The Placebo Effect

Greetings,

Story Listeners are part detective, translator, and healer. My placebo effect stories involve a different definition of placebo.

Most of us associate placebo with dummy pills or something other than the real thing. Placebo may be used in a research project where one group has the real thing and the other a placebo. Both groups are told the same thing so neither is aware who has the placebo.

My story begins in an unrelated way. I received a request from Jane Estrata to send several papers Gordon Roberts had written. Gordon had been at the Vanderbuilt Hospital for medical care under a Dr. Roberts for shy dragger syndrome. The syndrome, a rare disease of the autonomic nervous system is similar but different from Parkinson’s disease. Gordon gave me his papers before his death. Jane was doing a research project for Dr. Roberts, collecting articles patients had written. They hoped to publish a book, the first half explaining the medical perspective and the second half would include the articles by patients. In our phone conversation I said I had a question. How about asking the people with shy draggers syndrome what word they use to describe their condition. I knew this was a long shot and not part of the protocol. Six months later I received a call from Jane saying she was asking the question and most were replying, “stumbling in the dark.” The shy dragger patients begins to stumble as a drunk when the start walking and their blood pressure drops. Super specialists stumble in the dark as well since they do not understand this illness.  They can only treat the symptoms. The next most frequent answer had to do with the hand they had been dealt. Like in the cards they had been delt, a more fatalistic metaphor.

Jane obviously passed this on to the person who was in charge of the Shy Dragger support group. I received several calls from her that resulted in a trip to Phoenix to talk to the support group about metaphors. The unique feature, they met at the same time as the International Autonomic Neurology specialists from around the world. 

Guess who was there? Dr Roger Bannister, the man who broke the four minute mile. He was a neurologist in England specializing in shy dragger syndrome. He was on a panel that spoke to the support group including both patients and caregivers. They received an update on the latest medical findings, which didn’t seem to be much. The discussion was enlightening just the same.

Later as I was going out the entrance to the motel I met Dr. Bannister who was standing there. I introduced myself and said I had a question. He gave me permission to ask. “I work with volunteers in the hospital who listen to patients stories. And on occasion they have mentioned how a darkness in the face will become lighter as their story is shared. What is going on in the autonomic nervous system to bring about the change.” He said without hesitation, “The placebo effect.” Someone came up and interrupted our conversation. I am left with this two-word answer that doesn’t make any sense to me. That was my last and only chance to engage Dr. Roger Bannister. However, I filled the word for future reference hoping to understand some day. I had a clue without a catch.

Because of my role as a chaplain and a department manager I received a hospital management magazine with management articles as well as a few by physicians and nurses. One physician wrote a monthly column. A year later he had a column on “the placebo effect” where he says doctors in England have a different definition. He referenced an article from the English medical journal Lancet. I checked with the medical librarian and now I have the whole article. The core of the English definition is this, “The relationship the doctor has with the patient is equal to the treatment being given.” Aha! The stories Befrienders are hearing that bring about non verbal changes is this relational component the English call the placebo effect. It was this effect that allowed the volunteers and non professionals to become part of the Samaritan suicide prevention program.

This is an exciting breakthrough for a detective that has been wondering what to do with the clue “placebo effect.”

Then I heard about Dr. Herbert Benson’s book “Timeless Healing.” He wants to redefine the placebo effect with a down to earth application of the English definition that has a direct physiological benefit. However, he is translating the term, moving the definition to a new place. The change will require both professionals and non professionals to think differently about some basic realities.

I bought the book before one of our Thanksgiving trips to family in California. The book was a good read on the plane going and on return. On return we stopped at Las Vegas where my aunt was living in a nursing home.

Herbert Benson calls his story approach “Remembered Wellness.” Placebo is redefined as "remembered wellness" (Benson, p. 20-1). When people tell their story they can move from sad times to good times and in so doing they engage in self care from a health standpoint. This is “Remembered Wellness.”

“The placebo effect yields beneficial clinical results in 60-90% of diseases that include angina pectoris, bronchial asthma, herpes simplex, and duodenal ulcer. Three components bring forth the placebo effect: (a) positive beliefs and expectations on the part of the patient; (b) positive beliefs and expectations on the part of the physician or health care professional; and (c) a good relationship between the two parties.” (Benson and Friedman, p. 193) 

When prayer is present imperative ...

Greetings,

Our pre-existing environment for Prayer.

