Good cop vs. Bad cop – Splitting in medicine

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I continue to have this rather unsettling experience with an allied health colleague in my team. While meeting a patient together for the first time, she would interrupt the interview during my segment to tell the patient, either directly or indirectly, that I am interrogating the patient, I am being invalidating, the information I am collecting is not important, etc.

The funny thing is, I happen to know her outside of these interviews and she is quite lovely, which is why it shocks me every time she does this.

This behavior where one tries to intentionally or unintentionally cause the person of interest to see one party of the triangle in an idealized manner (e.g. good cop, usually the one doing the splitting) and the other party as an aggressor/ perpetrator/ incompetent member (e.g. bad cop) is called splitting. Splitting behavior is often associated with patients with borderline personality disorder or other cluster B disorders, and is thought to originate from childhood experiences that made them feel invalidated and devalued, causing the child to develop this particular way of relating to others to regain some sense of control. This behavior is hugely stigmatized in the mental health field and often labelled as the patient being “manipulative”.

I am not saying that this particular colleague has a personality disorder. In fact, I am not sure if she recognizes that what she is doing can negatively impact rapport building with a patient. I had a similar experience with a patient who split the team in half, with those who were put in the idealized role constantly fighting with those who were put in the perpetrator role over medical decisions relating to this patient. Residents are often victims of such splitting behaviors because it can be easy to put them in the role of an incompetent provider/ perpetrator, since they do have less experience and confidence to be able to appropriately defend themselves. I was surprised, however, to find that residents often fall victim to such behaviors performed by other members of the healthcare team as well. Bringing up such issues with supervising physicians can mark the resident as a “bad team player”, putting a permanent scarlet letter on his/her scrubs.

After getting sick of feeling bad for myself, I tried to put an objective lens (more or less) on this matter. Why are certain allied staff members motivated to split the patient against residents or doctors in general? Upon reflecting on how splitting behaviors originate in patients with personality disorders, the answer became clear. Patients are much more familiar with the role of a doctor than the role of say, a social worker, occupational therapist, or a nurse, even though each member forms a critical part of the circle of care for this patient. Patients are also taught from a young age that doctors are authority figures who they should lean on for guidance. Because of this, the patient can, unconsciously or consciously, act in a way that make allied health members feel like they are less valuable or important. After experiencing this on a day to day basis, they may have formed this way of relating to patients to regain a sense of control and value in the workplace.

I spent some time reflecting on this to end this blog on a positive note – how can one navigate this environment in a way that prevents such splitting behaviors from developing in the first place? I feel that this situation has gotten so large that it has become a global issue – demonization of doctors and distrust in the medical system, with serious implications for public health especially during this pandemic. Unfortunately, my conclusion was that there are no easy answers to this. How do we protect residents, allied health professionals, and patients so that they do not perform or fall victim to splitting behaviors?

I look forward to the day when I read this blog and feel grateful that such interactions are a thing of the past. Until then…. ??

I don’t know.

Witness to suffering

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As a doctor, a lot of the care that I provide has nothing to do with prescribing medications or performing procedures. Sure, they form a significant part of my training and my day to day work. However, there are also many times where all I can provide for the patients is my presence, to be a witness to their suffering and to create space for them to grieve and mourn.

This was a huge revelation to me in the earlier stages of training – recognizing that there are many things we can’t just “fix” in medicine, and that care doesn’t end with telling a patient “I am sorry, there is nothing we can do”. I never realized how difficult it is to be truly present to witness someone’s suffering until I had to do it myself. It is so easy to give into the temptation to comfort, or to give false hope or even mislead. At the beginning, I told myself that it is because I care deeply about the patients, and it was difficult for me to watch them suffer. However, the more I did this, the more I realized I was NOT helping these patients by quickly wrapping up their suffering in a neat package to replace it with something prettier – I could see how this made them feel confused and lost. Why then, was it so hard for me to change my behavior?

