Category Archives: Being in the World

Inner Democracy.1: Democracy isn’t just “out there,” it is also “in here”

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In this series of essays, in the 250th year of the United States of America, I will develop the idea of Inner Democracy – a democracy of mind and heart and soul – to complement our outer democracy.

We are at a crisis of democracy, there is extreme polarization, accusations of “the other side” being “fascist” or “socialist/communist,” and levels of mistrust in each other and in our democratic institutions that have not been seen in generations.

As Parker Palmer has written, in Healing the Heart of Democracy: The Courage to Create a Politics Worthy of the Human Spirit (2011),

“If American democracy fails, the ultimate cause will not be a foreign invasionor the power of big money or the greed and dishonesty of some elected officials or a military coup or the internal communist/socialist/fascist takeover that keeps some Americans up at night. It will happen because we—you and I—became so fearful of each other, of our differences and of the future, that we unraveled the civic community on which democracy depends, losing our power to resist all that threatens it and calls it back to its highest form,” (8).

We think of democracy as a form of government, as something outside of the individual person, but Palmer reminds us that democracy is ultimately about “you and I,” and not about something “out there.” Democracy is a “government by the people,”[1] and we are the people. The kind of democracy that Palmer envisions, one that is “worthy of the human spirit,” is the kind of democracy that moves us from Me to We. This Journey from Me to We is a difficult one, and it starts inside each of us.

Jeremy David Engels, in his book, On Mindful Democracy: A Declaration of Interdependence to Mend a Fractured World, defines “true democracy” as “ working together to care for each other and for the life we share,” (4). Democracy, for Engels, is about collaborating and caring, not just for ourselves but for our shared life together on our only ecosystem of the Earth.

There is a crisis of democracy in what we even mean by “democracy.” Is democracy a libertarian ethos of being able to maximize one’s own life, liberty, and, happiness, regardless of the consequences to others and the environment; or, is democracy a higher, spiritual calling of caring and collaboration?

Engels brings our focus on democracy from the individual to the community through synthesizing the spiritual traditions of yoga, Buddhism, and Christianity.  He draws on  Vietnamese Zen Buddhist Thich Nhat Hanh’s, “interbeing,” an intellectual/spiritual understanding of the interconnectedness of life, and the Christian community building of Martin Luther King Jr.’s “beloved community,” which then leads to democratic action. Engels re-writes the Declaration of Independence into a Declaration of Interdependence, recognizing the inherent interconnectedness of life.

Mindful democracy is a pathway and practice for developing the experience of inner democracy which can then be practiced in its outer form as building the beloved community and democratic action in the world. Inner democracy is an inner experience within the individual that can then lead to an outer democratic citizenship and government. We can think of inner democracy as a variety of spiritual democracy.

Steven Herrmann has written about the idea of “spiritual democracy:”

“Adopting the big idea of Spiritual Democracy, the realization of oneness of humanity with the universe and all its forces, can help people feel joy, peace, and interconnectedness on an individual basis. It can also inspire us to undertake sacred activism, the channeling of such forces into callings that are compassionate, just, and of equitable heart and conscience, and give us some tools to start solving some of these grave global problems, while uniting people on the planet.”[2]

Spiritual democracy, as defined by Herrmann, is founded upon an experience or realization of “oneness” and “interconnectedness.” He believes that this experience of inner democracy can lead to outer action, “sacred activism.”

Joseph Rael (Beautiful Painted Arrow) and I wrote about Spiritual Democracy in our book, Becoming Medicine: Pathways of Initiation into a Living Spirituality. We drew upon Herrmann’s ideas and combined these with Joseph’s perspectives, we spoke about the “inner journey of the democratic shaman,” and summarized a version of the Hiawatha story about Bringing the New Mind of the Great Peace. We made this chapter available as a free pdf download.

In a Becoming a True Human podcast interview with Jeremy David Engels, Chris Smith and I spoke with him about his book, On Mindful Democracy, and ideas about spiritual democracy, mystical democracy, inner democracy, and he had an idea of putting together a group of writers and thinkers to talk about The Varieties of Democratic Experience, with a nod to William James’ Varieties of Religious Experience.

