Walking the integral path with practical feet

Walking an Integral Path with Practical Feet

Charlotte Sun, RN, PhD Director 吉纳喜道院 Genesee Valley Daoist Hermitage

Note from the author: This article was originally written in 1996 as a chapter of a book by request of Craig Matsu-Pissot, a student of mine, who was editing a collection of essays discussing what it means to be human. At that time, he stated that he was concerned about the loss of connectedness, one human being to another, as individuals seem to becoming more isolated and less engaged with nature as they pursue the quest for what is seductively modern. To my knowledge, the book was never published. The manuscript has been edited. Names and places have been added for biographical clarification.

When a person perceives the world as an integrated whole, living in modern society can often be a challenge. Joseph Chilten Pearce in Magical Child (1) noted that all children have “special powers” at birth and that they are taught by parents, authority figures and society-at-large to distrust those powers or to essentially suppress them. He wrote that by age 5, most children are socialized to conform to the belief system of their parents who were socialized to conform to the belief system of their parents, etc. and the dominant societal values which do not place importance on intuition or knowledge gained from trusting our senses.

What is “special power”? Special power is the conscious awareness of subtle energy. It is the conscious awareness of the inter-connectedness of all things. It is the primal knowledge that we are born with which reveals the essence of creation. It is expressed as the subtle energy which flows throughout the universe and flows throughout our body-mind-spirit and which is the antecedent to all being.

Cheng-quan was in graduate Ph.D. studies when she had the opportunity to review Pearce’s research which brought to consciousness that she was well into her teens before she began to realize that other peoples’ physical, psychological, and spiritual perceptions differed significantly from hers. They did not exhibit “special powers.” They did not see subtle energy or demonstrate any particular sensitivity to the interconnectedness of all things. Prior to the awareness that other people who were close to her (family, friends, classmates, teachers, and other authority figures) did not seem to experience life as she did, she was under the illusion that everyone could see energy fields, feel subtle energy, and recognize that this energy was the underlying basis of life itself.

Although her awakening was not dramatic and happened over time, as her awareness increased, so did her sense of separation from her peers. Her willingness or ability to go along with the crowd diminished because her perception of inter-connectedness disallowed her to participate in many of the activities of children which are competitive, alienating, clannish, spiteful or hurtful. For example, she did not willingly participate in competitive sports and remembers reluctantly standing on a gym court during a ball game. Without her conscious participation, the ball forcefully landed in her hands (which was actually quite painful), and the team she was on won the game. The other players enthusiastically gathered around her and congratulated her for winning the game for them. She was stunned.

At a very early age, she realized that patterns of speech which detracted from others were competitive. She found it more satisfying to listen attentively to the words of others instead of interjecting comments about herself into every conversation.

Why was she still exercising “special powers” beyond the age of 5? A simple answer would be to say that her parents did not shut her down. Another answer would be to state that she did not reveal her “special powers” to others and therefore she was not pressured to relinquish them. In retrospect, it would be safe to say that both answers are true.

Born in 1941 and growing up in America, Cheng-quan struggled with the ideas which permeated her formal education: realism, idealism, and scientific thought. Throughout her studies and subsequently throughout the early phase of her career, she knew that there must be some way of thinking or school of thought which reflected hers. She attended a spiritually oriented nursing education program at St. Luke’s Hospital in New York City which professed the motto “heal the body and save the soul.” The teaching was primarily based on scientific research which stemmed from the belief that logical process uncovers truth. However, she was able to attend seminars about dealing with patients as humans which provided an opportunity to explore the realm of feeling and recognize that patients are not extensions of machines. The school was church supported and included in the curriculum the spiritual needs of patients as well as the psychological and social aspects of disease.

Although there was always the overriding, patriarchal heaviness of the religious teachings and the forewarning to “never get involved with a patient,” the school provided her the opportunity to develop a spiritual practice. Daily meditations in the school chapel commanded discipline from the students forming the basis of standards of practice which carried over into her entire life. However, the problematic concept of professionalism which was the underlayment of much of the teaching as to how nurses should behave seemed to create a shield or a barrier between the nurse and the people she was to care for. Much of the teaching seemed contradictory: know the scientific basis of the work and treat the patient with kindness and compassion, but don’t cross over the line.

Crossing over the line seemed to her to mean don’t use your special powers i.e. don’t trust your intuition when caring for patients or look beyond the surface of the physical body. She witnessed the dismissal of classmates who did not measure up to both of these ideals. And she witnessed the confusion of many students were not prepared to address the psychological, social, and spiritual practice of nursing.

