I was speaking at a healthcare advocacy meeting about the future of community behavioral health. A fellow presenter is the Research Director of the Anxiety and Traumatic Stress Program at Duke. Dr. Connor has received numerous awards, grants and lectures worldwide. She has developed a test instrument, a resiliency scale that assesses a person’s ability to overcome traumatic events.

Dr. Connor says if you can teach resiliency to patients, you can help move them beyond the stressors. For example, help patients regulate their emotions and not panic; teach them some way of staying calm under pressure (breathing, focusing, muscle relaxation); or help them to identify some inner resource and enable them to take one step forward. All of these can help patients get through the trauma.

Working with soldiers who suffered the psychic casualties of war, she found that the best way to treat the psychological consequences of war is to teach sufferers how to be more resilient. During the discussion, I asked her if I had heard her correctly, that the best way to deal with the psychiatric sequelae of war is to teach resilience, and she said yes. I responded that the best way to deal with the tragic consequences of war is to stop war. She said history had proven such an expectation unreasonable and the best we can do as psychiatrists is to develop better ways of treating post-traumatic stress.

Sadly, this represents the dominant view of how medicine is practiced in the 21st century. Doctors diagnose illnesses and prescribe treatment. This is done in spite of the fact that everybody knows the great advancements in medicine have always come from the discovery of cause and preventing its outbreak. Find the pathogens or toxin, and eliminate the problem at its source.

The best treatment for the tragic consequences of war is to stop war, not to patch up wounded warriors. Psychiatrists need to get out into community and talk about peace as a health strategy. There are medical doctors who are actually doing this. Patch Adams, M.D. and Deepak Chopra, M.D. are part of a global community of conscious peacemakers who see their jobs as preventative health strategists.

I recommend Chopra’s new book, Peace Is the Way: Bringing War and Violence to an End. Check out these websites as well: www.peaceisthewayglobalcommunity.org and www.patchadams.org.

We cannot cavalierly dismiss the idea of peace, balance, or harmony as unrealistic goals in order to justify dealing with the symptomatic manifestations of disease. It is better to promote peace than to simply promote resilience to the traumas of war. 

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My recent explorations in Maya country made me look with renewed interest at Jarad Diamond’s new book, Collapse: How Societies Choose to Fail or Succeed (Viking, 2005). Diamond is a Pulitzer prize-winning geographer at UCLA, a recipient of a MacArthur Fellowship and Japan’s Cosmos prize. He has spent his entire career wrestling with why once flourishing societies collapse.

Diamond studied four ancient societies across space and time that disappeared: the Viking settlement on the coast of Greenland, Native American Anasazi in the American Southwest, the Maya, and the Polynesians on Easter Island. All four, in spite of their diversity, made the same errors and experienced what Diamond calls “ecocide,” or intentional ecological suicide.

The Vikings who settled in arctic Greenland after 984 A.D. established a pastoral economy, raising sheep, goat and cattle. They also hunted caribou, seal and walrus, developing a flourishing trade with Norway. They disappeared 300 years later because of deforestation and soil erosion. Also, Viking prejudices about adopting any Inuit technologies like harpoons, dogsleds, or sealskin boats, doomed them.

The ancient Anasazi and Maya also disappeared because of increasing population, decreasing fertile land, and droughts. The seafaring Polynesians settled on Easter Island 1100 years ago. They cut down trees for canoes and firewood, and used the logs to help transport statues, some weighing as much as 80 tons. Eventually they chopped down all the forests and their society collapsed in an epidemic of cannibalism.

It doesn’t take a genius to see the obvious contemporary parallels. Diamond says, “Our society is presently on an unsustainable course.” Toxic waste, desertification, the polar ice caps melting, the proverbial floodwaters rising, and soon there won’t be enough species to fill the Ark. A culture of narcissism and materialism is leading to unparalleled greed, which is a shortsighted worldview, and one that presages a society’s failure.

I believe we can still change the course of our history, but we must have the will, and we must do it now. Can we, as a culture, make the political commitment to longer-term thinking rather than immediate gratification? Can we make the sacrifices it requires and give up some of the things we think we need, opting for fewer golf greens in the deserts, low-volume flush toilets, and less dependence on fossil fuels or genetically modified organisms?

Let us not let our greed exceed our need, or we will become another society that has reached its golden age. 

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While in the Yucatan a couple weeks ago, we hired a guide to show us around Maya country for a day. The dive-shop/condo owner where we were staying recommended someone she said was “the most knowledgeable guide around.” He is an American who speaks fluent Mayan and Spanish, is married to a Mayan woman, and lives in the villages. “He can be a little strange,” she cautioned. “How strange?” I inquired, thinking he couldn’t be much stranger than the people I’ve already seen. “Sometimes, he talks too much and you have to shut him up,” she replied.

It didn’t sound like much of a problem, and he certainly knew his way around, so we hired him on the spot for a full day’s excursion. I’ll call him Ernesto, who turned out to be a 61-year-old bipolar, dyslexic, ADD, alcoholic, chronic smoker, cave-diver, explorer, linguist, storyteller and writer. I learned this about him in the first 15 minutes, without my asking a single question or his knowing what I did for living. Once he satisfied his need to get this stuff out, he settled down and it turned out to be one of those remarkable days.

Ernesto took us to the less trafficked caverns, where we snorkeled in astounding freshwater aquariums. He took us to traditional villages, where kids still speak Mayan as their mother tongue. Before we entered the village, Ernesto stopped at a fishing co-op in Tulum to bring them dinner. The thatched hut was a single 8’ x 16’ structure made of wood and covered with palm fronds. There was a small out-pouching at one end that served as the kitchen with an open fireplace on which the mother of eight was grilling jungle meat.

The main room featured many hammocks strung out between the hut’s supporting poles. Traditional Maya are born, sleep and die in these hammocks. Their worldly possessions hung in bags from the support poles; there’s no electricity or TV, and the kids were attentive, well behaved and played happily together. The mother handed us a native taro root she called “koo koot macal,” accompanied by a gourd filled with honey. She motioned for us to dip the root in the honey. Ernesto lay down in a hammock where he told us stories and entertained the kids by speaking Mayan. They found his accent hysterically funny as they laughed together.

On the way home, he told us that he loves these people. They see him as a friend, never just the dysfunctional soul he himself sees. “It took me a lifetime to learn to love myself the way I felt loved here. That’s why I stayed, it took me a little while to learn, but easy has never been my path.”

To be loved, with all our imperfections, is what allows us to love ourselves and lets us reach out to love others. Don’t wait a lifetime.

P.S. Speaking about Mexico’s indigenous people, here’s an update on our trip to Huichol country, where we were invited to treat a witchcraft epidemic among the children (see Schlagbytes on “The Huichol Experience,” May 17, 24 and 31, 2004).

In the month after our departure there were a few minor manifestations of the illness, but for the last 7 months there has not been a single case.

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