I would like to further develop some ideas around inner democracy, drawing upon the work of other writers and some of my past writing. Joseph Rael (Beautiful Painted Arrow) and I wrote a chapter on “Spiritual Democracy” in our book, Becoming Medicine: Pathways of Initiation into a Living Spirituality. This draws heavily on Steven Herrmann’s work as well as Joseph’s teachings on peace and the idea that we are cosmic citizens. As Engels did, I drew upon Thich Nhat Hanh’s concept of interbeing and Martin Luther King Jr.’s beloved community in my book, Caring for Self & Others: Transforming Burnout, Compassion Fatigue, and Soul Loss, particularly in chapter ten, “Becoming Caring: Caring for All.” I am indebted to Jeremy David Engels for his book and for such an inspiring discussion in our podcast interview.

The perspective on democracy I would like to develop is the idea that the greater sense of “oneness” (or interbeing, interdependence, nondualism) that an individual experiences, the more fully they will be able to embrace the idea of democracy, which will lead to more vigorous outer expressions of democracy. A practice of inner democracy would, thus, be a contemplative path of the development of a conscious experience of oneness. This leads to a tripartite structure:

  1. Inner Experience of Oneness
  2. Idea of Democracy
  3. Outer Expression of Democracy

This tripartite structure follows the paths of the hero or heroine’s journey (as developed by Joseph Campbell), and the structure of initiation (separation/initiation/return) that Joseph Rael and I followed in Becoming Medicine. It also follows the structure of Jeremy David Engels’ book, On Mindful Democracy (xi-xii):

  1. Stand on Common Ground (Interbeing)
  2. Walk the Path of Interdependence in Community (Beloved Community)
  3. Practice Democracy with Hands and Heart

The idea of mindful or inner democracy can be grasped with the mind, but a mental concept may not be as resilient as an inner experience of democracy – of interbeing, oneness, interdependence – which then leads to outer expression. In this sense, mindful democracy can be a pathway to creating a foundation of inner democracy that then supports the idea and what Engels calls the “hands and heart” of outer democracy.

Inner Democracy could be taught through practices of reflection, contemplation, deliberation, dialogue, meditation, experiences in nature, or any experience in which the individual developed an expanded sense of self beyond the limitations of the ego and the flesh.

The movement of the individual from an identity of “me” to an identity of “we” underlies the inner practice of democracy.

Interestingly, there are many names for an experience of Oneness: nondualism, interbeing, unity, transpersonal, and nondifference, to name a few. There are also many names for interrelationship and interdependence:  I/Thou, Me/We, beloved community, and others.

One of the reasons I am excited about following this thread of Inner Democracy is that it provides a positive focus and practices that can be done irrespective of outer events in the world. In my Words Create Worlds series, I have focused more on resistance and opposition to words – uncaring words, words of Me-First, and words of fascism. Through Inner Democracy I am seeking to focus on building inner strength during difficult times. Perhaps chaotic and painful experiences in the outer world could even lead one to fall back upon practices of inner democracy. Inner democracy builds hope, resilience, post-burnout growth, post-traumatic growth. I agree with Jeremy David Engels’ view of democracy as caring and collaboration.

Ultimately, democracy isn’t something done “out there;” democracy is also, perhaps even originally, about doing something “in here,” in the inner space of the psyche, the work of cultivating inner democracy.

[1] democracy(n.)

“government by the people, system of government in which the sovereign power is vested in the people as a whole exercising power directly or by elected officials; a state so governed,” 1570s, from French démocratie (14c.), from Medieval Latin democratia (13c.), from Greek dēmokratia “popular government,” from dēmos “common people,” originally “district” … + kratos “rule, strength.”

https://www.etymonline.com/word/democracy accessed 3/8/26.

[2] Steven Herrmann, Spiritual Democracy: The Wisdom of Early American Visionaries for the Journey Forward, xiii.