However, as she began caring for patients as part of her study program, she became increasingly aware that psychological, social, and spiritual needs were often more in need of attention than physical needs. For her, knowledge of the inter-relatedness of all things did not As Cheng-quan began experiencing different jobs early in her career, she became increasingly aware of the cause of the separateness she had experienced earlier in her life. She chose not to work in jobs which she felt required her to comply with what she perceived as alienating group behavior. For example, she never worked in a staff position in hospital because she realized that nurses in hospital spend more time fulfilling State and Federal requirements, in particular, performing paperwork, than interrelating with patients. Nurses were not expected to go beyond taking care of patients’ medical needs. She worked through a nurses’ registry which allowed her to work as a private practitioner and to develop professional relationships with selected physicians* who requested her to take care of individual patients with special needs…patients with complex or compounded problems which required a broad spectrum of care and which addressed physical needs as well as psychological, social, and spiritual needs. She knew that approaching patients as “broken machines” who needed parts fixed did not facilitate healing.

* Selected physicians were those who saw their patients as people, not simply a body with some disease or defect which required mechanical intervention. They were physicians who openly recognized that patients were part of a greater whole, part of a family, and part of the community in which they lived. They were physicians who supported the concept of integrating psychological, social, and spiritual care with physical care.

She continued her search for academic support of her way of knowing by attending undergraduate university studies in psychology, administration, and education at Columbia University in New York City. She sensed that if she acquired recognized, academic credentials, she would be able to establish a methodology whereby her approaches to her life and work would be more generally accepted. The path was long and winding. She thought that study of the current methods of psychiatric approaches to patient care would provide her with knowledge and skills beyond those acquired in her basic nursing education which would turn attention away from the physical body. But, it became obvious to her that professionals working in the psychiatric arena separated the mind from the body and did not acknowledge the interrelationship between the two.

Having been born and raised on the east coast of the United States, in her early twenties, after completing her undergraduate degree at Columbia, Cheng-quan felt the need to move westward. She explored the Denver area but did not feel compelled to live there. In 1965, she traveled to the San Francisco Bay area and quickly made the determination that she should relocate there based on a deep inner feeling that that place would offer her the opportunity to more openly express her special powers. Without job or plans for further schooling, she shipped her belongings to San Francisco and boarded a plane. Within days, she was able to locate housing and also found a medical employment agency which she later learned was well respected in the medical community.

The agency was run by a nurse who worked closely with physicians to recruit and place nurses in special positions in the community. (The nurse retired soon after Cheng-quan found employment and the agency was closed.) Through the agency, she was introduced to Edgar Munter, M.D., a well known, elderly physician in town who called himself a “geriatrician” stating that his special expertise in caring for the elderly arose out of the fact that he was growing old with his patients. (The fields of gerontology and geriatric medicine did not yet exist.) He was looking for someone to work with him in his office who could offer his patients more that the traditional setting up of appointments and basic organization of the office. He said that his patients had “special needs.”

Cheng-quan saw this job as an opportunity to develop her skills in counseling patients and families on a personal level which included psychological, social, and spiritual needs. She was able to understand elderly patients who appeared confused and disoriented because she could see their energy fields and know what action to take to alleviate their distress. She was able to rebalance patients’ energy fields through the use of psychic massage or sometimes by projecting thought patterns without any bodily movement.

As a result of the success she achieved in alleviating patients’ discomfort, the physician asked to expand her office work to include making visits to his patients in their homes, in hospital, and nursing homes.

During her tenure at that job, a young, newly licensed physician, Hal Bailen, M.D., was brought into the office to assist with the increasing number of patients. He did not encourage his patients to take a myriad of prescribed drugs. He went against the growing trend to treat patients chemically for each and every complaint. His primary approach was to listen to his patients. Cheng-quan noted that as people aged, they accumulated complaints from earlier diseases/distresses which were never healed. By the time they were elderly, they often presented with multiple complaints which at times seemed overwhelming. She noted that it was quite common for elderly patients to have long lists of diagnoses on their records and long lists of prescription drugs which they took for multiple problems. Because each complaint was isolated and treated, the whole person was forgotten. She saw the inconsistencies in this separative approach and sought ways to address each patient as a whole person as well as a part of a greater whole.

She was able to elicit the support of the young physician who was willing to explore more wholistic approaches to patient care. Unknown to her, he was taking periodic trips to England to study Traditional Chinese Medicine at the Worsley Clinic which included training in acupuncture. (Such training was not yet available in the United States.) Years later, when she learned of this somewhat clandestine study effort, she understood some of the reasons why this newly licensed physician was able to step away from the traditional practices of western scientific medicine.