Problem solving engages the prefrontal cortex of our brain – the part that allows us to reason, filter and regulate our emotions. Being forced to turn away from problem solving therefore leaves us feeling exposed, out of control and yes – vulnerable. However, in turning away from problem solving, we can truly be present and focus entirely on the suffering of the individual in front of us. In psychiatry, this is called “holding space”. Having the space to grieve without feeling pressured to go into problem solving mode can be a deeply therapeutic experience that allows one to just “be” and not be judged.

Think about our daily lives – how often do we simply listen to our friends, family or significant others and be fully present to witness their experiences? As children, how many of us had the luxury of this experience when we tried to share difficult experiences with our parents?

I tried to imagine what it would feel like to have someone fully present to witness my suffering, to have an understanding of how this could help my patients. My mind shifted to when I pray or meditate at my altar. Sometimes, I am looking for answers – but more often than not, what I desire is to have the time to sit in my grief and to let it all out, and to have someone sit WITH me in my grief. The sheer presence of my goddesses and spirit guides had always comforted me in my darkest times, and this is what I could do for my patients when there is nothing else I could offer as a doctor. Simply being present in their suffering was a service I could provide in those dark moments.

Now, when I deliver bad news, I sit with them, quietly, with a tissue box in my hand. I stay present with their grief, and in doing so I hold space for them to process their suffering.

It is true that this is much harder with family and close friends – those who we consider part of ourselves and can make us feel particularly vulnerable when they share their suffering. Practice makes perfect and I am still working on it.

Sitting with your feelings

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I was reading “Maybe you should talk to someone” by the brilliant Lori Gottlieb this morning just before work, my little morning ritual, when one message really struck me: it is horribly difficult to sit with one’s own feelings, even for psychotherapists. I am no psychotherapist, but as a doctor, I always ask patients to reflect on their actions, thoughts, and feelings, and encourage them to do mindfulness exercises where they try to notice their thoughts and body without judgement.

The practice of witchcraft also asks one to recognize their thoughts and feelings, so that they can be used to enhance one’s craft and power. An aware witch is a powerful witch – she who rules herself can rule the world.

Why then, is it SO HARD for me, to sit with my feelings? I spend most of my days reading, watching TV, scanning through Youtube, or scrolling through my phone when I am not working in a desperate effort to distance myself from my emotions. In a way, working is almost an escape, because focusing my attention entirely to my patients shifts me away from thinking about myself.

A common concept discussed in psychodynamic theory and in family therapy is that a child who grows up learning that their feelings are invalid, internalize this and grow up to be adults who cannot tolerate their own emotions. The act of noticing and acknowledging their internal processes become associated with deep shame, rejection, and feelings of being misunderstood such that they learn to cope with this by becoming avoidant, not just of their own emotions but of that of others as well.

The difficult part of this is that our thoughts and emotions influence our judgement and worldview whether we acknowledge them or not. Being able to sit with, notice, and acknowledge our internal processes help us realize why we see ourselves, others, and the world the way we do, and lovingly readjust if there are biases at play.

This of course, doesn’t come easily at all. I realized my own tendency to avoid my feelings when a supervisor pointed out how I tend to get flustered if I don’t know something I think a patient wants of me, and how I would completely shift my behavior without even noticing that I am doing this. My supervisor asked me to sit and slow down, and notice the thoughts that arise in my head when this happens. This was an EXTREMELY difficult exercise – at the end, I identified a DEEP SENSE OF SHAME that arose when I felt that I wasn’t giving the patient what she/he wanted. Because this emotion was so difficult to tolerate, I avoided it completely, not even giving myself a second to think about it – unfortunately, this did not stop shame from influencing my behavior. Once I did notice the thought, also called “hot thought” in cognitive behavioral therapy, which in my case was “I am a failure”, I was able to lovingly tell myself: it’s okay to not know everything, you are doing the best you can. In slowing myself down and lovingly readjusting myself, I was able to be more present and authentic with my patients, which in turn made them happier.

When practicing magick, we ourselves form as much of the spell as the ingredients, incantations, and the spiritual forces that we summon to help us. When dark thoughts reside behind the spells that we cast without our knowledge, these thoughts can cause the spell to be weakened or even backfire. See the parallel here?