Robert Jay Lifton (May 16, 1926 – September 4, 2025)

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I just learned that Robert Jay Lifton crossed over on September 4, 2025 – a few months ago. His books and work were a tremendous inspiration to me when I was in medical school and psychiatry residency. I was able to see him speak once, at the International Society for Traumatic Stress Studies annual meeting in New York City. I also interviewed him by phone 8/13/21, which can be found on The POV interview website that I run with my friend, Usha Akella.

I was particularly interested in his concepts of malignant normality and the witnessing professional. Based on his work, as a social psychiatrist, interviewing Nazi doctors, atomic bomb survivors in Japan, and working with Vietnam veterans, Lifton went on to become a role model as a medical activist – speaking out about war, nuclear weapons, climate change, and late in his life, about the dangers of Donald J. Trump’s words and actions. Quotes below are from our interview.

“I came to the idea of the witnessing professional in connection with a companion term of malignant normality. Malignant normality being the imposition on a society of a set of expectations that are highly destructive but are rendered ordinary and legal. Of course, the most grievous and extreme example of malignant normality is in connection with my work on Nazi doctors. In that sense, the German physician at the ramp in Auschwitz and other camps, sending Jews and others to their deaths was functioning in a kind of malignant normality. That is what he was supposed to do. That was his job, so to speak.

Within malignant normality we professionals have the capacity for exposing it, identifying it, and combating it, and that is the development or evolution of the witnessing professional. He or she is witness to the malignance of the claimed normality and not diminishing one’s professional knowledge but actually calling it forth as a means of creating one’s particular witness.”

From his study of extreme socio-psychological situations, Lifton cautions us about the dangers of gradually growing to accept what is not normal – what he calls malignant normality. And he offers an antidote to malignant normality through the role of witnessing professionals whose ethics require us to speak up and speak out against social ills in the world – such as the climate crisis or American fascism and totalitarianism.

Lifton wrote the original foreword, “Our Witness to Malignant Normality,” for The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President – Updated and Expanded with New Essays. Bandy X. Lee, psychiatrist and author of Violence: An Interdisciplinary Approach to Causes, Consequences, and Cures, brought together a group of civic-minded mental health professionals in 2017 for a conference at Yale, which was later published as The Dangerous Case, a first edition with 27 professionals, and later 37 professionals. Another trauma expert (another influence on my education in trauma and psychiatiry), Judith L. Herman, co-wrote the prologue with Bandy X. Lee, “Professions and Politics.”

Lifton’s concept of the witnessing professional provides a view of professionalism which moves beyond the narrow confines of the four walls of the consulting room to include the a responsibility to the larger ecological, social, and political world.

“I became interested in the history of what we now call professionalism and the professions and, as you may know, it begins with profession as a profession of faith, of religious faith or commitment to a religious order. Over time, especially as we developed and moved into more of modern society, the idea of a profession became more associated with skills and increasingly technical skills. So, the idea of the professional or the profession became, what I would call technized, and the moral element of it was, in a sense, neglected or denied. In its most extreme form, the technized professional is a kind of hired gun for anybody who will pay him or her for professional knowledge.

So, the witnessing professional, then, is a return to the inclusion of an ethical dimension in professional work. If you or I carry out some form of psychiatric or medical healing―that can be seen quite easily as a moral or ethical act. We shouldn’t lose the ethical dimension of being a professional. It is true that sometimes, as a professional, we have to  step back and not experience fully another’s pain, or even the pain that we cause others, such as with a surgeon making a delicate operation or even a psychiatrist taking care of a very disturbed patient. But, at the same time we need to maintain, within the concept of the professional, that ethical or moral dimension and our own openness to some of that pain.”

Lifton’s work has inspired my own writing on the idea of medical activism as a professional, ethical responsibility, as well as my series of essays entitled Words Create Worlds.

Now, more than ever, we need to heed Lifton’s warnings about the risks of accepting malignant normality and we all need to embrace the idea of the witnessing professional.

For excellent overviews of his life’s work, see books:

Losing Reality: On Cults, Cultism, and the Mindset of Political and Religious Zealotry

Surviving Our Catastrophes: Resilience and Renewal from Hiroshima to the COVID-19 Pandemic

Witness to an Extreme Century: A Memoir

My 8/13/21 interview with can be found on The POV interview website, the-pov.com.

