The people who consult me are often desperately scared. An illness threatens the length and quality of their lives. They want to be well. They want to be cured. They want a miracle.

Unfortunately, miracles cannot be guaranteed or produced on demand. What is more certain is our ability to cultivate a sense of peacefulness and meaning even in the face of illness. This is miraculous in itself given today's world and medical culture. So many people sit namelessly, faceless and alone, on nursing home floors, passing the time before death.

We typically feel blamed for causing our illness, for we know on some level that we have contributed to our getting sick, if only by being in the wrong place at the wrong time. We sense that how we have lived has had some impact, whether through our lack of caring for ourselves, the diet we have followed, or the resentment we have never given away. We have some deeper subliminal sense that our illness somehow relates to the way we live. We have some awareness, however unconscious, that the illness makes sense in the context of our relationships and the choices we have made, or that our families have made for us. Regardless of how often doctors and others reassure us that the illness is entirely accidental, that sense of blame does not go away. We have an intuitive awareness that we and the illness are related, and that illnesses are not random. This awareness is implicit within Native American medicine and spirituality.

Buddhists call this awareness an appreciation of the causes and conditions of an illness. What torments us and causes us to feel worse about ourselves is the widespread Western European belief in the power of the individual.

Native cultures teach that the individual does not have the power to get well or sick all on her own, because illness occurs through participation in a life of many constraints. We are born into families with particular beliefs, cultures, values, and habits. These patterns are embedded in our identities. Only through later personal growth activities or therapy do we become sufficiently aware to change these patterns. We tend to think, relate, live, and feel the way our families do.

Beyond this, families are embedded in communities and cultures. Families do not consciously choose their values, beliefs, patterns of relating, and habits. The culture expresses itself through the family.

The New Age idea that "you caused your cancer, now fix it" doesn't work to promote healing. If, as Native philosophy teaches, cancer arises from every aspect of our being — including family, community, spirit, emotions, relationships, genetics, diet, and environmental exposure — how can anyone say that one person could cause such an event? I struggle to help people understand that they did the best possible given their resources and beliefs. With rare exceptions, people are always trying to do their best. Limitations come from how we were raised, our economic and political environments, and our continuing relationships, including those to our families and our cultures. Even life's mistakes can be viewed as unsuccessful or partially successful attempts at self-healing.

When a healing elder said, "Every thought is a prayer, and every prayer is answered," he meant to call our attention to the many prayers that are made each moment by each person. Many are contradictory. Two football teams pray for victory; only one can win. How is this negotiated?

To my academic friends I joke that God must be a parallel-processing, neural-network computer. This refers to the way that these devices separate, integrate, and respond to contradictory input. Many philosophers, including Native Americans, speculate that our thoughts create our reality. The Native perspective is that the Universe (Creator, God, or other name) must negotiate these thoughts to produce what we see before us. To illustrate, one elder told the story of a community praying for jobs. A power plant was built upriver and people began to get sick from the pollution. The prayers for jobs had been answered, but at a cost.

I help people see that the world is too big and too complex for them to single-handedly cause their illnesses. We may have been taught to want something (like jobs) without understanding the consequences (such as pollution and illness). We may have no choice but to participate in a society that exposes us to toxic wastes in the name of corporate profit. The ways of relating that we have learned from our families may have the side effect of eventually suppressing our immune systems. But we didn't know this consciously. These processes were not under our control.

The healing journey often involves our becoming more aware of those processes that contribute to the illness. Why? To change what we can change! To accept response-ability — the sense that we can respond to and change relationships and habits, even economic and political ones.

Therefore a healing journey must begin by addressing the blame a person feels for his role — real or imagined in getting sick. This sense of blame opposes the sense of peacefulness that is necessary for a cure. The sense of peacefulness is what one person called the greatest benefit of working with me. It must solidly exist regardless of what the actual medical outcome will be.

