At the Heart of the Lava Rock Clinic: conversations with Max Schüpbach and Amy Mindell

On the Oregon coast where the mist curls around the cliffs and the waves play with the shore relentlessly, Max Schiipbach, Amy Mindell and a team of process workers facilitate the Lava Rock Clinic, where people can discover the mysterious meaning and creative process behind illness. Since 1990, a group of about a hundred people has come together twice a year. In this community atmosphere, which supports even the wildest, weirdest and most beautiful aspects of their natures, people explore how body symptoms invite them to live their wholeness, go beyond pain, transform themselves and inspire change in the environment.

The Lava Rock clinic is open to everyone. Many people with illnesses, medical practitioners, therapists and students of life attend. While the program is constantly changing to accommodate diverse needs, a typical day at the clinic might proceed as follows. In the morning, either Max or Amy1 works with someone on a body symptom. They interview the person and help unfold the experience of the symptom. In the afternoon, people meet in small groups with trainers and assistants for personal work and exercises. In the early evening, Max and Amy offer supervision where therapists, clients and small groups get help with their processes and everyone can learn together. Participants also have

individual therapy sessions, and a medical doctor and sometimes a Chinese medical practitioner are present throughout the clinic. Visiting practitioners give presentations in the evening, and a trained staff is available for help 24 hours a day.

The clinic has generated an interdisciplinary and international network of people interested in researching process-oriented approaches to illness. Individual cases are discussed via an electronic mail conference. There is also a participant newsletter which offers opportunities for people to share their personal experiences.

What has touched me most at these clinics is how the static mechanistic idea of the body melts under the minute attention given to a person and her physical experiences. Meeting with the impossible and facing untenable body processes can be excruciating, especially for our normal identities, but it can facilitate an expanded sense of who we are.

The following are interviews with Max Schiipbach and Amy Mindell, the founders and facilitators of the clinic. The interview with Max focuses on current issues at the clinic, while the interview with Amy focuses on the process of working with body problems and illness. Gemma Summers accompanied me in the interview with Amy, and I appreciate

I will call them Max and Amy in the informal spirit of the

interview.

her presence and ideas. I'm grateful to both Amy and Max for sharing their thoughts and inspirations and for undertaking the unique project of the Lava Rock Clinic.

A conversation with Max Schupbach

Salome: Why did you start the clinic? Was there a dream?

Max: We wanted to start a clinic for a long time. I got impatient with the fact that there was no building. I thought, "How can we have the clinic before we have the building?" But we did!

Salome: What do you mean by "clinic?"

Max: I always wanted and hoped for a community setting to do ongoing work with people's body symptoms.

Salome: I remember you once said that the clinic is a democratic clinic which is based on people's needs and not on outer structures.

Max: The idea of a democratic clinic is important. My experiences working in different places around the world were also important I saw people having great experiences working on their symptoms in seminars, but when I came back, people said that it was very hard to keep the experience alive without ongoing support. Many people return to the clinic, so it is a community event where people get ongoing support.

In the past, we thought that personal processes were the main issue behind disease. Now, in connection with Worldwork, we're seeing that social issues have a bigger influence on health than we were aware of. You can't really sustain the healing of an individual without addressing the community level. You can make changes but many symptoms are so connected to collective consciousness that you can't work on them by yourself. Of course you can, but in a way you shouldn't be able to.

Salome: So it's not only important for people to have a supportive community, but also for a community to deal with the processes of people who are sick?

Max: Right It isn't always the case that being part of a community is better for people who are sick, but it can be necessary because die issues they are dealing with are community issues. They have to be

worked on in a community. To work with an individual as "sick" is as antiquated as the idea that if somebody has a liver symptom, you deal only with the liver.

Another point is that hospitals and clinics themselves are relatively new. Hospitals and clinics were cultivated in China in the beginning of Buddhist practice. I was attracted by the Buddhist idea that if you meet somebody who is in need, this person becomes your responsibility and is part of your Tao. If you meet somebody with a symptom then you are, in a larger sense, responsible for it My friend Kanitta, a psychotherapist in Thailand, ran into an abandoned child one morning on her way to the hospital where she works, so she adopted it. That makes my heart sing.

Salome: What have you learned personally by taking responsibility for running the clinic?