Our relationship for prayer is already present in a continuous mode, ever present from the beginning and through eternity. Luke’s Gospel gives more space and clarity to this environment in the 11^thchapter of Luke. Matthew’s Gospel being earlier sets if off.

In Luke a disciple, unnamed, asks, “teach us to pray as John’s disciples.” Teach is in the aorist imperfect meaning action in the present now. Jesus begins with what is commonly called the Lord’s prayer.

In the Lord’s prayer are verbs of interest. Hallowed, come, be done, are all in the aorist imperative meaning now, in the present. Give changes to aorist imperative where giving will be continuous in the present. The giving has no beginning or ending, it is ongoing. We are in a pre-existing environment. And it is each day which re-enforces the continuous. Forgive moves back and puts the focus on what we are to do in the present now. Deliver in "deliver us from evil" is also aorist imperative with a focus on the present now.

The prayer environment in the verb forms move back and forth between a focus on the present now and continuously. This gets expanded as Luke continues with the start from Matthew. Luke adds a story of needing to get bread from someone who has already retired for the night. The disturbance causes (what was to be continuos, rest for the night} to be interrupted by the persistence (aorist imperative) of the intruder. Permission granted to intrude on God in a present now.

Here is where Matthew and Luke unite in their verb forms which expand on our prayer environment with Luke 11:1-13 and Matthew 7:7-12  

We are to ask, seek, and knock continuously in the present. There is no indication of time out. And if we do take time out what we left continues. We are in a prayer environment as the air around us. Prayer becomes part of our autonomic nervous system where our prayers continue while other areas of consciousness take center stage. Coming back reaffirms, adds to, revises, what we ask, seek, knock. At all times we are ready and open for the outcomes of these three modes. Aha! Moments await us. 

Shalom,

Marlin 

A present imperative verb form involving "follow." "come and see"

“Follow” as a continuous action in the present, this is the Greek verb present imperative. We don’t have this in English as our verbs are more time centered than action.

The first time "follow" appears in the Gospel of John is in Chapter 1, and the last time is in Chapter 21. A lot happens in between.

Starting with chapter 1 and the present imperative verb form.

We have follow in the present imperative.

1:43th epaurion hqelhsen exelqein eiV thn galilaian kai euriskei filippon kai legei autw [o ihsouV] akolouqeimoi   

43 The next day Jesus decided to go to Galilee. And he found Philip and said to him, "Follow me."  

190 [e]
Akolouthei
Ἀκολούθει
Follow
V-PMA-2S

46kai eipen autw naqanahl ek nazaret dunatai ti agaqon einai legei autw filippoV ercou kai ide   

46 Nathana-el said to him, "Can anything good come out of Nazareth?" Philip said to him,"Come and see."

Come is in the present imperative and see is in the aorist imperative. Interesting contrast between present imperative and aorist imperative. Both focus on the present but one, Come, is a continuous present, and see, centers on the specific present along the way. Aha’s come out of coming as a continuous, where you stay alert continuously for insights in the present moment, like this insight in the now. Aha!

"Come and see" also appears in the story of the raising of Lazarus in the same two verb forms. Chapter 11.

At the end of chapter 12 we have follow and walk and believe in the present imperative, again use the word continuous with each.

Jumping a lot of chapters and more than one present imperative we find a significant number in Chapter 21. They are marked red here. Hopefully when I transfer this article to the blog. Yes they are in the red.

^{John 21: 15} So when they had eaten breakfast, Jesus said to Simon Peter, “Simon, son of Jonah, do you love Me more than these?”

He said to Him, “Yes, Lord; You know that I love You.”

He said to him, “Feed My lambs.”

¹⁶ He said to him again a second time, “Simon, son of Jonah, do you love Me?”

He said to Him, “Yes, Lord; You know that I love You.”

He said to him, “Tend My sheep.”

¹⁷ He said to him the third time, “Simon, son of Jonah, do you love Me?” Peter was grieved because He said to him the third time, “Do you love Me?”

And he said to Him, “Lord, You know all things; You know that I love You.”

Jesus said to him, “Feed My sheep. ¹⁸ Most assuredly, I say to you, when you were younger, you girded yourself and walked where you wished; but when you are old, you will stretch out your hands, and another will gird you and carry you where you do not wish.” ¹⁹ This He spoke, signifying by what death he would glorify God. And when He had spoken this, He said to him, “Follow Me.”