Words Create Worlds.11: What Are We Going to Do Now?

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Images: Renee Nicole Good and Alex Pretti were shot and killed by ICE in January, 2026. ICE photo by David Guttenfelder/The New York Times/Redux. The cover of The Clash’s 1979 album London Calling.

The Clash song, “Clampdown,” from the 1979 double album Londong Calling, starts with the question: “What are we going to do now?”

I have had this song by The Clash going through my head this past week. Now after the second killing of American Citizens by ICE in the past month, I keep asking myself, asking us, “What are we going to do now?”

The shooting death by masked government agents of Alex Pretti strikes close to home as he was a VA ICU nurse. Having trained and worked in the VA system for close to 20 years, I know the kind of professional dedication and commitment that VA employees bring to caring for Veterans who have served their country.

Renee Nicole Good had just dropped off her 6-year old at school before she was shot by armed masked government agents. Her last words were reportedly, “That’s fine, dude. I’m not mad at you.”

“What are we going to do now?”

I always wondered what “the clampdown” was when I listened to this Clash song as a kid. I wasn’t sure what it was, but I knew I didn’t want to work for it – and I know I don’t want to work for it now.

Taking off his turban, they said, is this man a Jew?
‘Cause they’re working for the clampdown
They put up a poster saying we earn more than you!
When we’re working for the clampdown

I pictured something like Hitler’s paramilitary Brownshirts, or some other loosely organized group that came together to inflict violence on it’s own people. I suppose this queston of those working for the clampdown about “is this man a Jew” made me think of the Nazis.

We will teach our twisted speech
To the young believers
We will train our blue-eyed men
To be young believers

The Clampdown seems to require teaching “twisted,” violent speech to the young of the nation, and invoking “our blue-eyed men” again recalls the Nazis. It continues to confound me how many MAGA and now ICE believers there are, who don’t see how words create worlds. The deaths of Renee Nicole Good and Alex Pretti are the worlds that have been created by the words of name calling and bullying and “othering” of Americans.

The judge said five to ten, but I say double that again
I’m not working for the clampdown
No man born with a living soul
Can be working for the clampdown

At least some judges are finding for the rule of law, but what happens when the judges are working for the Clampdown? I hesitate to dehumanize others and say they don’t have a “living soul,” but dehumanization, scapegoating, projection, and “othering” are key psychosocial operations that pave the way for violence. I can see questioning the humanity of those working for the Clampdown when the Clampdown dehumanizes others.

Kick over the wall ’cause government’s to fall
How can you refuse it?
Let fury have the hour, anger can be power
D’you know that you can use it?

It does seem like government is falling. We have a crisis between the federal government’s masked paramilitary organization. The Feds are blocking city and state government from investigating these shooting deaths of American citizens. Who holds the power here? Why are there armed masked men kicking down doors and kicking over walls? The seem to encapsulate the fury of the hour, which is how I always heard that line. The current President seems to have a fury of the hour, but The Clash seem to say that those with the fury are carrying the hour. Anger can be power. That is true. Anger can be power. “Do you know that you can use it?” This could be giving permission for paramilitary organizations to channel their fury and anger into anti-democratic activities and violence. But we can also hear this line from the perspective of those asking “What are we going to do now?” We can channel our anger into peaceful protest, into not looking away from abuses of power and tyranny. But again, this line could also be from the hooligans who have risen to power, looking toward their leader, ready to carry out the fury of the hour.

The voices in your head are calling
Stop wasting your time, there’s nothing coming
Only a fool would think someone could save you

Here The Clash tell us that it would be foolish to think that someone is coming to save us, we each have to refuse to work for the Clampdown.

The men at the factory are old and cunning
You don’t owe nothing, so boy get running
It’s the best years of your life they want to steal

Now the Clampdown also takes the form of the “old and cunning” men who want to steal the “best years of your life.” The Clampdown takes away your rights, it takes away your soul, it can steal away the best years of your life, and, apparently, it can even take your life with impunity.