I still find sitting with my emotions extremely challenging, but I consider it an important part of my journey as a physician and a witch to become more self aware. I will be sure to keep you updated on that journey – wish me luck!

Angels in our lives

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I was having my biannual review of competency today when my evaluator told me, “I am sure you are tired of people cheerleading you all the time but I just want to cheerlead you again, to keep up with your good work”.

I wish I could tell him how much his words meant to me. The thing is, at least in medicine where I work at, I do not get much cheerleading, if at all, for my successes. If anything, disclosing my research work or records of my other accomplishments have resulted in hostile behavior from supervisors and bias them to think that I am not invested in learning from them or that I think less of them because of my accomplishments. This is why I don’t offer up this information unless asked directly – even then, it is often met with, “Oh really? I guess you must be really bored here then”, or “Oh really? We need to make sure this becomes a good *learning opportunity* for you”.

This is a biproduct of an education system that thinks pointing out an individual’s flaws, instead of celebrating their accomplishments, is going to get them to learn more effectively. To this opinion, I would like to ask what evidence they are basing this on. Education theory 101 taught in teaching school states that for students who are internally motivated, strength-based teaching approaches work much better than criticism-based approaches. This is where the sandwich model of delivering feedback was developed, where teachers are coached to provide one constructive feedback in the middle of two positive feedbacks. Focusing only or mostly on short comings does NOT motivate a leaner to do better – it gets them to be comfortable with failing. One can call that developing resilience. Well, most residents would prefer to call it “learned helplessness”, which is one of the core dimensions of depression. If no matter what we do, all we can expect is criticism, then why should we try at all?

Of course, we are learners and there is MUCH we need to learn, and evaluations of those necessary skills make a lot of sense. However, evaluation for the sake of evaluation, not producing competent health care providers, discourages cheerleading and breeds and selects for educators who “get off” of criticizing learners to boost their own ego. The system that I am in even penalizes educators who give favorable evaluations to learners – someone please tell me how this makes sense. If we can’t count on our educators be our cheerleaders, in this harsh society where medicine and doctors are more demonized than ever, who can we depend on?

When I teach medical students, my first priority is to make sure that they are treating patients in a safe way and if they can’t, that they feel comfortable enough to come tell me. My second job after that is to make sure their learning goals are met in the context of what field they want to specialize in. If their field of interest does not relate to my field at all, then I make it a priority to get them home in time so they have the time to devote to self care and studying for their area of interest. Evaluations that I provide are always strength based, because more often than not, medical students are more than WELL AWARE of their short comings. I learned to do this from the many wonderful teachers I met in my life who have done this for me. My very own cheerleaders that taught me the joy of cheerleading for others and how rewarding that experience can be.

Cheerleading is not something to be taken for granted – many people, even in education, are not capable of this or know what it feels like. While this post was largely a rant of my frustrations towards the education system that I am in, I also wanted to take a moment to express my gratitude for the cheerleaders in my life – my husband, mentors, and of course my goddesses and spirit guides. May their lives be three fold as blessed as the light they have shone in my life.

Magickal cooking

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It has been grey, grey, GREY the last few days, which, in combination with my monthly cycle approaching, has just sapped the magick right out of me. I used to be REALLY ashamed of admitting that my spirituality waxes and wanes with the rhythms of my body, highs and lows of my life, and of course, the sun and the clouds of the sky. As I grow older, I am however learning to be more accepting and compassionate towards myself when this happens.

Cooking, for me, is the most accessible way to reintroduce magick to my life in times like this. After feeling drained and uninspired for the past week or so (as you may have noticed from the lack of blog posts), I decided to head to our small but cozy kitchen to cook up something magickal.

Truthfully though, what I cook for magickal purposes is actually not much different from what I would cook for sustenance. The biggest difference is the intent that I put into every magickal herb and plant that goes into that large soup pot – my favorites being celery, cilantro, lime, oregano, basil, bay leaf, thyme, star anise, cinnamon, and of course, rosemary. Having my husband, a green witch whose chosen goddess is Hestia, blow on these magickal herbs before they go in adds an additional oomph to my magickal cooking.