²⁰ Then Peter, turning around, saw the disciple whom Jesus loved following, who also had leaned on His breast at the supper, and said, “Lord, who is the one who betrays You?” ²¹ Peter, seeing him, said to Jesus, “But Lord, what about this man?”

²² Jesus said to him, “If I will that he remain till I come, what is that to you? You follow Me.” 

Remember Feed, Tend, Feed, Follow are continuous in the present. 

I am finding the mental discipline of present imperative, continuous in the present, generates a new kind of consciousness. 

How does the present imperative verbs impact you?

And a concluding question. Who is the person in the Gospels who uses the present imperative the most and what is the reason for that?

I will be posting more examples of the present imperative verbs from the Gospels. How about the Gospel of Luke and prayer.

Shalom,

Marlin

Pursuing a verb form in Mark’s Gospel

Finding more good in the Good News.

I don't know exactly when this Aha! became a curiosity. I began to notice the present imperative verb form appearing in various places in the Gospels. The word listen in Mark, Chapter 4, when Jesus begins teaching with parables may have been the first. Listen is in the present imperative meaning to listen continuously in the present. Without being any authority I have the impression the Greek present imperative is without a duplicate in English. Call me an amateur with a great interest in how language functions in the communication process.

A slow dawning for a new way of thinking and believing was a slow process over five or six years as I read the daily office with their Scripture selections. I now had the  benefit of the HUB and their interlinear made this search more feasible. All the parts of speech were listed for each word. Before I had been using a bound volume of a New Testament Interlinear without any listing of the parts of speech. There I could only make a guess on the endings of words from my limited knowledge of Greek

My retirement project has been to construct my own interlinear. I am near completion with the four Gospels. Now I have the time to check out some other things.

This is what my Aha! insight has uncovered up to this point. First, Jesus is the one who seems to use the present imperative verb form. That raises a few questions on its own. When he starts his ministry in the early part of Mark's Gospel we find him saying, repent and believe. Both are in the present imperative, The verb form is saying this is not a one time happening in time, this is a process over time, on going. Repenting and believing as you go, daily in every now moment, is lived within this framework/context of continuous.

I am nw collecting these places in the Gospel where the verb form appears. I have a good start already. I will gradually post them here. I will stay with The Gospel of Mark now since that has been the main reading in the Daily Office.

If your as curious about this as I am or if you know others who have pursued this: send me a snail mail to

Trinity Episcopal Cathedral, 121 West 12 Street, Davenport, Iowa, USA. 52803

Mark’s Gospel, chapters 2 AND 10

Two healing stories, the paralytic and blind Bartimeus.

Here we have Rise and go both place, go, walk, 

CHAPTER 2

Μαρκ 2:9 τι εστιν ευκοπωτερον ειπειν τω παραλυτικω αφεωνται 

σου αι αμαρτιαι η ειπειν εγειραι και αρον σου τον κραββατον 

και περιπατει Ä ? 

⁹ Which is easier, to say to the paralytic, ‘Your sins are forgiven you,’ or to say, ‘Arise, take up your bed and walk’? 

CHAPTER 10

10:49 και στα ο ιησου ειπεν αυτον φωνηθηναι και φωνουσιν τον τυφλον λεγοντε αυτω θαρσει εγειραι φωνει σε Ä 

⁴⁹ So Jesus stood still and commanded him to be called.

Then they called the blind man, saying to him, “Be of good cheer. Rise, He is calling you.”

10 ινα δε ειδητε οτι εξουσιαν εχει ο υιο του ανθρωπου αφιεναι επι τη γη αμαρτια λεγει τω παραλυτικω Ä 

¹⁰ But that you may know that the Son of Man has power on earth to forgive sins”—He said to the paralytic, 

11 σοι λεγω εγειραι και αρον τον κραββατον σου και υπαγε 

ει τον οικον σου Ä 

¹¹ “I say to you, arise, take up your bed, and go to your house.” 

Rise is present imperative. It is one of five in Mark. Rise continuously.

Fourteen occurrences all together in the New Testament, five in Mark. 

Again, with one exception with the word rise, Jesus is the one speaking. It is as if healing is not is not a one time event within a person but an ongoing experience in the present which brings a transformation within as well. Life has a before and after the event and the after will be continuous as it is now lived from a different perspective. Another Greek word for time becomes relevant, kairos, when the time is ripe, ready, in the fullness of time, in contrast to chronic, where we get our word chronology. Each of these healing stories in Mark are a kairos moment.

