Australasian Doctors Health Conference, Sydney, Australia, Sept. 15-16, 2017

I recently returned from a trip to Australia, New Zealand, and Fiji. I started in Sydney, Australia at the Australasian Doctors’ Health Conference. The conference was held at Luna Park in North Sydney with a great view of the city and the opera house.

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View of Luna Park (lit up below bridge) from the North Sydney Harbourview Hotel

I did two presentations at the conference. The first was a workshop co-facilitated with my mate, Hilton Koppe, called The Hero’s Journey of the Healer, where we looked at burnout as a necessary stage of the healer’s journey and also at the important role that mentors can play on the journey. We also made a distinction between instructors (who train you to do the technical job) and mentors (who help you find yourself in the work and sustain your humanity).

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I have recently come across the concept of transformational learning as defined by Jack Mezirow it includes several steps that parallel the process of initiation and the hero’s journey: a disorienting dilemma, realization that disorientation is part of the growth process, and then a reintegration with a new, transformed identity.

Transformational Learning Model

The second presentation was Circle Medicine: What’s Good for the Client is Good for the Clinician. This presentation reviewed a few of the circular models of healing I have been using lately: the Hero’s Journey, Whole Health, and the Medicine Wheel. I believe that we need to include both linear medicine and circle medicine in order to best serve our clients.

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I had a great time at the conference, caught up with some old friends and made some new friends. I also spent a few hours speaking with Gerald Arbuckle, author of the book Fundamentalism that I recently reviewed. Gerry and I have had an ongoing correspondence since I used his models of medicine concept in my book Re-humanizing Medicine, and also he wrote an endorsement for Walking the Medicine Wheel. It was great to finally meet in person and have a really good chat!

More blog posts to follow from this trip!

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“We Need to Be Disoriented Says Psychiatrist”

Here is a link to an article, “We Need to Be Disoriented, Says Psychiatrist,” by Chris Kelly from my recent talk at Western Sydney University, Australia. The article appears in Hunter and Bligh.

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Thank you Chris Kelly and Hunter and Bligh for this article that captures the essence of transformational learning – that we need to be disoriented and lose our bearings in order to really have the opportunity for transformational learning – learning that changes who we are beyond just learning new information. Transformational learning is a concept that Jack Mezirow developed. He listed ten different steps that I have condensed down to three steps in the circle below, corresponding to the circle of initiation: separation, initiation, return. This model also fits with Joseph Campbell’s hero’s journey model in which transformation comes through transitioning between worlds, cultures, or states of consciousness.

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This was part of a 2 hour talk I did for staff and students called “Caring for Self & Others,” based on the Caring for Self & Others workbook that Laura Merritt and I have adapted from my first book, Re-humanizing Medicine: A Holistic Guide for Transforming Your Self, Your Practice, and the Culture of Medicine. We had a great discussion about creating a counter-curriculum of self-care and contributing to the compassion revolution!

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Thank you to Sneh Prasad for connecting me with Dr. Asha Chand at Western Sydney University who coordinated this event while I was in Australia for the Australasian Doctors Health Conference. Thank you everyone involved in the talk! I will be posting about the other talks I did on my trip as well as some of the photos soon…

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Dr David Kopacz speaking at Western Sydney University about anxiety and stress. Image: Christopher Kelly

 

 

Review of Walking the Medicine Wheel by Michael H. Cohen

Thank you to Michael H. Cohen for his kind and thoughtful review of Walking the Medicine Wheel: Healing Trauma & PTSD. You can read the entire review here. A few excerpts below.

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CAN INDIGENOUS HEALING SYSTEMS RESOLVE COMPLEX, MODERN CLINICAL PROBLEMS SUCH AS TRAUMA AND PTSD?

“Answering this question, as part of a larger inquiry into integrative medicine, psychiatrist and integrative physician David Kopacz, and Native American visionary Joseph Rael (Beautiful Painted Arrow), have written Walking the Medicine Wheel: Healing Trauma & PTSD.”

“Importantly, the book notes that ‘the real importance of ceremony is that we are not just going through meaningless motions, but that our motions are full of deep meaning, our motions are the motions of creation.’

Healing not only helps the person – it changes the cosmos.