Through the efforts that were made in this physicians’ office, Cheng-quan was introduced to the field of longterm institutional care for the chronically ill, especially the aged. In time, she continued on her journey by creating a job in a San Francisco nursing home. The facility administrator was curious about her visits there to see patients managed by her “geriatrician” employer. He wanted to provide the same service to all of the patients and asked her to work there full time. Her presence was quite shocking to the Director of Nursing who could not accept Cheng-quan’s work if she was not in uniform and performing the duties of licensed nurses: dispensing pills and giving treatments. The Director asked her if she would work as a licensed staff nurse for a period of time to prove that she was, in fact, a qualified nurse. She declined the offer recognizing that she would have to prove her worth in a more creative way. Her continued presence for the purpose of

providing psychological, social, and spiritual support to patients ultimately led to the departure of the Director of Nurses who said she could not work in such an unorthodox setting.

At this time in her life, Cheng-quan did not openly discuss her ability to see energy fields or to alter them at will. She continued to work in silence and focused her attention on the evolving political involvement in health care. The Federal Medicare program had recently been enacted to provide health care for the aged. It’s companion legislation, Medicaid, was enacted to provide health care for people of all ages without financial means. She developed policies and procedures for caring for patients based on their potential for recovery. These policies became the basis for the administration of the nursing home in which she worked.

She made a study of the regulations which were being promulgated by official agencies regarding health care and saw that the beaurocratic expectations usually did not match up with patient needs. The existing health care facilities were not equipped to provide the type of services which the government was seeking.

She wrote a book Extended Care Guidelines for Patient Care Coordination and Counselling, which presented a review of problems in the care of patients during the recovery process. The work became a conceptual model which emphasized the patients’ specific needs as the determinant for selection of an appropriate facility. Developing health care facilities based on human needs was seen as a method to contain runaway health care costs while at the same time providing improved care. The long-term care facility program which she helped to develop was not accepted by the Federal government because at the time it did not fit into the existing ideas of how America’s health care delivery system should work. However, in the years following the misunderstanding of her work, the concepts she developed were integrated into every level of health care. The job function which she created was introduced universally throughout the country. She realized that her job was to plant the seeds of knowledge and not be attached to the specific time of their outcomes. She could look back from a distancein-time and see the growth which was stimulated by her earlier work.

Having completed undergraduate studies which were primarily based on scientific thought, she pursued graduate studies which included humanistic psychology – a trend of thought which moved away from the Freudian orientation she had been taught and more toward her way of thinking.

She also began a course of study in philosophy which included the teachings of Tehard duChardin where she was introduced to ways of thinking which were outside of the dominant Cartesian pattern of thought which permeated all of her previous education. Master’s level education was completed at Holy Names College in Oakland, California, a church-supported college. Interestingly enough, she had made application to the University of California, Berkeley School of Public Health and was turned down because she was not Native American and would not lend to fulfill the university’s affirmative action quota. That rejection ultimately provided her with the opportunity to attend an institution of higher learning which turned out to be more sensitive to her needs and also which provided a window for other academic pursuits which would address some of her unanswered questions.

Adjunct to her academic studies, Cheng-quan accepted a position to co-direct a major research grant at the University of California San Francisco Medical Center. Federal funds from the Regional Medical Programs were awarded to investigate cerebral vascular accidents (strokes). In that capacity, she was able to travel to many counties and teach in institutions and agencies of all kinds which provided care to stroke patients. She recognized that she had attained a position of authority which might allow her to introduce some of her concepts into the curriculum which was being developed as a national model. Stroke was listed as the third-highest cause of death in the U.S. at that time. For example, she stressed the importance of working with patients within the context of their family and community. She began teaching the importance of learning about pre-stroke lifestyle patterns as a way to individualize patient teaching. She vigorously supported the concepts of early rehabilitation for stroke patients which involved range of motion exercises, learning to transfer in and out of bed, ambulation training, and learning self-care techniques as opposed to the prevailing passive receipt of custodial routines i.e. “doing to” the patients instead of teaching them to work toward independence in activities of daily

living. Much of the rehabilitation teaching about care of the physically disabled had been developed in military hospitals post World War II and subsequently was disseminated to university medical teaching centers. The grant which she helped to administrate was bringing those teachings to the medical communityat-large. The teachings were primarily based on physical restoration — strengthening muscles and improving muscle coordination, improving patterns of speech, and teaching patients how to perform daily living activities with the use of adaptive devices such as elevated toilet seats with grab bars, extended shoe horns, and a multitude of mechanical devices which were being produced to assist people with disabilities to become more independent. She was also teaching neuro-vascular anatomy and physiology. However, she was able to subtly introduce the need to expand care to encompass psychological, social and spiritual needs. She taught that updated knowledge of physical care of the stroke patient was important but was not enough. Pre-stroke patterns of behavior that lead to the stroke syndrome also needed to be evaluated in planning for care in order to achieve more complete restoration. Patients’ patterns of coping with stress, if left unattended and unaltered, would leave patients with unresolved patterns of behavior which contributed to the disability.