You grow up and you calm down
You’re working for the clampdown
You start wearing the blue and brown
You’re working for the clampdown

I heard this as a warning. It is one thing to be full of a piss and vinegar as a young punk, but there is a risk that you “grow up” and you “calm down” and end up working for the Clampdown, even though you resisted it in your youth. I knew about the Brownshirts, but I didn’t know about the Blueshirts – are The Clash singing about the Irish party of that name? I’m not sure. It is clear though, The Clash are warning you not to work for the Clampdown, no matter whether you are wearing a brown shirt, a blue shirt, or a red white and blue shirt.

So you got someone to boss around
It makes you feel big now
You drift until you brutalize
You made your first kill now

This is always a chilling stanza. I always think of the kids who I had been friends with in elementary school who became thugs and bullies in high school. People who feel small and have listened to the “twisted speech” and become “young believers” that the way to feel big and powerful is to find someone to “boss around.” Once you have given over your power to the fury of the hour, you cease to direct your own actions, you become a puppet who drifts “until you brutalize,” and from there the next step is making “your first kill now.” Words lead to action which leads to creating worlds of violence and when you are working for the Clampdown, you can easily end up killing.

I had to look this line up on The Clash website because Google Lyrics listed it as “Doesn’t make you first kill now,” which really doesn’t make any sense.

In these days of evil presidentes
Working for the clampdown
But lately one or two has fully paid their due
For working for the clampdown

Doesn’t that just capture it! It sure seems like we are living in the “days of evil presidentes/working for the clampdown.” We can only hope that one or two will fully pay their due. Right now it seems like the Clampdown is in charge and unrestrained.

Ha! Gitalong! Gitalong!
Working for the clampdown
Ha! Gitalong! Gitalong!
Working for the clampdown

Not much more to say here – sounds like a cattle drive with masked armed men who have immunity under the Federal government, trying to heard along protesters and killing the occasional one or two.

Yeah I’m working hard in Harrisburg
Working hard in Petersburg
Working for the clampdown
Working for the clampdown

Everyone, no matter they are, they’re working – and either your working hard for the Clampdown, or your working hard against it.

Ha! Gitalong! Gitalong
Begging to be melted down
Gitalong, gitalong
(Work)
(Work)
(Work) And I’ve given away no secrets – ha!
(Work)
(Work)
(More work)
(More work)
(Work)
(Work)
(Work)
(Work)
Who’s barmy now?

The song just tails off with “work” and “more work,” finally asking “who’s barmy now?” Meaning who’s crazy, I suppose. “Clampdown” gives us much to think about in the United States at this moment. It gives us pause and reminds us that the Clampdown could be almost anything and could be almost anywhere, but right now it is here…now.

“What are we going to do now?”

Maybe the answer to that question is: you are either working for the Clampdown – or you are not.

Are you working for the Clampdown?

Clampdown, Live – Fridays 1980: shorturl.at/TdE5A

London Calling album, studio version: rb.gy/kdhzxe

Announcing the Becoming A True Human podcast!

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I’ve been thinking about how we need to build a community of practitioners discussing the problems of burnout, compassion fatigue, and soul loss. Isolation and loneliness contribute to burnout, and social connection is an antidote to burnout. To this end, we are creating the Becoming A True Human podcast. Who is “we”? Well, for now, it is me and my good friend Chris Smith – therapist, meditation teacher, Whole Health educator, storyteller, author (Be a Good Story), founder of the Academy for Mindfulness consulting, and all-around wise guy (and I mean that in multiple senses of the phrase).

The audio of the episode 1, Lost, is at the bottom of this post.

Chris Smith
Dave Kopacz

What is burnout? Just what exactly is it that burns out? How can whatever is burned out be re-ignited?

What is compassion fatigue? How does compassion wear out? Should it really be called empathy fatigue? Is the problem that there is too much compassion going out? Or not enough coming in? Or could it be that institutional structures and protocols make us busy with so many things that there is little time left in the clinical encounter for caring?

What is soul loss? Could we think of the soul being the “thing” that burns out? Not necessarily in a religious or metaphysical sense – although it could be if that fits your belief system – but in a metaphorical and psychological sense. If in burnout we lose connection with our souls, how can we reconnect and either go on a quest to find our lost souls, or create a welcoming environment in our bodies and lives so that our souls can return and flourish?