That is why this is such an important book. Walking the Medicine Wheel shares wisdom from two divergent traditions—one clinical and the other focused on healing through imagery, sound, poetry, introspection, visioning. The quest is nothing less than clearing the fog of the aftermath of war, instilling sacredness, and reclaiming the whole self.”

Review of Gerald Arbuckle’s Fundamentalism at Home and Abroad

Gerald Arbuckle is an anthropologist and Catholic priest from New Zealand who lives in Australia. He has written on a variety of topics including bullying, humanizing health care reform, humor, Pope Francis, and his latest book is on varieties of fundamentalism in the modern world.

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In Fundamentalism at Home and Abroad, Gerald Arbuckle brings his understanding of culture as an anthropologist and his perspective as a theologian who sympathizes with the broad-mindedness and inclusiveness of Pope Francis. Recognizing that there is a “global epidemic of fundamentalism both religious and political,” he examines fundamentalism across the world and throughout history, paying particular attention to the rise of fundamentalism in the United States (what he dubs “Trumpism”), Islamic terrorism, the reforms of Pope Benedict, and even “siloism” in health care that creates fragmentation and competition. (28). He views fundamentalism as something all “individuals, cultures, and religions have a capacity for,” and that it is a “form of organized and institutional or civic religious anger in reaction to secularization, political changes and globalization; it often intimidates or coerces people to achieve its ends,” (28). He describes a typical fundamentalist leader as someone who “is a populist, homophobic, charismatic, authoritarian man who likes to bully,” (15). The book is very topical given the current fundamentalist movements across the globe that appear to be breaking out in an “epidemic.”

What is perhaps most useful in the book is in understanding how “we” (each and every one of us) can so easily turn to this ideology as a way of simplifying the world and resorting to black and white categories based on separation of the larger whole into smaller sub-parts. While it is useful to understand “others” fundamentalism as a response to cultural trauma and disorientation, it is more important to seek out our own fundamentalism. The sense of us vs. them paves the way for subtle discrimination all the way to self-righteous violence and genocide. Viewing fundamentalism as a reaction to cultural trauma and cultural disorientation, Arbuckle sees fundamentalists as “boundary setters” who oppose “openness and choice,” (9). He also describes suppression of dissent, even of moderate opposing views (such as we see with the stereotypical demonization of the media by fundamentalists). Arbuckle sees a spectrum of violence that can begin with a manipulation of facts on one end and physical violence against people at the other end. He describes the common fundamentalist tendency toward paranoia (which a psychological perspective understands as a projection of fantasies about one’s own unconscious on to another group).

In response to cultural trauma, Gerald Arbuckle describes four different possible reactions or solutions (75).

  • escape into an unreal golden age or utopian past
  • chronic paralysis
  • seeking to refound or reform the culture in light of changing circumstances
  • fundamentalist movements

We see all four of these responses “at home and abroad.” Many in the United States feel paralyzed, many escape into glorifying the past, but the fundamentalist movements are the most dangerous and are the primary focus of the book. Arbuckle does describe an alternative to fundamentalism: refounding narratives are positive solutions to cultural trauma that draw on the founding beliefs of a culture while adapting those beliefs to changing times.

Refounding is a process of storytelling whereby imaginative leaders are able to inspire people collaboratively to rearticulate the founding mythology of an institution and apply it to contemporary needs through creative dialogue with the world. The purpose of refounding narratives is to find a positive way out of trauma by allowing people to reenter the sacred time of their founding with imaginative leaders who are able to rearticulate the founding mythology in narratives adapted to the changing world. (93).

By mythology, Arbuckle does not mean something that is false, but rather a story that makes emotional sense of the past. The difference between a refounding narrative and a fundamentalist solution to cultural trauma is that the fundamentalist response is “closed to dialogue and…dissent” (94). The fundamentalist response is strident, closed, rigid, and aggressive, whereas a refounding narrative is creative, collaborative, open, and ultimately regenerative. There is a great deal of similarity in Arbuckle’s description of refounding narratives and the hero’s journey that Joseph Campbell described, in which an individual and culture separates from traditions that are no longer adaptive, transforms into a new identity (by getting in touch with the “sacred time”), and then returns back to society, bringing personal and cultural transformation. Whereas a refounding narrative creates new meaning and new modes of being while incorporating the essence of the past, fundamentalist reactions are based on “ideological necrophilia,” the “blind fixation on dead ideas,” so that there is nothing new, only an aggressive attempt to recreate a past that may or may not have even existed in reality (78).

