are needed, those are perfectly valid but at the same
time the goal is to optimize the person’s health.
Ellie: I’ve read that physicians have a
far lower level of morale and work satisfaction than many of their
patients. Is that true?
Lee: A recent survey by the American College of
Physician Executives showed that approximately 70 percent of physicians
suffer fatigue on a daily basis, 60 percent have experienced burnout
within the past year, and 34 percent are depressed on a regular
basis. So yes, it’s true.
Ellie: What are some reasons for the startling
statistics?
Lee: By their nature, physicians are often change
adverse, caretaking, and they tend to be perfectionists. The way
medicine has changed in the past 20 years — physicians now
see on average 25 patients a day and the busyness doesn’t
allow them to keep up with the medical advances by reading the literature
— it’s tough for many to handle the fact that what was
once built on constancy is in flux.
Ellie: When a perfectionist can’t perform
at his best — there must be all kinds of ramifications…
Lee: There are. When a perfectionist is in a situation
where he can’t keep up with the literature, can’t spend
enough time with patients, and doesn’t feel like he’s
doing an adequate job, day to day, moment to moment, that causes
huge stress.
Ellie: You run one-day and week-long workshops
for physicians and their families. How do you help the individual
deal with stress and anxiety?
Lee: First I run a person through personality
scales and ways of looking at perfectionism and work addiction and
things of that nature. Then I teach him/her various stress management
tools. The next piece is how to use different communication techniques
and processes, like nonviolent communication, empathetic listening,
and intuitive listening. I also incorporate psycho-synthesis techniques,
which bring together the aspects of someone’s personality
in a way that fits their life as it is today. Through examination,
the physicians in my workshops learn things like, “I can be
vigilant in my work without having to be anxious.” Once they
get that they can create another personality in a particular circumstance,
they can move forward without the anxiety.
Ellie: It sounds like a variation of the Quadrinity
— honoring each aspect of the self, not letting one overshadow
the others, causing imbalance, anxiety, or depression.
Lee: From the Quadrinity model, what’s happening
with a Type A personality is that the emotional is overtaking the
intellectual, causing intense stress. Using the Quadrinity model
they learn to let the intellectual have its space without being
overtaken by the emotional, which is the source of the anxiety.
Ellie: In your just-published article titled,
“Mild Depression, Medical Illness or Invitation for Self-Growth,”
in Holistic Primary Care, you point to the Hoffman Process as a
possible alternative to pharmaceuticals for mild to moderate depression.
From your perspective, why is the Process effective in restoring
someone’s wholeness?
Lee: Because wholeness, from my understanding,
comes from a connection with your spiritual self. To understand
your intellect, your emotional capacity, your physical self, a whole
person is connected with their Quadrinity, their spiritual center.
And from that place, there’s not much room for depression.
Ellie: The UC Davis research study on the Hoffman
Process, published last November, confirms that as well.
Lee: If you read the UC Davis study published
in Explore Journal, you learn that the greater someone’s spiritual
connection, the lower the rate of depression. It doesn’t mean
that you’re not going to get sad about life events, but it
doesn’t lead to a state of depression.
Ellie: To be clear, we don’t claim that
the Process is a cure-all for depression, but that there are important
openings that happen by doing the Process, and that one of the byproducts
of this work is diminished depression.
Lee: Exactly. If a person is profoundly depressed,
the Process is probably not going to be enough to shift it. For
that person, psychotherapy and possibly medication is a way to go.
I want to make that point as a physician.
Ellie: I appreciate the distinction. Lee, you
did the Process in August 2005. How did it affect you personally
and professionally?
Lee: On a personal level, I’ve had depression
for most of my life, and I haven’t since the Process. There
might be sadness, but it doesn’t get further than that. One
of the funnier changes I’ve experienced relates to travel.
I used to be a whiny traveler; “Oh, the flight’s delayed,”
or “Oh, this hotel’s just mediocre.” The Process
helped me recognize that dark voice, so now, the moment I feel it
coming up, I reach up to my shoulder, pull off the little head,
and I focus on who I’ll see and the fun that I‘ll have
on my trip. It completely shifted my travel life, which is substantial
since it’s about half of my life.
Ellie: How else are you different?