Yesterday, for example, I made the soup of protection and prosperity – which really was Laksa, a traditional Malaysian soup. Today, I made soup of love and health – a tomato spring vegetable soup, and soup of prosperity and protection – basil tomato cream soup. See how it works here? These soups are just soups, using regular ingredients that one can find in most kitchens. What makes them magickal is the intention to harness the plant spirits and blessings of Hestia to add spiritual meaning and purpose in our lives. The added protection, prosperity, love, and health of course does not hurt!

I truly believe that magickal food does, in fact do what they are intended to do if the intentions are true and present during the cooking process. After eating my “love” soup, my husband and I had a lovely afternoon cuddling, napping together, and making art. Yes, one may call this confirmation bias or positive psychology – but really, who cares? It makes me happy, it makes my husband happy, and invites a sense of spirituality, peace, gratitude, and wonder to our home. If that is not magick, then well, I don’t know what is.

Until it happens to you

No, this blog post is not about Lady Gaga’s timeless song, “Til it happens to you”, although I would encourage any soul to check it out.

I feel that we, as humans, are motivated by our survival instincts to engage in victim blaming. Aligning or identifying with the victim feels like admitting our own vulnerability, because if the victim was “victimized”, and we are like the victim, then we are also vulnerable to being victimized.

To cope with this fear, one points out the victim’s flaws, whether it be regarding the victim’s character or behavior, trying to make the victim as unappealing of a human being as possible, one who we can’t possibly be similar to. In short, we dehumanize the victim so that we can feel safe.

I have certainly been guilty of this myself. I did not come from money or anything special, really, and my academic achievements used to be the only thing that made me stand out from the herd and gave me a sense of belonging and identity. Because of this, I had absolute faith in my ability to tolerate whatever hardship my research or academic career otherwise would throw at me. Unconsciously, I was TERRIFIED of ever admitting that I could face a situation that I couldn’t tolerate in academia. Therefore, when I heard about other trainees leave their abusive supervisors, I used to immediately go into victim blaming mode for my own survival, thinking that the abused student/ trainee was “weak”, “useless”, and probably deserved the bad treatment anyway.

If you read my previous blogs, you will know that the goddess eventually decided to teach me a lesson and gave me an obstacle that I could not overcome. I, for once, could not tolerate the abuse that was thrown at me and had to leave that position, the learning opportunities that came with it, and the possibility of a good evaluation in that rotation. When I shared this story with my colleagues, some were sympathetic and offered me words of support and advice. Others however, looked at me with judgmental eyes veiled by fear, almost wanting to scream at me “You deserved what happened to you, that would NEVER happen to a normal resident”. They interrogated me to find out what I had done wrong to deserve this outcome, so that they could be reassured that it was my fault, and that it would never happen to them. It did not escape me that I had also felt the same urge to judge when other colleagues would confide their struggles to me – I was being taught an important lesson that would stay with me forever.

My work in providing compassionate care to my patients as a physician DEPENDS on my ability to identify with them. If a patient with an extensive substance use history walks in the door with yet another overdose – I cannot hope to provide empathy and support that the patient needs in that moment unless I feel a kinship with them. The patient was likely living in highly marginalized conditions with multiple social stressors – the substance use was a way of coping when they had no other resources. I have also been at the end of my rope at the mercy of strangers for my next meal or a roof over my head. This person could be my brother, sister, mother, father, or even me.

What do I do though, when that survival instinct to feel safe is so deeply engrained into my biology? This is when I dig into my identity as a witch and ask for the help of my goddesses and spirit guides – to allow me to transcend beyond my human nature to recognize that we are all children of mother Gaia. Spiritual leaders in witchcraft and other paths often come from dark pasts – I deeply believe that this is no mistake. I believe that these individuals are angels sent to earth to learn a lesson, so that they can alchemize their suffering into healing light.