Max: The clinic has been a major learning in terms of my personal growth. Working together with a team and also being in a position of responsibility and eldership has been a huge challenge for me. I go back and forth between being an elder, a teenager and a baby. I try to support all of us who work at the clinic as a team and I try to make the benefit of the clinic my first priority. I've been swept around by the complexities of such an enormous project and have cursed it at times, but I'm very grateful for my learning. It has been a wonderfiil and powerful process. And working with Amy is the icing on the cake!

Salome: It's beautiful to see you think so much about the whole. From my experience with the low-income clinic in Portland, I know something about the struggle of growing into eldership.

Max: I get screwed up a lot too, but it's getting better. I have a leadership position in the clinic and yet I woik within a team of peers. This is something I have not had much experience with and I haven't seen many models for this.

Salome: What about the connection between symptoms and Worldwoik? What are the advantages and disadvantages of doing group process?

Max: We've been experimenting with this idea for a while — that we need to bring in group process at the clinic. We have already done this in a way, but it needs further research. We're getting feedback

from participants who say that they want more group process, and then we get feedback from other participants who say that they don't want group process. In general, you can say that the more physically well you are, the more interested you are in group process. The more physically weak you are and the more serious your disease gets, the harder it is on the body to stay in conflicting atmospheres for extended periods of time.

My hope and vision is that more political action will come out of the clinic. I see us creating social activism groups for the issues that come up, so those who are interested can go ahead and address these issues in the world.

Salome: Have you thought about someone dying at the clinic?

Max: Sure. There are several issues here. First, what can we do in terms of medical support? From my own medical background, I feel that the biggest ally in regard to the safety of a person is humility, being aware of your limitations. Up to this point at least, we know that it is not possible, in terms of finances and staff, to have a medical safety net We do have doctors, and together with the patients we try to figure out how severe each person's state is. We know that people could go into crisis or need an intensive care unit It's possible to get somebody to a Portland hospital in less than an hour using a helicopter. In an ambulance it's less than an hour to a Newport or Florence hospital.

Other than that, we hope that the clinic will be a place where you can die. One idea is to connect the clinic with a hospice. There seems to be a need for that You hear some participants say, "I nearly died, but I wanted to make it to the next Lava Rock clinic." Tom Hammond, who died a week or two after a clinic, said this. From what participants say about the contact that happens between them, this makes sense.

If someone died at the clinic that would be a good place to die. One thing that impressed me was when a client with an aneurysm, his therapist and Amy openly discussed their feelings about this.

The therapist wanted a helicopter, the patient wanted the freedom to go for a walk on the beach and die there, the medical doctor gave various medical options, and Amy facilitated the whole process. People should be able to make their own decisions about how to deal with a particular situation.

Salome: It also seems important that the dying process is part of community life.

Max: There are some good books on the tribal life of Aborigines in Australia and of !Kung Bush People in Africa. Many of these people live in a way which reminds me of an ongoing symptoms clinic or Worldwork seminar. The way our communities are organized isn't tribal but some aspects resemble tribal life. In most tribes, birth and death have a naturally established place and people attend to them as they happen. For example, a group of the !Kung were running out of water. At one point, a few of the older people couldn't take it anymore and the tribe knew that as the group moved on, the older ones would stay back and die. Everybody knew that it was normal to die, so the group said good-bye and left the older people behind. For one reason or another, it rained that night and the next day the older people caught up again. Everybody was happy about that and they went on together.

The idea that death and dying are repressed in white Western society is well known. Focusing on the process of death has re-emerged through the work of Kubler-Ross and others who have increased general awareness of the dying process. The more this awareness happens in the clinic, the better.

Salome: What is your relationship to death?

Max: If it will come, it will come, but it ain't over until it's over. That's my viewpoint this morning. I thought I was dying a couple of years ago when I was in a car accident. I was amazed at the lack of drama in me when I thought I was dying while my car turned over! From working with dying people, I know that death is a powerful transformation pro cess filled with awe.

Seminars generally include a time when the group focuses on itself as a whole; this attention to the group atmosphere is what is meant by "group process."

Salome: At the clinic, people find themselves having experiences as learners, patients, teachers and healers. Why do you focus on training in a clinic on illness?