Gerald Arbuckle describes, in his last chapter, a number of antidotes or responses to fundamentalism, what he calls pastoral responses. A few of these follow.

  • We are all in danger of becoming fundamentalists.
  • Have a sense of humor. As Arbuckle amusingly points out “there is not much fun in fundamentalism” (155)
  • We need to be aware of the dynamics of prejudice and discrimination.
  • Receive without prejudice migrants and parishoners from cultures different from our own as Christ would wish.
  • Be alert: Ideology is a prejudice that is integral to all fundamentalist movements.
  • Cultivate the art of dialogue, which is the antidote to fundamentalism.
  • Remember, violence in all its forms, for example terrorism and bullying, is contrary to the Gospel.

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Gerald Arbuckle provides a much-needed discussion of the cultural and religious roots of fundamentalism (both our own and other’s) as a response to cultural trauma and disorientation. He calls for us to be open and inclusive and to engage in refounding narrative of continually returning to the “sacred time” of the mythological roots of our cultures and histories and be continually adapting these to the present moment. Particularly for Americans it is of utmost importance to be aware of fundamentalist movements within the United States that can foster violence against ourselves as well as others. If fundamentalism functions through this separation of groups into self/other, then perhaps the antidote is to see us as all connected and all related, that, after all, is one of the founding narratives of this country of immigrants. We must use the same eyes to look at ourselves as we use to look at fundamentalism abroad. As Pope Francis encourages us, we should strive to be builders of bridges, not walls.

 

“A person who thinks only about building walls, wherever they may be, and not building bridges, is not Christian. This is not the gospel” (Pope Francis, in Arbuckle, xi).

 

 

 

Veterans, Vairagya & Vast Self

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I have a new essay out in the quarterly on-line magazine, The Badger. This essay looks at the state of vairagya from Hindu philosophy, similar to a state of non-attachment and compares this with the negative vairagya state that many Veterans have upon returning home – they feel disconnected and detached. I also add some perspectives from my ongoing work with Joseph Rael (Beautiful Painted Arrow) and that is where his concept of Vast Self comes in.

This is a piece I had written for Walking the Medicine Wheel, but we had to cut it down quite a bit and I thought this piece was worth publishing. I particularly like the idea of a Veteran Monastery – a place for quiet contemplation, healing, and recovery!

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Here is the link to the article.

Finding the Held-Back Place of Goodness in the Broken Hearts of Veterans

Thanks to The Center for Courage & Renewal’s blog post about Walking the Medicine Wheel: Healing Trauma & PTSD that Joseph Rael and I wrote!

You can read the blog here. It is an excerpt from the book that I edited and includes some quotes by Parker Palmer about the two ways the heart can break: it can shatter – injuring self and others, or it can break open into greater goodness and compassion.

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Center of the Heart by Joseph Rael (Beautiful Painted Arrow)

Courage & Renewal tweeted about the blog: “David Kopacz (and Joseph Rael) unpack the #courage of our veterans through the lens of @Parker Palmer’s ‘broken-open heart.'”

 

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Warrior Healing by David Kopacz

A Review of Patient-Centered Medicine: A Human Experience

A Review of Patient-Centered Medicine: A Human Experience

By David H. Rosen and Uyen Bao Hoang

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This is a new and updated edition of Medicine as a Human Experience originally published in 1984 by David H. Rosen and David E. Reiser with two guest chapters by George L. Engel (one of the founders of the biopsychosocial model still taught in medical schools). As a disclosure, one of the current authors, Uyen, is a friend of mine whom I know through living and working in New Zealand.