Shalom,

Marlin Whitmer, BCC (Ret.)

Bureaucracy is Everywhere

 I am selling a lake home where my first wife and I lived for 21 years before her death. Since then I have lived there most of the time but less for the last five years since I remarried and my new wife has a nice home in town. I kept the lake house for recreation and a big garden. But during the garden season this year I realized the driving was getting too tiresome. And with the kind of hot weather we had from time to time I wasn’t keeping up even though I had some help one morning a week. 

I contacted the realtor who sold us the property in 1990 to get the name of a new realtor. The previous realtor had retired. The new person had seventeen years of experience, even with property along a waterway. She immediately made suggestions, new carpet, new paint, and remove most of the furniture. People like space. We were into a fast pace which continued to the end of October when it went on the market.

Some major issues remained: Flood insurance and a new septic system. A survey was done and Fema was notified. They finally responded in our favor partly. Not all the property is in the flood plain. That makes a difference somehow. A contractor for a new septic system drew up the plans. I submitted them to the Lake Board President who sent a letter back indicating permission.

The winter weather slowed sales but by mid January we had a buyer. Closing was first schedule of February 8^th. Questions about a loan moved the closing to the 25^thof February. Then the week of the 2^nd I received an email from the Board Secretary they had not received my detailed drawing of the septic system. The first was more of a sketch. I was under doctors care for a sinus infection so in no way could I respond. The realtor went to work. Friday of last week some of the board met with the contractor and all questions were answered. They didn’t need a detailed drawing. The President apologized for not making it clear about needing a second diagram.

We are now back on go with letters giving the okay. 

When I received the word for a second detailed drawing, never mentioned before, I send back an email which included this short paragraph.

“Thanks for your reply. This is a great example of a constraint. I could go into greater detail. It is all about bureaucracy. I read a book on the subject and the chapter on constraints was the best. So here we are dealing with a constraint that surfaces three months after the first letter. Not costly to you but we will see how much for me.”

The constraint has been satisfied. But I now have an up to date example of how bureaucracy is everywhere, don’t just criticize the government.

Shalom,

Marlin 

From Blind to Seeing

In the Gospel of Mark, chapter 8, we have a healing of a blind man, but he only half sees at first. As a literary devise he will represent the disciples on the level of understanding, sunsets. They are hanging in there as disciples but they are blind to what is actually taking place. Peter becomes our leader of the half blind, not understanding, "hardness of heart".       

Now I want to introduce Otter Scharmer,  a professor of leadership and management from the Massachusetts Institute of Technology. He has an article entitled:" uncovering the blind spot of leadership."

His opening remarks, "Why do our attempts to deal with the challenges of our time so often fail? The cause of our collective failure is that we are blind to the deeper dimension of leadership and transformational change."  Change requires a descent, so goes his Theory U, a big Capital U. on the downward side you have various states of blindness. Lets see if Peter fits as Jesus makes the descent on the way to the cross. 

Jesus big death preparation event is the Transfiguration. Luke's Gospel makes the clearest statement about this. Mark’s Gospel has Peter saying, ""Rabbi, it is good for us to be here; let us make three dwellings, one for you, one for Moses, and one for Elijah." He did not know what to say, for they were terrified." Terrified, ekphobis in the Greek. We have the word phobic in English for fear. Peter has a phobic reaction on the spot, out of fear, literally.

What does Scharmer have to say about resistance in the descent. One form of behavior is called VOF, voices of fear.  Peter becomes typical then as well as folks today who expressing fear about changes.

Peter's blindness is not over. Earlier At Cesarea Philippi Jesus asks who do people say that I am . Peter has it half right. He half sees. Mark 8:31-38  “Then Jesus began to teach his disciples that the Son of Man must undergo great suffering, and be rejected by the elders, the chief priests, and the scribes, and be killed, and after three days rise again. He said all this quite openly. And Peter took him aside and began to rebuke him.”

Scharmer talks about voices of judgment. VOJ. Peter judges Jesus’ understanding of the Messiah. Peter is not ready for the way of the cross.

Peter’s blindness continues. He oscillates and boldly claims to be courageous. Mark 14 Peter said to Jesus, "Even though all become deserters, I will not." Jesus said to him, "Truly I tell you, this day, this very night, before the cock crows twice, you will deny me three times." But he said vehemently, "Even though I must die with you, I will not deny you." And all of them said the same.