I address these questions in my book, Caring for Self & Others: Transforming Burnout, Compassion Fatigue, and Soul Loss, but we need to have further discussions around these topics as I feel strongly that we need a kind of ongoing practice, a yoga of burnout, in which we continually work in our own practices as well as in building communities of caring to support each other with this human, all too human dilemma.

Based on the topics we discussed in the first episode we titled this episode “Lost,” even before we realized that we somehow lost video of me and only recorded video for Chris! In this episode we explore topics of burnout as an initiation into becoming a wounded healer, soul loss, yoga for the health of healers, and we end with a meditation exercise and a poem, “Lost” by David Wagoner.

We don’t really know what we are doing with the technology aspect.

Let me tell you a story that illustrates the problem.

My high school friend Jack and I drove across the country after college. We were into the beat poets and writers, reading Kerouac’s On the Road, and envisoned a trip full of excitement and philosophical observations. We had a microcassette recorder and would talk into as we were driving, having many deep discussions and creating a record of what we saw.

Somewhere around South Dakota (having left from Chicago area) I noticed that the wheels of the recorder weren’t moving when we were recording. It was then that I noticed that there was a pause switch that was clicked on and prevented any recordings from being made! All of our bits, routines, observations, and experiences were lost! We were a bit crestfallen and we made half-hearted attempt to resume recording, but something had been lost – the energy, the enthusiasm. I think we eventually gave up on it. Maybe you could say we burned out on the idea after investing so much energy and enthusiasm and not having anything to show for it.

From a mindfulness perspective, there is surely some kind of lesson here – about not being attached to goals or outcomes, about being in the present moment versus memorializing experience, and maybe even that the organizing ego is an illusionary construct for creating a reduced and more manageable limited reality (if you want to take it that far!).

Well…I remembered this story after Chris Smith and I had just had our wide-ranging and enthusiastic discussion as we recoreded it on Zoom, only to realize that I had messed up the settings and we only had Chris’ video and both our audio. Well, crestfallen again! Urgh, technology failure again!

So, I think I have figured out how to share the audio of our video podcast, rather than have video of just Chris and my disembodied voice. Titling this episode, “Lost,” was prescient as we lost the video. Chris also spoke of his caring for self routine and how he purposefully skips some days so as not to get caught up in perfectionism, performance, and productivity. We’ll consider the lost video as a sacrifice to the Divine or the Cosmos, a giveaway, in addition to it being a bumbling failure of technology.

So, welcome to the first episode of the Becoming A True Human podcast – Lost – it highlights the vulnerability and imperfection of being human, that we are all a work in progress and that our work is a yoga practice – yoking mind, emotions, body, soul. The practice of Becoming A True Human is an ongoing practice, we can only do it in the present moment and the next moment we are again lost, at sea, trying to figure it out and Keep It All Together (KIAT). We will attempt to have the next episode as video and hope to post it on the Becoming a True Human YouTube site.

Burnout: Soul Loss & Soul Recovery

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I will be giving a keynote presentation at the 13th annual Giving Voice to Experience conference, whose theme is “Maintaining a Soulful Approach to Psychological Research and Practice: Swimming Upstream in a Technological Society.”

13th Annual Giving Voice to Experience Conference

“Maintaining a Soulful Approach to Psychological Research and Practice: Swimming Upstream in a Technological Society”

June 25, 2022, 8:30 am – 5:30pm, Seattle University 

Oberto Commons – Sinegal 200

My talk on “Burnout: Soul Loss & Soul Recovery” seems even more relevant now than it did when the conference was originally planned for March of 2020 – at that time the pandemic was just evolving and we didn’t know one day to the next whether we would be gathering or not. I was already, at that time, beginning to look at the similarities between burnout in health care and the ancient concept of soul loss. After all, what is it that stops burning in burnout? What is it that we lose when we feel we are just pushing ourselves through the motions at work? Where have our hearts gone? Where have our souls gone? Now, after two years of pandemic life and social distancing, as well as the larger social injustice issues and division in the USA and war and conflict in the world, it seems even more vital than ever that we re-connect to that which makes us fully human.