At the end, brothers and sisters, we are ALL human. We are ALL vulnerable to the same misfortunes and follies, to the same depths of sorrow and loss. This was one of the many lessons the goddess had planned for me when I came to this earth, and I hope to share it with you today.

Have a blessed new moon, child of Gaia. I embrace you.

Embracing the Other

Working in a hospital as a doctor is an interesting experience because while you are working on a team, you are often the only doctor on the floor, especially if it is overnight and you are on call.

The responsibility of being the only doctor feels HUGE the first few nights any resident does call by themselves, and it never really goes away as staff physicians often tell me. Once in awhile, a physician from a different specialty will work on the floor with you as a part of a “buddy system” to be an extra pair of hands on the floor, which is always greatly appreciated. The downside of being that “off specialty” doc is that they are often othered by the team, seen as less competent, and treated as such as well.

I was having yet another overnight shift at the ED where my staff happened to be this off specialty doc. However, he had been working as a ED physician for many years and considered himself (perhaps accurately) a specialist in the area. Unfortunately, the night went very poorly for him. Several resuscitation cases came in that he could not manage on his own – he had to call the help of another ED doc but alas, it was not enough to save the patients. I was not involved in those cases so I did not know of the details of what happened in that resuscitation room.

The rest of the night marched on with a heavy mood. I could hear whispers from all corners of the hospital talking about how these cases did not go as they should have, that another physician would have been able to save them. It was hard to control myself from not thinking what they were thinking. Would the outcomes have been different had it been a different doctor? Someone who was trained in ED from residency?

When it came time to review some of the patients with this physician, I could see the worn and defeated look on his face. As soon as I started presenting, he abruptly cut me off and without giving me a chance to finish, he started to ask basic questions, insinuating that I basically did not know what I was doing. When I showed him my documentation proving that the information was all there, he LOUDLY told me that residents are not to be trusted and that because of this, I must follow a way of presenting as per his preferred style to demonstrate that I “am not making stuff up”. I was dumbfounded by this experience. Immediately my mind went to what I was going to put on this supervisor’s evaluation for treating his residents this way. Then, the goddess whispered in my ear, “no, Embrace the Other”.

He was alone in this entire ED, managing a highly acute floor by himself in a truly difficult night. He was further othered by the staff here due to the failed resuscitation cases. I imagined what I would have felt in his shoes, and my heart immediately broke for him. The thing is many resuscitation cases are not “salvageable” when they come into the hospital. Patients often have the wrong idea of what a resuscitation is like from TV shows – miraculous recovery is extremely rare. Even if a person’s heart is to start beating again, the chance of them regaining much of their baseline level of functioning is even smaller. With his years of experience working at the ED, I am sure he knew this too, and so did the rest of the ED team who were judging him. However, amidst all this background information, his identity as the “other” is what shifted their view into judgement and criticism instead of understanding and empathy. His harsh criticism of my work, increasing his voice so that everyone else could hear, was probably an unconscious effort on his part to re-exert his power and sense of control on this floor. Yes, it came at my expense, but what I had to endure was far less than his suffering.

Gritting my teeth and controlling my breath, I told him “Thank you so much for teaching me this, it is very helpful.” He nodded and sent me on my way to see more patients. At the end of the night, when he was doing my evaluation, he said “I was so glad you were here, it would have been a rotten night without you”. It was in this moment when the teaching of the goddess became apparent. Had I not shown understanding and patience in that moment, I would have pushed him further into the darkness. In choosing to set my ego aside to embrace the Other when nobody would, I accompanied another physician, another human being, in his journey from darkness back to the world of light.

Anger, Compassion, and Forgiveness

It was the first one of my series of night shifts at the Emergency Department – I was excited to work in the ED again (one of my favorite places to work at) and was looking forward to having a productive and rewarding night.