Max: These are incredible questions because many of them are posed in the feedback we get from participants. I think that for many people it's just fun to learn. Aside from that, it's a reflection of the holistic idea that you cannot be sick without being a healer. The moment you become a patient you also become a healer. It isn't possible to be only a patient or a healer. Many people who are famous for studying particular diseases get the diseases themselves and die from them. Other people get a disease and then become healers. So if you want to work with disease, you have to train the healer in the patient

Also, in death and dying many people become identified with being students or teachers. The teacher often comes forward strongly. We see again and again when we work with people on serious illnesses that the illnesses carry important messages. It's the fate of the carrier of these messages to bring them to us. So it's important to have training as a part of the clinic. However, we realize that training isn't a priority for everybody, and we try to create diverse opportunities for people to find what they need.

Salome: Do you have interests in terms of research?

Max: I would like to learn more about the connections between abuse, disease and social change. I'm also interested in the connections between allopathic medicine and other medical systems. It's a big research project to combine these different systems so they can work together, for the benefit of each other, in ways that allow us to follow people's needs. We're just in the beginning of understanding this interface.

We are also studying how particular diagnoses are connected to childhood dreams and contents of

dreams. We hope to learn what kinds of symptoms are connected with particular processes, and how they connect to cultural and political life. At this point, we're just about sure that such a connection exists for breast cancer. In our opinion, many processes around breast cancer connect with the issue of being able to live a part of yourself that is tougher, knottier and less soft. If this is true, we can theorize about how individual processes and illnesses are connected to the Zeitgeist. We don't know enough about this kind of epidemiological background of diseases.

Salome: If Process Work comes up with correlations between illness and certain processes, is there a danger that this will affect one's ability to follow an individual's process?

Max: I'm optimistic about this. There is the master of the tonal and the master of the nagual. No matter what you study, there are people who are at home with the nagual and who want to follow the unknown, and people who by temperament and nature are more interested in following the tonal and in creating systems around it. We find these tendencies everywhere, even in process workers. Both inclinations are useful and should be supported.

Salome: Have there been any surprises while developing the clinic?

Max: The biggest surprise is to see the ecstasy, humor and detachment that is present when you go deeply into the processes of people who are dying. It is a privilege to go deeply into the experiences of disease. This is a politically incorrect thing to say because it is a privilege to have a healthy body, but, in terms of personal development, a disease can be an incredible opportunity. One of the reasons people are afraid of death and illness is because they are not aware of the incredible process in the background.

Salome: One final question: do you have a wish for the Lava Rock clinic?

The terms "nagual" and "tonal" are used by the Yaqui Indian Don Juan as described in Carlos Castaneda's many books, especially in Tales of Power (New York: Simon and Schuster, 1974). Applied to Process Work, Mindell defines "tonal" as the doings of everyday life, the primary process. The "nagual" is the not-doings within the tonal, the secondary process (Mindell and Mindell, Don Juan seminar, 1992).

Max: Material ones! I'd like it if we could be financially sound. In the United States, at this point, being sick means being poor for many people. Half of our participants in the upcoming clinic will attend on scholarships. We would like to give them even more help, especially with travel, housing and ongoing therapy after the clinic. The staff works for minimal salaries. I hope to change this eventually. I also wish for our own seminar room, and it would be great to have a house which we could use as a hospice.

A conversation with Amy Mindell

Salome: Is there anything you'd like to say first?

Arny: The basic question of the clinic is,"What is life about?" Everyone involved in the clinic has to face the question of why we are here. I pose the question without answering it because people have their own answers. And people must answer this question, because whether they answer it consciously or unconsciously, it determines how they work with others.

Salome: How do you answer it?

Arny: In the context of the clinic, life is about discovering what nature is asking of people through their physical experiences. I'm concerned with helping people make sense of their experiences and to use them. My primary goal is not to heal people. While I am interested in healing, my primary goal is to make life so worthwhile that healing becomes irrelevant I want to make life so wonderful, crazy and magnificent that the pain becomes irrelevant, and even if you still have pain, it becomes something amazing. We succeed every now and then in making this happen. That's why we see so many extreme experiences in the clinic.

Salome: What do you mean by extreme experiences?

Arny: Extreme experiences are experiences which are beyond a person's greatest dreams. They are be-

yond what people ever thought they could be. Getting in touch with such peak experiences is why I love being at the clinic.

Salome: What interests you right now in terms of body symptoms?

Arny: I'm interested in how your body doesn't belong to you and how many of your experiences are dreamt up.4 They belong to the culture or are dreamt up by some other force. The happiest person is a woman or a man who knows that body experiences are only partially his or hers. They are yours to facilitate, and in this sense are like a group process where you facilitate what's trying to happen in the field. But you can't do much about your deepest body experiences. You can only adjust to them as the Tao. That's what fascinates me. It's a central issue for me.