Scharmer talks about Voices of cynicism. VOC. Not an exact fit here. Peter is more arrogant. What does fit is Scharmer’s failure of will. Moving down the left side of the U is about opening up and dealing with the resistance of thought, VOJ, emotion, VOF, and will, VOC.” I’d say Mark’s Gospel anticipates Otto Scharmer rather well. Mark could have taught at MIT.

These examples from Mark’s Gospel and from Scharmer’s article are not the end of the story.  

Scharmer talks about leadership with a difference. He quotes, Bill O’Brien, who’d served as CEO of Hanover Insurance. He first asked, what is the most important learning experience in leading profound change, O’Brien responded, “The success of an intervention depends on the interior condition of the intervenor.”  Jesus talks about our interior life in Mark’s Gospel, “It is what comes out of a person that makes the difference.”

And the experience of the Risen Christ, without a shadow of doubt, changes the interior life of Peter. He isn’t ready to sing the Halleulia Chorus the first day, huddled with the rest in the upper room, but he is on this way. And the journey is told backwards in the Easter lectionary.  We are now getting earlier accounts of Peter. On Easter Sunday we went fast forward with Peter in Joppa about to have an experience that confronts him as a Jew and his rules for easting what is unclean. His inward change as the Holy Spirit is at work, brings a statement showing blindness overcome. He says to a room full of Gentiles, Not his everyday experience,  Acts 10:34-43 "I truly understand that God shows no partiality, but in every nation anyone who fears him and does what is right is acceptable to him.”   

We need to spend time with the Greek word Peter uses “I truly understand, I now see,”   katalambano  Lambano is the word for receive. He is receiving a new understanding, a new revelation of Christ at work.  Receive the Holy Spirit will be center stage again.

Jesus says Receive  labete, aroist imperative, a form of lambano meaning, continuously receive the Holy Spirit. Peter is on his way. And this is no one time event. This is a life time of maturation and transformation in the Spirit.

I incorporated katalambano in the Befriender training model where during our reflecting and debriefing times we would receive something new, some insight, some interpretation, some meaning, some consequence, some outcome as they like to say in hospital language. I trust the Holy Spirit to provide Aha! experiences. some with a little a and some with a big A . Aha! katalambano. 

I was a distance learning facilitator on the Healing Power of Story Listening for the Wayne Oates Institute. There health care provided receive CEU’s. At some time during the six weeks one or more of the participants would have an aha! experience. Seeing anew or being renewed in the discipline of listening. 

The Aha!s were not over for Peter. He and Paul still had to work things out in the council at Jerusalem as to what the Gentile mission meant. The same is true for us. The aha’s are not over for us. we don’t have it all worked out here at Trinity Cathedral or elsewhere. Like an early Greek Bishop said, we are in perpetual progress through labete, continuously receiving the Holy Spirit, in order for our blindness to be overcome. Then we too can say with Peter, katalambano. “I truly understand.” 

Shalom,

Marlin Whitmer

A New Opportunity

A New Landing Site (Beach Head) Feb 1, 2019

Greetings All,

This article from the Quad City Times this week may not be all that impressive to some, but I became very excited. Follow me after you read the article.

In the late 80's we had a project at St. Luke's hospital called Umbrella for Caring. We arranged to follow patients form hospital to home with Befrienders from six chuches doing the follow up. The experience was written up and published in the Journal of Pastoral Care. I gave a talk at the College of Chaplains at the time. The Executive Director insisted it be published when he encountered some resistance.

I have scheduled a meeting with Dr. Jim Bang this coming week. I have no idea where our conversation will lead. I will share the three year study from the late 1980's. Could the project be renewed. A new ingredient would be parish nurses to compliment Befrienders.

If anyone is interested in follow up you can write to me, snail mail, I will give updates from time to time in the blog, even the death sentence if that is what happens. Before the death sentence I will add what I call footnotes that support relational communities, even liturgical communities, for a healthy community. Jesus continues to heal. "Brokenness is not the last word."

The Rev, Canon Marlin Whitmer,
Trinity Episcopal Cathedral
121 West 12th Street
Davenport, Iowa. 22803

I have the wonderful title of being a Community Facilitator. Since I made it up I am avoiding certification at all costs. Meaning I am not spending a penny to be certified.

Shalom,
Marlin