For a number of years, Seattle University used to host the Search for Meaning Book Fesitval that I attended regularly. It saddens me that SU is no longer running that program since 2017, but I am honored to speak there and be part of the tradition of inquiry into life’s meaning and greater purpose. Here is the abstract for the talk:

Keynote Information 

“Burnout: Soul Loss & Soul Recovery in Mental Health Care”

presented by David R. Kopacz, MD

Burnout and compassion fatigue are becoming the norm in healthcare after two years of a pandemic. The World Health Organization recognizes burnout as an “occupational phenomenon,” with feelings of energy depletion; increased mental distance from one’s job, negativism, and cynicism; and reduced professional efficacy. While many perspectives on burnout focus on prevention through stress management techniques, we can look at burnout as “soul loss” which can then become the beginning of a transformational healer’s journey. A transformational perspective shifts our focus to the care of the soul and on how to recover soul once it is lost – this is a valuable skill for us as healers to use in our own lives as well as in our therapeutic work with clients.

David Kopacz is a psychiatrist in Primary Care Mental Health at Seattle VA and a National Education Champion with the VA Office of Patient Centered Care & Cultural Transformation. He is an Assistant Professor at University of Washington and is certified through the American Boards of: Psychiatry & Neurology; Integrative & Holistic Medicine; and Integrative Medicine. David is a graduate of University of Illinois, undergraduate in Urbana-Champaign and medical school and psychiatric residency in Chicago. He has practiced in the US and New Zealand. His publications include: Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine; Caring for Self & Others: Transforming Burnout, Compassion Fatigue, and Soul Loss (in press); and with Joseph Rael (Beautiful Painted Arrow) Walking the Medicine Wheel: Healing Trauma & PTSD; Becoming Medicine: Pathways of Initiation into a Living Spirituality; Becoming Who You Are: Beautiful Painted Arrow’s Life & Lessons for Children Ages 10-100.

Here is the link to the conference for registration and a flier for the conference. 6 CEUs are available for the one day conference. For further information about the conference, please contact Professor Steen Halling: shalling@seattleu.edu

Nature, Medical Humanities & Medical Activism

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Jonathan McFarland, President of Doctor as Humanist, and I recently had the honor of presenting at the University of Washington Nature & Health conference on Thursday, October 14th, 2021. Our overall talk was Nature, Medical Humanities, and Medical Activism. Jonathan presented on Nature & Medical Humanities and I presented on Nature & Medical Activism. Here is the powerpoint from my talk.

Thanks so much to Josh Lawler, Star Berry, and the whole conference team from the University of Washington Nature & Health program. It all ran very smoothly and professionally and brought together great speakers from around the globe. There is a groundswell of interest in looking at the bi-directional effects of Nature & Health – we, at Doctor as Humanist, are planning a free, virtual symposium next month. Register for free for our Nature & Medicine: Restoring the Balance Between Earth & Health – we hope to see you next month!

Nature & Medicine: Restoring the Balance Between Earth & Health – Nov 12 & 13

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I am on the Doctor as Humanist’s conference planning committee for our free, virtual, international symposium – Nature & Medicine: Restoring the Balance Between Earth & Health on November 12 & 13, 2021. Register here.

We’ve got a great line up of speakers and round table panelists, including Bob Lawrence, one of the founders of Physicians for Human Rights and Center for a Livable Future Professor Emeritus in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health and the founding director of the Center for a Livable Future; Rachel Corby, author of ReWild Yourself: Becoming Nature; Julia Corbett, author of Out of the Woods: Seeing the Nature in the Everyday; Lewis Mehl-Madrona, author of Coyote Medicine and Narrative Medicine; Qing Li, author of Forest Bathing: How Trees can Help You Find Health & Happiness, amongst many others. Link to the program.