Gemma: Do you mean that your body belongs to the larger field?

Arny: The body belongs to nature and is part of the evolution of the species. For better or worse, my job is to adjust to it.

Salome: This implies a connection between symptoms and Worldwork.

Arny: It's all the same thing, whether you're working with symptoms or Worldwork. The focus is to find the Tao and bring it down to earth. It's making the background field, energy, symbols and physical experiences realizable for people.

That's why it's possible for me to write so many books. I'm not doing anything, in a certain sense. I'm doing the same thing all the time. I'm learning how to open up my own mind so that my virtual reality is other people's worlds. Then I can help them unfold their worlds. But I can't do that if my mind is closed. So a big part of my work is inner work, opening myself up to what's happening so that I can work with it.

See Arnold Mindell, River's Way (London: Routledge and Kegan Paul, 1985): 48-50 and Goodbread, "Dreaming Up Reality" Unpublished, 1989.

Two of MindelTs books are especially relevant to working with body symptoms, comatose states and dying: Working with the Dreaming Body (New York: Viking-Penguin-Arkana, 1986) and Coma: Door to Awakening (London: Boston, MA: Shambhala, 1989).

Salome: How do you do that?

Arny: I notice when I don't understand something and when I feel uncomfortable. Then, I work on myself. I ask myself, "Why is it that I'm uncomfortable with this person? Where do I have to grow with this client? Where am I blocking out their reality?" I study myself first and then I study the client For me, growing means opening up to the empirical world around us.

Salome: To open up continuously reminds me of shamanism.

Arny: Shamans open up to the spirit world. They're not necessarily opening up to ordinary reality. They may go into altered states to see what's behind that reality, but for me reality itself is a manifestation of the divine. Similarly, the Australian Aborigines see the real world as God and as the proof that God exists.

Salome: When you work with body symptoms, is it really spiritual work?

Arny: Working with people is a deep meditation for me, in which something in me dies and something else opens up to what's happening. I'm carried in the process by being open and empty at times. That's why I love working with people.

Gemma: When you talk about being open to everyday reality, it sounds like a form of diversity work. You are open to diversity in the everyday world, as opposed to being open to diversity in a "oneness" kind of way.

Arny: That's right The focus is on experiences which are different than me and on allowing differences to happen.

Salome: What are your thoughts about working with people in the clinic who are close to dying?

Arny: I think about the clinic as a place for living your life and living your dying. It's possible that someone might choose to die there, but it's unusual for people to die while we are working with them because people who come to the clinic are usually interested in living their experiences. The only time someone died in my presence is when we worked

The Extreme States Clinic was developed by Arnold

on the issue of death and the person wanted to die. They were ready to die, so I supported them. People have died in my arms, but no one has ever just died.

I think about death, but it's not a big issue for me whether someone dies or not. At the clinic I'm more concerned with the people who are learning Process Work. Sometimes they aren't aware of subtle things, for example, that older people have brittle bones. Before you do anything energetic you need to ask people about their hearts and backs and other things, and find out if they are strong enough. People sometimes don't ask enough questions in regard to illnesses, although the clinic is there to train them in that.

Salome: Would you like to do more with training?

Arny: Yes. One aspect of training is really about inner work. In dealing with near death situations people have to clear up their resistances to death. People freak out when someone is about to die. Many of us resist the process of death. If that resistance were removed, people would be more detached and happy about death. They could notice it was time to die It is easier for a person to die if the therapist supports this process and thinks that dying can be a good experience. In terms of relationship, it is always a sad experience when someone leaves the house, so to speak, but the more developed the therapist, the easier the client feels about death. On the other hand, the more the client accepts her process, the more the therapist can. We try to train people in this area, but we can't make them feel at ease with it. Accepting death requires inner work.

My hope for the clinic is that our work goes beyond the present paradigm of healing. "Do you feel better?" is an important question, but I want to go beyond feeling better. I want to help people enjoy themselves. Are you enjoying your life? Is your life weird and exciting, awesome and strange? Are you thrilled when you wake up in the morning with your symptoms? I want people to be totally alive in life and death. That's what I'm interested in and what I hope for both the Lava Rock and Extreme States clinics.6 Both of these clinics should provide

1, Ph.D., George Mecouch, D.O., and Joseph Goodbread,

an opportunity to go beyond the traditional paradigm of psychology which distinguishes experiences as normal or abnormal, as healthy or pathological. Of course pathology is the great shadow smoking its fumes in the background, looking in on us and asking us if we can actually heal anybody. This question is also good because it makes us try hard.