This new edition features a foreword by Andrew Weil, MD, who puts the book in context within the current frameworks of the biopsychosocialspiritual model of medicine and integrative medicine. Dr. Weil writes that not only does Patient-Centered Medicine “define the role of health professionals in the new model of medicine that is coming into being, it gives a great deal of practical advice about the attitudes and skills they should develop to care best for patients” (ix).  The current edition includes Norman Cousins’ (author of Anatomy of an Illness and The Healing Heart) original foreword entitled “Physician as Humanist,” which invokes the framework of humanism as a partner or counter-balance to the technological and interventionist aspects of medicine. Cousins stresses the interconnectedness of science and humanism, ending with the statement, “I pray that, even as you attach the highest value to your science, you will never forget that it works best when it serves your humanity” (xvii).

The book next includes a prologue, written by Dr. Uyen B. Hoang. Uyen tells of her own path as a healer, as a Vietnamese-born American, training in medicine, going through burnout in the contemporary practice of psychiatry in the United States, and then moving to New Zealand to practice, “in search of something greater, on a quest for expansion and truth” (xxv). With honesty and integrity, Uyen brings her own personal experiences of medical practice to the book which bridges the thirty-some years since the book was first written. Dr. Rosen also shares personal elements of his own work and journey to humanize the more theoretical aspects of the text.

The text elaborates the four essential principles of medicine as a human experience: acceptance, empathy, conceptualization, and competence, stating that these are required to prepare physicians to be “compassionate champions for health” (4). The grounding of the book is in the frameworks of humanism and the psychotherapeutic understanding of human relationships. George Engel’s two chapters give us the opportunity to read, in his own words, the ideas of the founder of the biopsychosocial model. Throughout the book, Drs. Rosen and Hoang focus on the idea that there is no separation between the humanistic and scientific approaches. Rather than a duality between the art and science of medicine, they offer the perspective that the therapeutic relationship is rooted in the human science of presence and connected observation.

What could be improved in this book for the next edition? I think the authors do a good job of retaining the focus of the original and updating it to the present times. I think a larger discussion of what is now called the biopsychosocialspiritual model that Dr. Weil mentions in his foreword could be helpful. Another area to consider is the work on compassion-based practices as an antidote to burnout. These elements are present in the book, but could be further developed. That said, this book easily joins the work of other healers such as Robin Youngson, Tony Fernando, Allan D. Peterkin, Andrew Weil, Lewis Mehl-Madrona, and the late Lee Lipsenthal who have been engaged in what I call the compassion revolution in medicine.

Patient-Centered Medicine: A Human Experience gives the reader a great overview of biopsychosocial, humanist and psychotherapeutic perspectives of human interconnection and inter-relatedness. It combines the enthusiasm of the younger psychiatrist with the wisdom of the older psychiatrist in order to guide students, doctors, nurses, and clinicians through training and into practice. Patient-Centered Medicine is also a source of renewal for practicing doctors and clinicians, reminding us all why we went into medicine and health care in the first place.  Drs. Rosen and Hoang close with the following sentences: “We must encourage introspection, healthy relationships, play, openness, and joyous, creative expression. We must spawn a generation of doctors who are not afraid to love” (142).

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David H. Rosen and Uyen Bao Hoang

 

 

New Article in “The Badger”

“The End of E pluribus unum?

The De-evolution of “Out of Many, One” to ME First!”

My new article in The Badger examines the national and international movements away from seeing all people as interconnected (as One) to the separation of nationalism, racism, and xenophobia (fear of the “other”). The motto of the United States on the Great Seal is e pluribus unum, which means “out of many, one.” However, more and more, we are seeing an attitude of “ME first” which promotes bullying and selfishness above our motto of seeing unity within diversity.

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Spirituality Today Book of the Month: Walking the Medicine Wheel

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Spirituality Today has selected our book, Walking the Medicine Wheel: Healing Trauma & PTSD, as Book of the Month!

Spirituality Today is based in the UK and focuses on “Challenging Paradigms and Expanding Consciousness.”

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You can read the full review of the book at this link.

Excerpts from the Spirituality Today review.

In Walking the Medicine Wheel its authors offer an approach to repairing the shattered psyches of PTSD suffers through a number of different healing modalities. These are essentially anchored within and around the mandala of the Medicine Wheel of Native American Tradition – a map through which initiates can more closely understand and appreciate mankind’s relationship with those natural forces that permeate through the world of spirit and the psyche of man.