Unfortunately, not quite having adjusted to the night schedule, my brain was foggy and my body was exhausted. I still tried my best to be chipper with the team and present for my patients, reminding myself of my goal to be a good team player and a healing light. Despite my efforts, I made two consecutive mistakes within the first 3 hours of my shift – both small mistakes not affecting patient care, but still quite a deviation from my usual performance. I tried to not think about it and move on, telling myself that I need to be more careful tonight as I am having an “off day”.

After suturing a patient at 3AM in the morning who had decided to do laundry in the dark in the wee hours of the morning, my staff and I had a disagreement over the type of sutures I chose to use. I decided to go with patient preference in the choice of sutures, and he wished that I had used a different suture which has evidence for causing less scarring. It was a matter of opinion and practice, and he did not hold this against me in any way. He just provided me education and made it clear what his preference would be if we were to suture another patient that night. Normally, I appreciate this kind of straight forwarded communication because it allows for a smooth shift and running of the team. That night though, I found myself getting extremely angry over this, thinking to myself “HOW DARE he decide to make an issue of this on a very busy overnight shift”.

Recognizing that my anger was completely out of proportion and irrational, I took a small break and sat in the lounge area where I could take off my mask and breathe. I went over my shift and my experience working with him so far. He was a great supervisor – he had clear communication, let me know right away what he likes and what he doesn’t like, and allowed me a good amount of independence. Why then, was I so upset with him over this small disagreement?

In situations like this, psychiatrists recommend that patients go back to the time before the argument had even started, to check in with their emotional states that may have influenced their reactions to the argument or discussion. In that moment, it became crystal clear to me that I was already very upset at MYSELF for making those small mistakes in the earlier hours of the shift. Despite my best efforts to suppress these thoughts, my mind was already on edge by disparaging thoughts targeted at myself. Specifically, I was telling myself that I was a failure and a bad doctor because I had made those mistakes.

Everybody has off days. Doctors and nurses are human, and therefore, are vulnerable to making human error. The mistakes that I made had not harmed anyone, although they did cause minor inconveniences. I took a deep breath and meditated. I looked at the sigils I wrote on my badge – protection, peace and patience. I thought of my goddesses and asked for their guidance. I then thought of what I often tell my patients – What would you have told your friend if they made these mistakes? This made it clear what the issue was. I had no compassion or patience for myself and immediately jumped into a judgmental mindset – an attitude I would have NEVER taken towards any of my colleagues. The consequent feelings of being a failure was so painful to sit with, that I had displaced my anger towards myself to my supervisor as soon as there was opportunity for such transference.

Displacement, according to Freudian principles, is one of the maladaptive defense mechanisms where one unconsciously transfers/ displaces their inner conflict, usually stemming from earlier life experiences, to a situation or a person that is not a part of that inner conflict.

I was grateful for the guidance of my goddesses for giving me the space and calm to realize that self-compassion, or lack there of, was at the root of this issue. I inwardly expressed my gratitude to my goddesses and allowed myself to feel the feelings of shame and disappointment at myself for the mistakes I had made. I then told myself “I forgive you – I forgive you for these mistakes and for being harsh on yourself. I honor that your desire for perfection came from a place of wanting to be a healing light. I embrace you and I love you”. Immediately, I felt a sense of relief come over me.

I was able to return to my shift and had a great night – we helped many people and my supervisor and I made a fantastic team through a very busy ED shift. While this shift had not gone exactly as I had planned, I was grateful it happened. It was a wonderful reminder of the importance of self-compassion and forgiveness. I was also reminded that when all else fails, I will always have my spirit guides and higher self to show me the way.

Shadow Work and Projection

Lately, I have been noticing that “Shadow Work”, a concept originating from psychoanalytic theory, has been appearing more than ever in mainstream media. I often hear it in the context of Wicca, a modern religion combining witchcraft practices and psychological principles, as well as many other spiritual paths.