A spiritual approach to stroke offers thanks for the symptoms and sees them as challenges to learn deeper lessons about life. The resultant disability is seen as a gift to provide time and space to experience aspects of life which were previously ignored. Cheng-quan saw the importance of providing this wider scope of care as an outcome of her “special powers” which allowed her to see patients’ energy fields. She could perceive the psychological and spiritual aspects of patients. Her approach to care was not limited to how patients appeared after illness had brought them to the world of medical care.

Because stroke is such a pervasive disability, the need to integrate these other aspects of care was accepted by her peers, in particular, the nurses who were involved with patients on a more comprehensive basis. By the completion of the grant research project, many of the progressive concepts of the curriculum which were developed and taught throughout the granting period were assimilated into medical and nursing school curricula and were being practiced by the health care community-at-large. While she was co-administering the National grant on neuro-vascular research, Cheng-quan was sub-contracted to the university’s medical continuing education department to participate in the writing of a curriculum and teaching of classes for the inaugural State board examination to license nursing home administrators. This enabled her to meet practitioners of long-term care facilities from many areas of California who needed to complete 100 hours of education before taking their tests. This work provided her another window to introduce concepts of long-term care management which encompassed psychological, social, and spiritual needs of patients.

Armed with a new Master’s degree in education from Holy Names College, she was eager to put into practice methods of teaching which would engage existing practitioners in more expansive approaches to patients. The challenge was in allowing the practitioners to cultivate their own sensitivities and to broaden, from within, their perspectives regarding patient care.

A large part of class time was devoted to active student participation in the form of role-playing and group discussion on ways to more completely address human needs — not only patients in institutions but patients as part of the outside community including family and friends. Cheng-quan recognized that patients in nursing homes are part of a whole and that effective care for them included interacting with society-at-large. She taught principles for the development of programs to transport patients to community activities and also encourage patients’ families and friends to visit the nursing home. She stressed the importance of providing space for patients to entertain their family and friends away from the open community space where most patients spend a major part of their day. Children were encouraged to visit and visitors invited to share meals with the patients. This was one way to introduce the concept of the inter-connectedness of all things in a way that was acceptable to the practitioners. Using contemporary approaches to mental health aligned with scientifically based research data on the neuroanatomy and physiology of humans, she developed and taught a basic curriculum which encouraged a multi-faceted approach to patients.

After the teaching program for nursing home administrators was completed, Cheng-quan returned to her

work. One of the nursing home administrator students who had studied with her in preparation for the state examination approached Cheng-quan with an offer to sell her nursing homes so she could retire. In collaboration with another person, Cheng-quan embarked on a fifteen-year work project which culminated with the application of many of the theories and practices which she developed over her years of teaching and consulting in a variety of health care settings.

Psychiatric nursing theory and practice, then research and teaching of neuro-vascular anatomy and physiology provided a vehicle to approach the way of being which acknowledged Cheng-quan’s special powers. These two fields reached beyond the anatomy and physiology of the human body as taught in medical schools. At that time, psychiatry and psychology were not accepted as “hard” sciences because they did not work within measurable perimeters. Neurology was considered “hard” science but its study was self-limiting because it looked for a measurable chemical response as the basis of human behavior. Thus, her search was not over. There was still a sense that something was missing in all of the education and practice she had experienced. She continued the quest for more knowledge about subtle energy and its role in healing.

Meetings with Laozi

One day, Cheng-quan picked up a throw-away newspaper which appeared on her doorstep. (She had never heard of nor seen that paper before or since,) The paper contained listings of classes, and one class in particular caught her attention: four weeks of taijiquan instruction for $16 at an address near her home. That started her on a five-year path of the study of Daoism from a teacher who took her as a student. She began with the study-practice of yin-yang hands.

Place the hands right over left as if gently holding a large globe. Starting with the right hand on top, slowly raise the left hand and lower the right hand keeping the palms facing each other. Using free form, move the circle around to various positions and concentrate on the hands. As one hand rises, it becomes very light (empty). As it descends, it becomes heavy (full). This sequential progression of the hands symbolizes the concept of yin and yang which forms one of the basic precepts in Daoism. This practice symbolizes dual power which instigates all change. Neither yin nor yang exists in an absolute state. The hand movements constitute a beginning practice of the experience of yin and yang energy as it flows through the body.