This framework is remarkably similar to many Western psycho-spiritual constructs and has a particular resonance with ideas expressed by Carl Jung in his philosophy of personal individuation. Here the concepts of the Four Directions within Native philosophy and the Four Functions in Jungian analysis merge and complement each other.

…within the pages of this book such sufferers may well discover a vitally important lifeline…the ideas presented here should demonstrate to everyone that opportunities for personal growth can emerge even from the darkest recesses of the sort of fractured mindset that trauma creates.

This book has been beautifully produced and has a real quality feel to it. The inclusion of the remarkable visionary artwork of Native American Joseph Rael has resulted in a publication that carries with it an energy that stimulates the soul of its reader along the way.

…a publication with a warm heart – one that beats loud and clear from within its pages and which I feel reaches out to those suffering in pain and torment as a result of the nightmares derived from their military service.

In short, Walking the Medicine Wheel is a remarkable and highly impressive collaboration between two insightful, spiritual-warriors ― two hardened veterans of front-line psycho-spiritual conflicts whose combined approach to the challenge of trauma has created a deeply moving and very humbling publication indeed.

Thanks Spirituality Today for the review!

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Link to our videos on Walking the Medicine Website.

 

Search for Meaning Book Festival

Yesterday was the 3rd Search for Meaning Book Festival since moving to Seattle. This is put on yearly by Seattle University and every year I learn about fantastic authors and have met amazing people.

I was getting ready to go in to see artist and author Salma Kamlesh Arastu’s talk on “Seeking Oneness,” when my friend and co-author, Joseph Rael (Beautiful Painted Arrow), called me with a couple of ideas and visions for our next book, Becoming Medicine.  In one of the visions, Joseph said he saw Picuris Pueblo, where he grew up, but instead of houses, there was mist, and then cosmic beings came to him and said, “You are a Mist-ical Being, you are now responsible for the mist-eries we are bringing to the people.” He explained that people should be respected as they get older because they hold the past – however the older you get the more spiritual responsibility you have as well. What he said this vision showed him was that there is a parallel reality to this one because as the mist cleared, he could see the houses at Picuris, but that there was an exact copy of the village up above the village. He said the people in both villages go about their days without awareness of those living just above/below the reality that they are living. Joseph often tells me that we should be always seeking our Higher Goodness and I wonder if this is part of what this vision means, that there is a way for us to live that has more Higher Goodness in it than the way that we are now living.

Anyway…I told Joseph, I better getting going to this lecture, it is on Seeking Oneness and if there is only One, I’m not sure what I’ll get if I am late – maybe just 0.95, that’s not the same as Oneness. We both had a good laugh at that and I went into the lecture.

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Salma Kamlesh Arastu is an amazing artist and an embodiment of Higher Goodness! She spoke of her artist’s journey from her work with Embracing All in the Rhythm of the Lyrical Line, to her Celebration of Calligraphy, her work with Turning Rumi, and most recently her Unity of Sacred Symbols and Texts and Unity Mandalas.

She said in her talk, “I speak the Language of the Heart and I know we all speak the Language of the Heart.” She briefly spoke of her journey in the world, from her birth in India into the Sindi.Hindu tradition, to her life in Iran and Kuwait, her marriage and embrace of Islam, to now living in Berkeley, California where she has her studio.

Her art journey started with loopy, calligraphy-like paintings of people, a style shown above. Her first art book, The Lyrical Line, illustrates her work from 1998 – 2008.

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She said she also started to copy Arabic calligraphy, marveling in its beauty without knowing the meaning of the words and this led to the collection in her book, Celebration of Calligraphy.

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Her next evolution in her work happened when she began turning through the pages of the poet, Rumi, and she created a series of paintings that were inspired by lines from Rumi. She also has been inspired by the Hindu saint and ecstatic, bhakti poet, Meera Bai. Her book, Turning Rumi: Singing Verses of Love, Unity, and Freedom collects her work of this period.

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Her most recent work has been to seek the unity in the world religions and to capture their words and truth in written words over beautiful multi-dimensional paintings. She says paints the same words over and over again, using thinned acrylic paint to create a multi-dimensional image. “Each prayer that I paint, over and over again,” she says, “is like a healing for me.” This has led to her book, Unity of Sacred Symbols and Texts.