The problem of self-blame is rampant in our culture. Doctors ask me if I don't encourage people to feel worse if they don't get well. I respond that my first task is to help them abandon the concept of blame. I aim to nurture compassion and loving-kindness. I understand that people are always doing the best they can, given what they have learned (their beliefs and experiences) and what resources are available to them (their income, social class, education). No one would intentionally give herself cancer. No one would purposefully give herself AIDS. No one would press a button to destroy his kidneys, except for the most desperately suicidal, and even those people are still doing their best given their beliefs and resources.

People do not make mistakes; they make unsuccessful attempts to heal. Even the antisocial criminal is struggling, however unconsciously to heal some aspect of his or her life, perhaps to steal back the love he or she was never given.

An example brings these concepts alive within a unique human being and shows some of the ways I help people find peacefulness.

Ursula was a forty-seven-year-old woman healing uterine fibroids and migraine headaches. Through our work together her fibroids had dramatically shrunk and her headaches were almost gone. Then she came to one session very different, feeling drained and wanting to give up. Suddenly she was having fantasies of dying in her sleep. During the preceding week Ursula sixteen-year-old daughter had spent a night of intense retching after getting terribly drunk at her birthday party. Ursula son had been arrested for assault. One of her psychotherapy clients had killed himself. Her boyfriend had declared his inability to make a commitment because she was too old for him. Business was falling off and she was worried about money. A client had bounced a large check on her and hadn't yet replaced it. Ursula felt as if she was coming down with a major sinus infection, or at least a bad cold.

Ursula looked absolutely drained. I suggested she lie down with her head to the north so that her brain was closer to wisdom (wisdom is a quality of North on the medicine wheel). Next I did energy and bodywork with her. Energy healing is hard to describe, and some readers will doubt its very existence, imagining that my mind fabricates the sensations of moving my hands through and above another person's energy field. But science is catching up with this therapy, and studies are starting to demonstrate the validity of this phenomenon. Nevertheless, for our purposes in this book, the validity of these studies isn't as important as how people respond to the process of therapy.

I began by placing my right hand over the sinuses above Ursula eyes. My left hand roamed above her body, several inches out of contact, feeling her energy field. All of her energy felt subdued, as if she had contracted her soul into a small ball inside her heart the only area that felt normal to me. In Chinese medicine the heart is the seat of the soul. As my left hand moved above Ursula's body I felt her energy slowly increasing. I imagined moving healing energy through my right hand and into her sinuses. Having been raised "hybrid Christian," I sometimes imagine that the Christ spirit, or Christ consciousness, moves through my hand, rearranging molecules and structures in the person's body, thereby creating the healing. I feel comforted by the connections of this feeling with my childhood visions of Christ, even though I understood that my grandmother's version, which she passed on to me, was not like that of basic Christianity. (As I later read the work of Christian mystics such as Meister Eckhart, Hildegard of Bingen, Matthew Fox, and Thomas Merton, I realized that my Christ was their Christ, a higher principle of love and consciousness of all humanity — what my grandmother called "the chief spirit of the humans" — who heals by mere thought or glance.) I felt this healing energy coursing through my right hand into Ursula's sinus area. I can't always make this happen on demand, so it's an honor and a privilege when it does.

On impulse, I began talking to Ursula about stepping back and looking at her life the way angels would see her. "How would they see me?" she asked, genuinely puzzled, turning her head on the massage table to peer at me. She was sweating at the edge of her short brown hair. The setting sun was still bright against the white wall.

"They see you as exquisitely precious and lovely beyond belief," I answered. "They see your life as a beautiful work of art, whether you heal or not, whether you live another day or not, whether you solve any of your problems or not, whether your children succeed or not, whether your clients live or die, pay or don't pay. You and your life are art in their dimension, and no human life is bad art. Even the most sordid life is appreciated and honored. Their joy in you, your suffering and pain, your happiness and pleasure, is so complete that you need not do one more thing for them to love you passionately forever." Streetlights were beginning to flicker on outside the window.

"How do you know this?" she asked. I could see people crossing the street at the corner by Carnegie Hall.