Over time, Cheng-quan was instructed in an ancient long form of Yang style taijiquan, concepts of Daoist nutrition, and ways of being which encompassed an entire lifestyle. The teacher oriented her to Daoist principles and practices. He taught her to seek answers without asking questions. She learned that Daoism is a way of life. One physically raised in America cannot “convert” to Daoism overnight. She began to recognize through the teachings that her world view was “Daoist” in the sense that she perceived the world as an integral whole, not as separated parts or as the sum of its parts.

Through her study and practice of Daoism, Cheng-quan realized that Daoists are not “groupies.” She gradually found increasing validation for her way of being. She grew to accept the fact that Daoism is not an easy philosophy to explain and that those who live it are not easy to understand. The opening verse of the Dao de Jing, the great classic of early Daoism makes this clear.

The way that can be talked about is not the constant way. The name that can be named is not the constant name. Non-being is the name of the origin of heaven and earth; Being is the name of the mother of all things. Therefore: Constantly in non-being, one wishes to contemplate its subtlety. Constantly in being, one wishes to contemplate its path. These two come from the same source, but are different in name. The same source is called mystery. Mystery and more mystery. It is the gateway to myriad subtleties.2

Although any rendering of the Dao de Jing into English compromises the thoughts conveyed is its original script, the message is a reminder that what we see is not what wholly is. To limit one’s perception of reality to the gross, material level is to deny the more subtle levels of existence which also play a major part in life.

The difficulty in explaining Daoism is more explicitly stated by Zhuangzi in chapter two of his Inner teachings:

The way never had boundaries; language has never been constant. Borders exist because of affirmations.

Outside of the universe, sages see without discussion. Inside the universe, sages discuss without deliberations. When it comes to the passing times and generations and the records of things of yore, sages deliberate without debating.

The great way is not called anything: great discernment is unspoken; great humanness is unsentimental; great honesty is non-complacent; great bravery is not vicious.

When a way is illustrious, it does not guide; when humanitarianism is fixated, it is not constructive; when honesty is puritanical, it is not trusted; when bravery is vicious, it does not succeed. These five things are like looking for squareness in something round.

So we know that to stop at what we don’t know is as far as we can go. Who knows the unspoken explanation, the unexpressed way?

Among those who do know, this is called the celestial storehouse: we can pour into it without filling it, we can draw from it without exhausting it; and yet we don’t know where it comes from. This is called hidden illumination.3

These words acknowledge that the daoist sage can spend years studying without understanding if arbitrary boundaries are placed on knowledge. Daoism is a difficult path to walk. But once the body-mind-spirit is opened to the subtle energies of life, an awakening occurs that makes the struggle worthwhile.

Dao is the eternal ultimate: it is beyond knowledge. From this teaching, Cheng-quan saw value in focusing on the more visible aspects of the Dao. The more conscious she became of the inter-relatedness of all life, the more she was able to understand the relationship between the material and spiritual worlds. She recognized that Dao provides the link. This fundamental inter-connection and unity is the core of Daoism.

Perception which has been defined as “special powers” provides the life experience to support this theorem. Dao as the ultimate source of all, the origin before origin and uncreated which creates everything is the essence behind power. Essence precedes material manifestation.

Understanding Chinese culture helps to cultivate Daoist practices. This knowledge brought Cheng-quan to seek higher education which would bring her to a better understanding of the cultural and historical foundations of Daoism.

Once again, a throw-away paper appeared on her doorstep. Therein was described a nearby graduate school devoted to teaching Asian philosophy. By that time, in the mid 1970’s, there was a movement in the U.S. to bring teachings of Asia to America. Some scholars in the San Francisco Bay area who had traveled to India had requested that a teacher be sent to America to introduce Asian philosophy in an academic setting. Eventually the Institute of Asian Studies (later renamed the California Institute of Integral Studies) was founded with the idea of integrating Asian and non-Asian thinking as a way to address some of the problems being faced in the mid-twentieth century. Cheng-quan’s experiences of special powers since early childhood and years of walking alone found another path for expression in the doctoral studies of philosophy and religion at this unique graduate school.

Simultaneous to pursuing doctoral studies, Chengquan was developing the policies and procedures for the long-term care facilities which she co-owned. As her studies progressed, and as she deepened her practice of taijiquan, she was increasingly able to articulate her deepest beliefs as to how to better assist people with chronic disability. And, being in the top administrative position in the work setting, she was able to institute policies which reflected her ideals. Over time, the nursing homes she administrated traveled further from the accepted medical model of scientifically based requirements of the national government. To address the differences of opinion which arose as she more fully expressed herself through her work, she drew from the four right efforts in Buddhism:

To prevent negatives from arising. To put an end to existing negatives. To initiate things which are wholesome, and To strengthen wholesome things already in existence. (4)

Based on this teaching, a policy was written and a

poster created which outlined the various aspects of the integral (physical, psychological, social, and spiritual) approach to patient care which she aspired to provide. It was called the Five Rights to Wholistic Living:

Developing right attitude Developing right environment Developing right exercise Developing right nutrition, and Ensuring right health care

These rights formulated the basic postulates for the development and implementation of policies and procedures which affected the lives of staff, patients, families, the medical community, and the lay community-at-large. Each of the “rights” provided subject material for research and development. However, each aspect was addressed simultaneously to avoid separatism in approaches to care.