Salome: How do people go beyond the healing paradigm?

Amy: It happens when we work with people and also, when the whole community gets inspired. The clinic has a social responsibility in this way. However, the clinic is only a few years old and hasn't been able to pick up much social responsibility yet. But its social responsibility is to make information about working with body symptoms available to the outside world. It should be on Cable New Network (CNN). Imagine if everybody in the United States watched CNN and said, "Wow. You mean the pain in my chest is this incredible power trying to come through me? My prostate cancer is really the sensuality I never had? Oh, I must turn the TV off right now and work on myself." That's the direction I want to take and see the project go in. We'll connect to the media when the time is right

Gemma: I saw a report on the news that African Americans have twice as much heart disease as white Americans and that the treatment they get from doctors isn't as good. It made me really mad. Racism wasn't mentioned once in the whole report Nothing was stated about the obvious.

Arny: This requires social action and refers to the fact that global problems influence body problems. Thus, to really do something about body problems and illnesses, society needs to change. That would be preventative medicine. So one aspect of the clinic is getting information out to the public, and another one is facilitating public change so that the stresses and strains on people are relieved. Mainstream conventionality, rigidity and lack of diversity screws us all up. Everything that's diverse in us, everything that's unusual, creative, fascinating

and wonderful is at stake. We repress most of these experiences because of Christianity, Judaism, and other religions and belief systems.

Another interesting quest for me is to wake people up to the experiences of wellness and illness as they happen in a given moment. You can feel yourself getting ill when you can't accept what's happening to you and you start to repress it I want to focus more on inner work which makes people aware of this. For example, I notice that in this moment I'm getting sick because of how I behave toward myself and the environment Now the environment is making me ill, and what can I do to change it? The body is an antenna for yourself and the environment

Salome: Your focus on minute sensations is touching and inspiring. Is there anything else you would like to say?

Arny: An alternative clinic for working with body symptoms and extreme states is actually a very unusual establishment! But it's not a clinic in the usual sense. The word "clinic" is an adaption to where people think they are at. It would be better to call it womb or birth. The clinic is a huge being giving birth to all these little dreambodies.

Arny Mindell, Ph.D., analyst and founder of Process Work, is author of 12 books. He is a former training analyst at the Jung Institute in Zurich and has been a resident scholar at Esalen Institute. He conducts seminars throughout the world and teaches at the Process Work Center of Portland and the Research Society for Process Oriented Psychology in Zurich. He works with large group conflicts, diversity and social change, and is co-leader of the Lava Rock and Extreme States clinics.

Max Schupbach, Ph.D., is a co-founder of the Process Work Centers of Zurich, Switzerland, and Portland, OR. He works half the year in his private practice in Portland and travels worldwide teaching Process Work. He is the originator of the Lava Rock Clinic which he leads with Arny Mindell. The Lava Rock Clinic combines Process Work with

psychosomatic medicine, allopathic and naturopathic medicine and community building.

Salome Schwarz, Ph.D. candidate, and Certified Process Worker, is a therapist, program developer and co-founder of Portland Health Services, a therapy clinic for people with low incomes. She co-fa-

cilitates workshops in various places in the world. She is currently writing a dissertation on living with irrational impulses, non-ordinary experiences and hidden forces in the atmosphere and their significance for therapeutic work and community development.

The pictures which appear on various pages in this issue of the Journal were done by individuals working on their physical symptoms. The original art is in crayon on newsprint. The art has been published anonymously to protect the individuals' privacy. Thanks to everyone who took the risk to let us include their pictures here.

.-"'-U'"' ■■■■ ~Sx*aei

After Cervical Surgery

This picture was drawn at the Lava Rock Clinic. The woman who drew it had recently had cervical surgery. She says, "I feel a deep connection to the last four generations of women in my family and to their unresolved issues. There is a similarity in feeling between my invisible wound and the issues that my fore-mothers don't talk about. They are all so easy to deny.

This experience reminded me how fine the line is between being sick and being healthy. I am learning to integrate death more into my everyday life and relationships. I find that I have to stand up for what I really want, feel and know, as though I am going to die at any moment."