One of the projects we are doing as part of the symposium is the Tree of Medicine – a photomosaic on the Mosaically site. You can post on Instagram or Twitter with the hash tags: #NatureMed2021 and #DoctorHumanist and we’ll upload your photos into the Tree of Medicine. You can write a few words of why this photo is important to you and how it relates to Nature & Medicine. Here are a few of the photos I’ve posted.

An unexpected beautiful scene on a walk through Seattle – reminding me that Nature is here, now.
The face on this tree on San Juan Island’s Lime Kiln State Park reminds me of the sentience of nature.
Cannon Beach, Oregon, a breath-taking & invigorating view.

The idea behind this conference is to highlight the many benefits of nature & health while also expanding our idea of being a medical professional to including the health of the Earth. We are in a symbiotic relationship with Nature and cannot exist apart from Nature. In fact, we ourselves are nature, we are made up of nature, our backyards are nature. I’ll be giving a workshop on Saturday 11/13/21 with a focus on Nature is Here, Now. The care of Nature begins with the care of ourselves, the nature of our homes, the nature of our backyard, and breaks down the artificial separations of humans/nature and city/nature. I’ll be joined by a couple of great psychiatry residents I’ve been working with, Eunice Stallman, MD (who has been doing an elective on Narrative Medicine) and Lewis Kerwin, MD (who has been doing an elective on Nature, Health, and Design). We’ll be joined by my friend, photographer and author, John Riggs, author of Clear Cut – The Wages of Dominion. I wrote a review of his book on 5/8/20.

Each of us on the planning committee recorded a short video on the Tree of Medicine project and the Nature & Medicine: Restoring the Balance Between Earth & Health, here’s the link to my video.

We hope you join us!

Nature & Medicine: Restoring the Balance Between Earth & Health on November 12 & 13, 2021. Register here.

How are you doing…really?

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How are you doing…really? New post on CLOSLER: Bringing Us Closer to Osler

This is a reflection piece on the challenge of answering this simple question, asked so many times a day, “How are you doing?” While this is usually asked in passing, the true answer to this question is increasingly complex for health care workers as the pandemic wears on.

You can read the essay, here, and some past essays published on CLOSLER, here. The piece features a detail of my painting, “Planting the Seed of the Heart,” which was published in Walking the Medicine Wheel: Healing Trauma & PTSD.

Thanks again, CLOSLER, for all that you do for person-centered care & provider well-being!

Planting the Seed of the Heart, D. Kopacz (2016)

Haystack Rock & Cannon Beach, Oregon

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Cannon Beach, looking South at Haystack Rock

We recently took a drive down the Oregon coast and I took a lot of photos of birds, sea, sky, and sand at Cannon Beach and Haystack Rock. A number of birds nest at Haystack Rock, including Tufted Puffins, Murres, Gulls, and Cormorants. I didn’t realize that we had puffins on the Pacific. I had tried to see them in Nova Scotia, without success. I had seen many at a relatively close distance in Iceland, but all the photos turned out slightly blurry, unfortunately. Here we got to where we could see the Tufted Puffins with our naked eye and then I zoomed in and took photos where they landed, somewhat blind. While you can definitely tell they are puffins, they are a bit blurry – so the challenge of getting a clear puffin photo continues! The more serious photographers had tripods and that would likely help. Here is a collage of a few blurry Tufted Puffin photos.

We also saw flocks of pelicans and I was able to get some better photos of these interesting birds. We also saw them diving and catching fish at times.

The beach was wide, the sand soft and good for walking barefoot. I can see why this beach is so popular and I didn’t expect the abundance of seabirds and other shore life. The light was amazing at times, one morning a continuous interplay of cloud and sunshine. I even saw a sun halo one day.

There was, of course, a lot of sealife in the tide pools, starfish and sea anemones.

All in all, a relaxing and invigorating trip! There is nothing like walking barefoot on the sand for hours each day!

Every Thought Leads to Infinity:

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Perspectives on Personal Growth, Psychosis & Spirituality:

Carl G. Jung’s Red Book & Philip K. Dick’s Exegesis

I presented this paper at the International Society for Psychological and Social Approaches to Psychosis, New Zealand/Australia annual conference, August 2012 in Auckland, New Zealand. I thought I would share the slides from the talk.