An early example of introducing an integral approach to patient care was working with staff to develop a new policy for an employee dress code. The staff agreed that it would be beneficial to provide a more comfortable, homelike environment for the patients. They agreed that staff in uniform tended to subordinate patients to staff, foster co-dependency between staff and patients and sometimes instigate hostility in patients who were frustrated with being institutionalized. It was acknowledged that collaborative work between patients and staff would be a greater impetus to the healing process which needed to take place within the context of the integral approach to patient care. It was agreed that staff would select functional clothing which would allow them to practically participate in the patient care program.

Since staff was used to wearing uniforms, the new policy was enacted with the understanding that workers were encouraged to phase out their uniforms. Within two to three months, the following transition took place. Nurses continued to wear white pants but added colored or print tops. Some wore street clothes with white smocks. Housekeepers began wearing white uniforms. Maintenance workers began wearing street clothes. Dietary staff began wearing street clothes with aprons.

Group discussions revealed that the nursing staff had the most difficulty relinquishing the uniform. Some stated they had worked hard to earn the right to wear a uniform and felt attached to its symbolism. The significance of the white uniform being identified with power and authority was more evident with the housekeeping staff who said that wearing white would make them look “more professional.” Further discussions on the dynamics of uniforms and their impact on patient care produced the eventual outcome of all staff wearing street clothes.

Cheng-quan acknowledged the need for some staff to evolve through the phase of “letting go” with regards to making changes in their dress. However, employees who could not adjust to the new dress code over time demonstrated the potential inability to be flexible or make other changes necessary in addressing patients’ needs as they were being approached with the newly introduced philosophy. Those staff eventually left the job with exit counseling that their choice to not adapt to the wholistic philosophy of care was in no way a negative reflection on their future employment elsewhere.

Official inspectors did not approve of the dress policy and complained that patients and the public would be confused as to who was in authority. This feared confusion was alleviated by having employees wear attractive name badges with their title engraved on them. The staff’s rationale for continuing the dress policy which they developed was that they were working with patients and families over a long period of time and were able to establish interpersonal relationships which did not need to be defined by a uniform. However, the issue ran a lot deeper. The policy disturbed inspectors who continued to be uncomfortable with this approach to patients and who sought every possible way to contradict the way that care was being offered by staff.

The introduction of wholistic concepts into the nutritional program of the nursing home proved to be one of the most challenging aspects of transformation. Eating habits are influenced by culture. Edward Espe Brown in Tassajara Cooking (5) wrote:

“The pure actions of the cook must come forth from his realization of the unity of all things and beings; and by seeing clearly into the minds and hearts of others, from a leaf of cabbage he must be able to produce a sixteen-foot Buddha.”

Cheng-quan recognized that to effectively alter the

nutritional service received by patients, attention first needed to be paid to the staff that was preparing the food. She turned to her Daoist teachings to develop in-service classes for the dietary staff because these teachings were practical and easily implemented.

Daoist tradition governs nutrition with the following simple rules:

Eat only when hungry, not out of habit Eat only natural foods Increase grains and vegetables Chew all food very well Don’t over-eat at any time When eating, keep liquid intake to a bare minimum* Take deep breaths whenever you get the opportunity

* This concept must be understood within the context of Chinese herbal theory and Daoist theory of diet.

Cheng-quan had learned that feeling happy or serene while eating is important to the proper assimilation of food. She also knew that food eaten in its original state retained the essential energy provided by nature. This knowledge needed to be experienced by the staff before such wisdom could be imparted to the patients. Attention was paid to the dietary staff to offer them alternative approaches to food and nutrition. Field trips were made to nearby and not so nearby settings which provided them the experience of serenity while eating. Experiments were made providing them food which was prepared in anger and food which was prepared with love. After they experienced the difference in the vitality of the food, they were able to grasp the concepts which were being introduced.