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Verses About the Oneness of God

Salma said that as a child, her mother would tell her, “You are created for a special reason – it is up to you to find out what it is.” Salma Kamlesh Arastu’s artwork reveals that special reason that she was created.

Please visit Salma’s website and look through her beautiful artwork.

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The next talk I went to was by Corinna Nicolaou titled A None’s Story: Searching for Meaning Inside Christianity, Judaism, Buddhism & Islam, which is also the title of her book. “Nones” she says, are the fastest growing self-reported religious affiliation. This is the group of people who do not identify with a particular religious affiliation. However, this does not mean that they are not spiritual or do not pray or even believe in God. She says that Nones are different than Atheists, by ticking the box of “none” for religious affiliation, they are more rejecting organized religion than spirituality or God. She cites research from the Pew Research Center that 30% of people under the age 30 report no religious affiliation. She quotes Putnam and Campbell, from their book American Grace: How Religion Divides and Unites Us, that Nones distance themselves from religion because “they think of religious people as hypocritical, judgmental, or insincere.”

She writes that she started her quest through “a desperate search for the bits and pieces that might make my pot whole,” (A None’s Story, oo5). With a sense of humor and the spirit of a true seeker, Corinna Nicolaou embarks on a four-year journey of church, temple, and mosque attendance, seeking to learn from the inside what each of these religions has to offer and to teach. In her talk, she said that “Religions provide a space to ask the questions about living and dying.” In her book she concludes “No matter what religious road I was on, it seemed to lead back to the idea that we come from, and eventually return to, a common source. We are parts of a whole. We can be different and still make up a healthy totality. I had long ago given up trying to make sense of how I might define ‘God.’ I figured God was too complex a concept and could be imagined a number of ways. I was driving in my car one afternoon not even thinking about any of this stuff when these words popped into my head: God is that which unites us all…I suppose that’s the best definition I’ll ever have of God,” (266).

A person in the audience at the talk asked about the loneliness of not belonging to a particular religious community. Corrina Nicolaou spoke to this and it sparked a question of my own that I wrote in my notebook, “What to do when no one religion feels like home, but all do?” In her book she writes about this. “To commit to none, but to call on all: what would that look like on day-to-day practical terms? With no official place of worship to call home, my spiritual practices will be mostly self-guided,” (283). She jokes about making the rounds of religious places of worship again, “A-to-Z,” and that she could “draw the boundaries of my spiritual identity ever larger” (285).

I kept looking at the back inside cover of the dust jacket. It is an irregular circle with colors of blue, red, yellow, and green in it. I thought, “Why is it irregular?” “Why this little splotch of splashed colors?” Ahh, I get it, the front cover of her book has four separate colors of circles and the one circle at the back brings together her journey into one mulit-colored circle, a little lop-sided, because we are not perfect and the journey is never over. Oh, yes, and I see that her name is written in four different colored letters! Beautiful, that visually sums up the journey!

Oh, yes, and one more thing, the talk that Corrina Nicolaou gave was in the Vachon Gallery at Seattle University and hanging behind her is a beautiful painting by Salma Kamlesh Arastu called “Equal Rewards.” I asked Salma, later, what the name of this painting was and she said, “Equal Rewards – men and women get equal rewards.” I think this applies to all seekers as well, no matter where you are seeking, you will get equal rewards because the reward does not come from the place you are seeking, but it comes from the journey of seeking and it is spoken, whispered to you, in the Language of the Heart.

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One last thing to mention, at both these talks I spoke with another audience member afterwards. Angie Louthan is quitting her job as a pre-school teacher in order to bring into existence The Kind Fest. You can contact her at: AngieLouthan@gmail.com, website still under construction for the event.

She is planning to host it in Everett, Washington in September. I think this is a much-needed event to focus on manifesting kindness in these times. I wrote about the Compassion Revolution in health care in the past and I am very concerned about the hardening of the American heart and the deafening of American ears so that it is harder and harder to hear what Salma Arastu calls the Language of the Heart. Actually, on the way to the Search for Meaning Book Festival, I had seen a yard sign in our neighborhood:

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