In psychology, the Shadow is an analytic principle that identifies the part of one self that has been split from one’s conscious identity. While it is hidden from one’s conscious mind, this Shadow forms a significant part of one’s personality and how they relate to the world. While different branches of psychoanalysis calls the Shadow by different names, they generally agree that identifying the shadow is an important part of psychotherapy as it brings into awareness one’s behavioral patterns, in particular in relationships with others, that has been hidden from their conscious mind. For example, imagine a girl who has been raised by an unpredictable mother who would swing from being verbally and physically abusive to the most loving creature in the world within a split second. A belief forms in her that adults, or authority figures in general, are dangerous and not trust worthy, and that she is not worthy of receiving unconditional love and care. This belief, this way of seeing the world is so painful for her that she represses it deep into her unconsciousness – it becomes her shadow. As an adult, she has recurring issues in her life resulting from rejection of authority figures and accepting love or care from others, particularly from those that remind her of her mother. Unconsciously, she projects her belief that authority figures cannot be trusted and that she is unworthy of love and support whenever she meets a person or a situation that triggers this shadow to reappear, lifting her away from reality and making her see the world through the veil of her shadow.

Shadow work as a Wiccan principle centers around identifying one’s shadows and bringing them into consciousness, so that one can ask for help from spirits, gods and goddesses of the highest good to integrate the shadow into one’s true self. Working through one’s shadow is thought to allow for the emergence of a more whole, and integrated self, which makes them more aligned with the Universe and their magick more powerful.

The concept of the shadow has existed far before modern psychology and Wicca. Many spiritual paths dating back thousands of years and religious teachings have identified the role of the unconscious mind in how we see the world. Many meditation practices, in particular, focuses on making room for one’s shadows to appear into the conscious mind so that they can perceive the world as it is without the cover of the shadow. In Buddhism, it is said that when Buddha was born, he looked up at the sky, down at the earth, and said “Between the earth and the sky, only I exist”. There are a number of different interpretations for this saying. My favorite one is that Buddha understood that he himself, was most responsible for how he sees and relates to the world; that he understood that only himself is the true builder of his Universe.

What can we do then, once we become aware of this shadow? Freudian psychoanalytic theory states that bringing the shadow into one’s awareness, also known as “insight” is enough of a treatment in itself to alleviate the impact of one’s unconscious influences in their psychopathology. Internal family systems talk about making space for the shadow in one’s mind by accepting it and allowing it to co-exist peacefully with the other parts of one’s identity, so that they can be integrated into a more mature and resourced part of themselves. Dialectic behavioral therapy, which incorporates a significant amount of its techniques from Zen principles, suggests that one should mindfully notice, without judgment, one’s shadows as they emerge, accept and honor them, AND at the same time, make an active effort to see the world without the influence of their shadow. In Gabrielle Berstein’s “Universe has your back”, she shares a mantra/ prayer where she beautifully demonstrates this principle of honoring one’s shadow while a making a commitment to see the world without it.

In ancient witchcraft or paganism, the influece of the Shadow or the unconscious was at times descirbed as being “posessed” by the evil spirits and energies from one’s past. For example, exorcims or banishing spells were often targeted at expelling the evil spirits hunting a person’s mind that originated from a traumatic event(s) from their past, such as war or rape, producing anxiety, depression, and even psychosis.

As a physician and a practicing witch, I find myself adopting both approaches. As you have probably already guessed, the above example of the abused and neglected girl is my own story, my own shadow. Using the psychoanalytic theory, I recognize that unconscious beliefs originating from my childhood trauma influences how I relate to others and the world. I try to keep this in mind when I find myself suddenly spiraling into fear-based decisions and judgements of others so that my world is not always covered by my shadows. I embrace my younger self and tell her, Of course you had to guard yourself from trusting authority figures, because trusting them was not SAFE. I understand and honor you, and I also recognize that we are at a safer place now where we are surrounded by wonderful mentors and have the resources to defend ourselves. I also recognize that I am still hunted by the evil spirits of my past, the spirits that hunted my mother, and hunted her mother. I ask for strength from my goddesses and higher spirits to help me see the world in its truth, and to shine light in my path to banish the evil spirits of my past. I used to struggle with consolidating magick and medicine especially with matters of the mind, seated in the brain which we understand so little about. Now, I understand that they are in fact two slightly different paths that ultimately aim to get us to one shared destination – moving us closer to peace and love.