In-depth study of the American diet and subsequent rules and regulations governing nursing home nutrition revealed major differences between theories and practices that Cheng-quan was learning on her Daoist path and those which were in practice in the long-term care setting. In particular, the absence of whole grains, frequent use of highly processed, pre-packaged foods, and highly concentrated sweets seemed to have a negative effect on patient behavior. Evaluation of patients revealed increased patient mental confusion and agitation after meals and complaints of hunger within one hour after meals. It was important to note that dietary staff who prepared the food and nursing staff who served the food were primarily eating the Standard American Diet (SAD) too. Staff education had to precede any changes in dietary policy in order to promote understanding and acceptance. Group sessions were held to discuss the challenge in developing a more healthful diet. Over time, the following changes were introduced:

Soups made from scratch Introduction of whole grains Reduction of added salt Use of sea vegetables Home-grown sprouts of beans and seeds (managed by dietary staff) Substitution of oil and butter in place of shortening Switching to whole-grain flour Switching to fresh or frozen vegetables Serving at least one serving of raw salad daily Serving fresh fruit daily Switching to herbal teas Creating non-meat protein recipes Decreasing quantity of red meat Decreasing concentrated sweets Decreasing use of pre-packaged foods

Staff members were encouraged to bring recipes from home which were expanded to large-quantity cooking. Cooking workshops were held to experiment with new recipes and new foods. Staff was eager to participate but there were challenges. The “regular” wholesale food supplier stated that whole grains were not available. There was no local whole food distributor. Initially, staff had to go to a not-so-nearby natural food store (the Berkeley Co Op) until we could convince a whole foods wholesale distributor to make deliveries directly to the facilities. The more the staff got involved in creating the dietary changes, the more they were willing to make changes in their own food choices. As they began to experience the health benefits of eating better, they were more effective teachers to patients.

Probably the most challenging change to achieve was the switch away from highly concentrated sweets. Over time, home-made, whole-grain muffins replaced sweet rolls, coffee cakes, pancakes with syrup, and donuts. Nine-grain cereal replaced pre-sweetened cold cereals. Whole wheat bread replaced white toast with margarine and jelly. Cakes made from scratch using whole grains and reduced amount of sweeteners replaced pies

and cakes. Fresh fruit desserts, such as fresh bananas blended with orange juice and cinnamon and frozen to a soft consistency, replaced pudding, Jell-O, and ice cream.

The huge amount of uneaten food wasted each day was one factor which prompted research in improving the nutritional program. An outcome of the changes made demonstrated an increase in the quantity of food served that was actually consumed. Behavioral improvements were also recorded. Staff and patient involvement in the planning and implementation of nutritional policies affected people deeply. The activities promoted a great deal of caring and sharing between staff and patients.

The winds of change were surmounting Cheng-quan’s ability to practice her way of long-term care. As the staff increased its knowledge and use of non-meat protein, the State of California Department of Health coined the phrase “visible protein” which was defined as meat, poultry, and dairy products, and required that “visible protein” comprise the federally mandated requirement for servings of protein per day. This mandate ran counter to the research and development of the use of non-meat protein. Also, the facility was admonished for not serving white bread and large amounts of white sugar as part of the regular diet.

Cheng-quan knew it was time to make another career change. She carefully removed herself from the responsibilities of ownership of the nursing homes. She began teaching graduate school as part of a consciousness studies program at John F. Kennedy University in Orinda, California. Her initial course offerings were based on Daoist theory and practice of nutrition. Further courses were developed when she was asked to found and direct the Integral Health Studies Program at the California Institute of Integral Studies in San Francisco. The curriculum was designed to teach health-care providers how to provide care which reflected the practices of various cultures and acknowledged the importance of a multi-faceted approach to health. Throughout her teaching career, Cheng-quan continued to deepen her Daoist practices. Eventually, she was teaching Daoist healing practices as part of the graduate school curriculum. Students were excited to delve into other ways of knowing and receive validation for what had come to be called “alternative” care. Cheng-quan stressed the importance of naming non-conventional ways of care “complimentary” in an effort to create an arena of cooperation, not competition. Although there was a ready audience for this teaching at the time of its inception, a change in school administration created an environment of contention. The program was ultimately merged into the school’s Somatic Psychology Program.

Further Meetings with Laozi

In 1973, Cheng-quan began traveling to China. Stepping onto Chinese soil felt like “going home.” She made a commitment to visit often to refine her practices of taijiquan and qigong and to continue her journey of Daoist life. One day, while wandering in the Gelin hills of Hangzhou, she met an old Daoist master, Bao Zong de, who took her as his tudi (disciple). This special relationship furthered the way of her Daoist wanderings. He explained Daoist texts to her and inducted her as the twenty-fourth generation student in his Long Men lineage. He gave her her Daoist name: Cheng-quan.

