review: Kitchen Table Wisdom
by Rachel Naomi Remen, MD
The DSM-IV, which outlines the symptoms of every imaginable mental health disorder, is often referred to as the Bible of mental health treatment providers. And while it’s true that diagnosis is important for insurance reimbursement and that it is often helpful for narrowing down medication options, I propose that another book should take its place on the hallowed bookshelves where the DSM-IV sits. Consider it, perhaps, the New Testament. Kitchen Table Wisdom is an inspired and inspiring collection of essays by Rachel Naomi Remen, a doctor who became a therapist. Her chapters are short and, read in the morning, they can become daily devotions, reminding us of our purpose here on earth.
In one piece, Remen reminded me that when sitting with a client who is in pain, often just listening is enough. She writes of a time, many years ago, when she attended a workshop led by Dr. Carl Rogers, the founder of client-centered therapy. Before watching Rogers in action, Remen, a doctor at the time, couldn’t imagine how just listening could be helpful to anyone. She believed it was her expertise that caused people to heal.
Before he demonstrated his method with a volunteer, a physician from the audience, Rogers paused. He turned to the audience and told them, “Before each session I take a moment to remember my humanity…. I too am human…. I too am vulnerable. And because of this, I am enough. Whatever [the client’s] story, he no longer needs to be alone with it. This is what will allow his healing to begin.” (p. 218)
What Remen watched unfold before her eyes was nothing short of miraculous. She watched the physician volunteer shed layer after layer of masks, “until finally we glimpsed the beauty of the doctor’s naked face.”
This experience changed Remen forever. She came to see that “Becoming an expert has turned out to be less important than remembering and trusting the wholeness in myself and everyone else.” (p. 217) She adds,
Much in the concept of diagnosis and cure is about fixing, and a narrow-bore focus on fixing people’s problems can lead to denial of the power of their process. Years ago, I took full credit when people became well; their recovery was testimony to my skill and knowledge as a physician. I never recognized that without their biological, emotional, and spiritual process which could respond to my interventions, nothing could have changed at all. All the time I thought I was repairing, I was collaborating. (pp. 223-24)
And finally, “When we listen, we offer with our attention an opportunity for wholeness.” (p. 220)
I could quote Remen all day. But it’s better to just pick up the book and read her stories.
Okay. Just one more: “Diagnosis is simply another form of judgment,” says Remen. “Naming a disease has limited usefulness. It does not capture life or even reflect it accurately. Illness, on the other hand, is a process, like life is.”
My piece, “Listening,” was inspired by Remen’s story. Sitting with a client in terrible suffering, wondering what I could possibly do to ease it, I remembered what Remen had written of her transformative experience witnessing Dr. Carl Rogers. And I invited my hero’s journey group to listen.