I sheepishly replied, "I've had some conversations with them." Here's where I find myself walking on thin ice. My brief conversations with angels have been among the most profound experiences of my life. Though some would argue that these experiences are just imagined, I think not, because they have always changed me for the better. They gave me more compassion, more kindness, more love for humanity more flexibility, more tolerance, and more willingness to accept and forgive the foibles of others. They made me a better human being and a better doctor. If imaginary, I need more of these fantasies, and I wish I could produce them on demand. The visions of psychotic patients, on the other hand, are definitely not angelic, for those visions aggravate their fear and deepen their suffering.

"One of my most powerful experiences," I continued, "happened during midnight mass on Christmas Eve in a wooden Catholic church in South Burlington, Vermont. The choir was singing the 'Hallelujah Chorus.' I looked at the window above the cross and saw an angel outside, seemingly hanging in space, wings folded behind him. Then feelings and words exploded inside my mind; other people have reported similar experiences.

"'We have to be careful when we talk to you,' the angel said, 'for even a small part of the love we feel for you would destroy your nervous system. We have to give you very small doses of what we feel or we would hurt you.' I sensed the potential for pain even in the ecstasy of that contact. The angel proceeded to explain, or rather give me an instantaneous understanding, that surpassed what is possible with words or pictures of the angels' view of us. They see us as works of art, with their dimension holding a kind of gallery in which each of our lives can be seen in its entirety as a multidimensional structure. This is a dimension outside time, in which beginning and end are present together.

"I try to communicate that vision directly or indirectly to my patients. I try to teach them to love themselves at least a little like how an angel would love them. So maybe we could just begin to imagine that level of unconditional love. Humor me, and play with imagining that everything about your life is exquisitely perfect just the way it is."

I had other perspectives on Ursula's life problems. I knew that her daughter was a very bright, athletic, straight-A student in a difficult private school. I knew that her son had fought back from a bitter depression in which he had almost killed himself, and was doing quite well. I had heard the story of his "assault" and felt certain the charges would be dropped. I had met Ursula's boyfriend and believed she would be happier without him; he was self-centered and unable to care for her in the manner she deserved. I knew she was a very good therapist. We had talked about her suicidal patient at length when he was still alive, and I knew she had done everything possible. He had actually died in a psychiatric hospital, relieving her of any liability or even culpability for his demise in the eyes of established psychiatry. She had done everything correctly in the conventional sense of psychotherapy, only she had not saved him, as she so desperately wanted to do — that was why she blamed herself for his death. Therefore we could afford to focus on unconditional love, self-forgiveness, and loving kindness. As we did, Ursula's energy field grew stronger and stronger. Her nose seemed less stuffy. She breathed easier.

I finished by rubbing points on her neck and skull that are related to sinus problems; I had felt blockages in the movement of energy at these areas. Then I used a technique called craniosacral therapy, in which subtle pressure is applied to the cranial bones to make shifts so that energy and spinal fluid can flow more smoothly. Ursula's breathing deepened. Her body relaxed. She felt more calm and peaceful. She was ready to continue the work we were doing on shrinking her uterine fibroid and eliminating the remainder of her migraine pain.

I was encouraging Ursula to lovingly see herself as perfect. She could only do so by letting go of self-blame. Eliminating self-blame is so different from the individualistic concept of the New Age approaches that tell people, "You created your illness, now get over it." From this limited understanding of the complexity of health and disease, people feel like failures if they can't heal. The complexity of health and healing is phenomenal, and our small minds can't control or even begin to imagine the myriad forces involved in making us sick or making us well. But everyone is capable of some degree of personal and spiritual transformation, and even of imagining the possibility of angelic intervention and miraculous healing. Miracles are possible, but not something to feel guilty about if not achieved.

Once we eliminate feelings of personal blame we must address hope. Hope is hard to define, though we can immediately recognize those who have it and those who don't, even if we don't know how we make that distinction. Real hope is a by-product of creating a sense of peacefulness.