Lee: I learned at the Process why I over-ate —
I was caught between my mom and dad’s eating patterns, and
I adopted both, which created huge, internal stress for me. Since
the Process I’ve changed how I relate to food, and I’ve
lost 35 pounds, which feels great.
Also, with my family, I’ve learned to be more of a calm observer
instead of an angry guy. What used to happen was someone would do
something, I’d get angry, and then I’d get angry with
myself for being angry. Then I’d get depressed because I would
internalize the anger. That no longer happens.
Ellie: How do you, as someone who helps doctors
find balance, maintain it in your own life?
Lee: I meditate every day — a loving kindness
or appreciation-based meditation and occasionally a mindfulness
meditation. Many of my meditations involve contacting my spirit
guide and just sitting in that space for a half hour each morning.
In Process lingo, every day I’m sure to spend a little time
on my “River of Life.” From a physical perspective,
I’ve always exercised, and since I changed my diet and eating
habits, I feel better in all areas. The other way I stay balanced
is to have good boundaries and a good capacity to say no. I’ve
lost my need to be a people pleaser. All of this has a huge impact
on the quality of my life, my work, and my degree of happiness.
Ellie: Speaking of happiness, I saw a statistic
that 18 percent of the U.S. population is depressed at any given
time. From your view, why are so many people depressed so much?
Lee: I think social isolation, being separated
from family and community, is the number one cause of depression
in this country. The majority of Americans don’t live where
they grew up and they’re not close to their family. Where
the Process works beautifully is that it gives you a sense of connection
with the spiritual whole or spiritual collective. And in doing so,
you’re no longer alone.
Ellie: Great point. What other factors contribute
to widespread depression?
Lee: I believe many people are depressed due to
anger or hostility turned within. We’ve become a more hostile
society, and for most of us who try to be do-gooders, it doesn’t
resonate with our ego; “I’m not supposed to be an angry
person.” Often we get mad at ourselves for getting mad. And
if you turn the anger within, that’s depression.
Ellie: How relevant, from the medical perspective,
is a person’s spiritual life to their resiliency and general
well being?
Lee: I look at spirituality as a sense of connection
with something bigger than yourself, which can be found within a
religious context, in a love relationship, in unconditional love
with your children. It can be found in nature. There are a lot of
places to find spirituality in our lives. With that in mind, I think
it’s perhaps the most critical element of our sense of well
being.
Ellie: Are there statistics around spirituality
and health?
Lee: People with spirituality in their lives have
about 25–28 percent — depending on what you’re
looking at — lower death rates from heart disease and cancer.
More importantly, it has an impact on our emotional well-being.
Ellie: When working with physicians, do you focus
on spirituality?
Lee: Oh, absolutely. At first it’s with
some simplicity: What are your values? What’s your life mission?
What do you receive joy from? Who receives joy because of what you
do? One of the ways physicians touch their spiritual being is through
service, so a big piece of the work is on how they serve, who they
serve, and how to enhance service in their lives.
Ellie: Again, if spirituality is a connection
with something greater than yourself, then service is a spiritual
act.
Lee: Yes, and sometimes things get out of balance
because as a physician you’re taught to take care of the patient
first, your family second and yourself third. To me, that’s
backwards. We need to take care of ourselves so we can be loving
and present for others.
Ellie: Do you recommend the Process to other doctors?
Lee: I recommend it to physicians who struggle
with family issues, to those who have anger or hostility and are
dysfunctional in their healthcare system or their office, and to
individuals who are extremely compulsive, Type A, or depressed.
Ellie: That could cover a lot of people!
Lee: (laughs) Exactly. The nice thing about physicians
is they’re generally really smart, well-meaning people. So
if they’re hostile, angry, Type A, and dealing with severe
family issues, more often than not they do not want to be that way
and they’re willing to make change. So in that regard all
I usually say to a doctor I send is, “Just go, don’t
ask.” (chuckles)
Ellie: When someone’s ready, those words
are enough.
Lee: Right. And since they know and trust me,
they know my words are being said compassionately.
Ellie: Lee, thank you on behalf of the Hoffman
community for your support of the Institute, for sharing of yourself
with us like this, and for working with physicians to change the
health care system one human being at a time.
Lee: You’re very welcome.
For Information on Lee’s Health Professional Program, please
call 1-800-769-0638 or go to www.healthclassics.com.
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