Each subsequent visit to China included treks from village to village with the master who offered Daoist healing practices and teaching to local villagers. Respites in villages brought her closer to the heart of Chinese life and gave her the opportunity to live in rural temples. Together, they directed the reconstruction of the Luo Dong Ai Daoist hermitage in Dong Yang, the village where the master was born.

One of the greatest lessons the master taught was to maintain inner peace and serenity regardless of what busy-ness is going on outside. They traveled in the countryside as well as the city. China is not a meditative place. There are millions of people moving about. Busses and trains are crowded and there is always new construction underway which is noisy and disruptive. But these distractions were serving as a reminder to maintain inner quietude regardless of external chaos.

As an outgrowth of her expressed interest in wholistic management of chronic disability, Cheng-quan was introduced to the Chinese concept of Qigong Institutes which she discovered were comparable to American nursing homes except that Chinese facilities were not specifically geared to care of the aged. Another major difference was the Chinese idea of healing involves patients being actively responsible for their own welfare.

Part of that is the practice of qigong — a way of life which includes active exercises, quiet sitting, Chinese medical nutrition, and healing thoughts.

When Cheng-quan was first brought to a Qigong Institute, the staff openly talked about how qigong practice facilitates returning to the source and how it often “opens up special powers.” In China, there was full recognition of those special powers which she had always placed outside the mainstream of her American life. She continued her work in the practice of qigong which has brought her to a fuller realization that subtle energy is the manifestation of Dao and that it is perceivable when in the qigong state. She learned that the qigong state is the original state of being and realized that she had maintained that original state since birth.

Shortly before her old master passed into immediate awareness of the transcendent Dao, Cheng-quan was asked to create a Daoist hermitage in America which would exemplify the teaching she received. Upon returning to America in 1993, she co-founded the Genesee Valley Daoist Hermitage in Genesee, Idaho — a natural, traditional setting which provides an environment for self-cultivation as well as offering the opportunity to cultivate the soil for producing one’s own food. The work of self cultivation encourages the practitioner to return to the original state of being. Following the path of self cultivation allows one’s anxiety, grief, and disappointment about life to fall away. Meditative practices help reveal profound intuitive insight into the nature of reality. Advanced practice frees the practitioner from worry and seeking self pleasure. The need for acceptance by others and the need to compete with others often fades away. Self cultivation provides the internal environment for self healing by allowing the primal knowledge of the body to re-emerge. Self healing involves self-sustenance and self-reliability. Self-reliance facilitates healthier relationships with others because one is approaching others not with the need for acceptance but from a steadfast security based on life experience.

A self-reliant person can enter into collaborative relationships which allow each party to maintain their own sense of being. The more one can heal one’s personal environment, heal one’s body-mind-spirit through nutrition, moving practices, and quiet sitting, the more one can go into the world of red dust and feel at peace. The practice of Daoism is the practice of self cultivation. Self cultivation is the process of acknowledging our particular capacity to project onto things and people outside ourselves all that we cannot accept within ourselves. The process is ongoing and requires daily attention.

People often ask how best to practice self-cultivation. Focus on those aspects of your being that hamper you from walking alone. Self cultivation obviates the need for comparison and criticism. Develop inner strength to follow the way alone even amidst a crowd. Those who follow the way of Dao through the complexities of modern life walk the path as compassionately and harmoniously as possible. They act with self-awareness and work for the welfare of the greater community.

Over time, the spontaneity of accord with outer worldly business serves to increase their skills in acting in harmony with the greater whole. In return, the Dao offers a smoother path to walk which includes ever more frequent states of grace. Self cultivation concerns the way one walks and talks. One takes on the knowledge that method is more critical than the outcome of action. Actions are self determined. Outcomes are always affected by a myriad of forces and may be quite contrary to any projection made at the outset. One sees the futility in projecting expectations and increasingly trusts turning toward stillness to experience Dao.

Endnotes

(1) Pearce, Joseph Chilten, Magical Child. New York: E.P. Dutton, 1977.

(2) Wu Yi, The Book of Lao Tzu (Laozi) (The Tao te Ching) (Dao de Jing). San Francisco: Great Learning Publishing Company, 1989, p.2.

(3) Thomas Cleary, translator, The Essential Tao (Dao) An Initiation Into the Heart of Taoism (Daoism) Through the Authentic Tao Te Ching (Dao de Jing) and the Inner Teachings of Chuang Tzu (Zhuangzi). New York: Harper-Collins Publishers, 1991, pp. 75-76.

(4) Birnbaum, Raoul, The Healing Buddha. Boulder, Colorado: Shambhala Publications, Inc., 1979, p. 47.

(5) Brown, Edward Espe, Tassajara Cooking. Berkeley, California: Shambhala, 1973, p.i.