Manifesting and Crafting

I love crafting.

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My love of crafting is one of my regular reminders that there is something magical inside of me.

Not just crafting, I love anything where I am engaged in creating something that has not existed before. I love building things out of clay, painting, western and Chinese calligraphy art, making music, and creating digital art. This translates into research as well – my favorite part about doing a research project is at the very beginning, where I am coming up with a research question and designing a particular technique or optimizing a protocol.

Most of the time, if not all, I do not have any clue as to what the final product is going to look like. I am just captivated by the joy of creation. I put my hand on the equipment, smile, and let my intuition guide my work. I know that as long as I am having fun, the outcome will ultimately be a reflection of that joy.

This is a little statue of the goddess I made. It is of course not perfect – far from it, in fact, if you want to consider the technical aspect of it. However, when I look at it, it brings a smile on my face, and I feel the joy that I felt while creating my little goddess. It is amazing how energy translates as well – when I showed my little figurine to my husband, he immediately smiled and gave her a loving pat on the head.

As witches, we co-create our destiny and the world that we live in. The Universe becomes a product of the beautiful harmony between our intentions and the spirit. Lately, I started to wonder why then, do I not approach co-creation with the joyful wonder and curiosity that I have when I am crafting. Instead, often, I find myself approaching new situations with apprehension, and at times, even outright assumption that the outcome would be horrific.

Thinking outside of magic, self-fulfilling prophecy is a well-known and studied concept in psychology. It applies to situations as well as people. If one believes that the outcome of a situation will be horrible, and therefore there is no point in trying, the lack of effort and negative behaviors that this person exhibits as a result of these beliefs will ultimately result in a bad outcome – thereby confirming this person’s “prophecy”. Another well-studied concept in psychology is Confirmation Bias. Confirmation bias is one’s tendency to look for evidence that is confirmatory to the person’s ideas/ beliefs/ opinions, adding additional evidence that the belief was correct. For example, if I approach a new rotation with the preconceived idea that it would be a bad rotation, my mind would unconsciously look for signs that it is a bad rotation, focusing on negative incidences and remembering them instead of positive experiences that also occurred with the same or even greater frequency. Overtime, these negative experiences will be much more salient and accessible in my memory than the positive ones, making me CONFIRM my BIAS that the rotation was in fact, bad.

As a witch, I believe that the Universe returns the energy that I put out. This is a Universal notion that is echoed in many different cultures – I strongly believe that ideas that resonate and persist in multiple cultures speak to the Universal truth. Therefore, if I approach a new situation with negative energies, the future that I co-create with the Universe will reflect this negative energy, ultimately leading to a negative outcome.

Crafting and co-creation are both acts of creation. I can tell myself that I approach crafting with much more joy than I do towards entering novel situations in REAL LIFE because I have complete control over what I craft while I have very little control over my reality. However, believing this is a CHOICE that I made. In crafting, I do not have control over the weather conditions that my air dry clay is exposed to while on the balcony. I have no control over the hairs falling out of my dollar store brushes, and I certainly have very little, if not ZERO control over my tempéramental computer and its constant struggle to run my lengthy codes. What is different is that in crafting and even in research, I have unconsciously made a decision that whatever is produced at the end of it is worthy of love. This allows me the freedom to approach crafting with wonderous curiosity and without fear of the outcome.

I am very well aware that many situations in real life are not enjoyable and even painful. I will not lie to myself and say that all parts of life are joyful, even if I make significant efforts to believe that they are. However, I can make the choice that no matter what, at the beginning, end, and in every step of that journey, I will love myself and trust that I am worthy of love of the Universe. Co-creation is working with the Universe to shape my reality. The product of co-creation, therefore, is my future self.

This blog therefore is a declaration to myself and you, my brothers and sisters, that I make a commitment to believe that no matter how circumstances outside of my control tear me apart, I am, even if I am in pieces, worthy of the love of the Universe. I trust that no matter what, I work with the Universe to co-create my reality where the outcome will always be of love.