The Difference Between Healing & Curing

Although we have a ways to go, the zeitgeist is catching up to the idea that 85-90% of medical conditions are caused by or exacerbated by psychological trauma, and we all have been traumatized to some degree. Science now understands the physiology of how disease-inducing dysregulation caused by the impact of trauma on our nervous systems, immune systems, hormonal systems, inflammatory systems, and epigenetic influences on our DNA expression lies behind most hard to treat medical conditions. 

We now know that the body is a repository for trauma, and its symptoms may betray the secrets we try to keep or the memories we bury deep. But what if the body is not just a passive aggressive toilet that buries our toxins in our tissues? What if the body is actually our greatest ally? What if it’s less about keeping the score, bearing the burden, or carrying the weight of our stories and more like a doorway into an inner world that might reveal vast mysteries and point the way towards not just symptom relief, but also unexpected healing, self compassion, behavior change, relational repair, community healing, and dare we say unconditional love?  

As Frank Anderson, MD and I prepare to teach IFS As Medical Treatment, a Zoom class about how to use the Internal Family Systems model to address medical conditions, I’ve been pondering a lot about the difference between healing and curing, since they so often get conflated when they’re actually quite different.

Learn more about IFS As Medical Treatment and register here.

In my medical training, we rarely used the word “healing.” We might talk about a healing wound or a healing fracture. But to talk about healing a person, healing the wounded heart, or healing the nervous system was considered fluffy “woo” nonsense.

Cure, on the other hand, was the goal. Anything short of cure was seen as a narcissistic injury for doctors, who like to feel in control and prefer to feel like the hero or heroine who saves the day. There was little insight into the difference between healing and curing, and even less emphasis placed on healing, even if it meant cure might not happen.

This all seems wrong-headed to me. As I wrote in Mind Over Medicine, you can be healed without being cured, and you can be cured without being healed. To be cured means to be free of disease or symptoms. To be healed means “to make whole.” When you are healed, wholeness is restored at a level that transcends the body but can also include the body. You can die healed, or you can heal and be cured. Sometimes but not always, when people heal, cure follows.

It’s my opinion that when it comes to the relationship between psychological trauma and medical disease, making this distinction is tantamount. Even though the data is clear that the nervous system dysregulation caused by psychological trauma leads to medical disease, it would be unscientific to claim that treating trauma is guaranteed to cure disease. What trauma experts can claim ethically is that cutting edge trauma treatments, like IFS and also others, heal trauma. And when you heal trauma, you activate memory reconsolidation, taking advantage of neuroplasticity to lay down new neural pathways. This can fundamentally repattern the nervous system and reverse the chronic nervous system dysregulation, which can lead to a cascade of events that may reverse medical symptoms. In other words, if you heal first, you might be cured. But there’s no guarantee. 

There are, however, many anecdotal reports from people who had radical remissions and were cured from “incurable” diseases. When asked what, if anything, these Olympians of healing did to be proactive about winning the gold medals of healing, many claimed to have done deep trauma healing and intensive shadow work, diving into the most painful aspects of their lives and going the distance to heal from all that buried pain.

Over and over, I have heard stories of people with remarkable cures who became very involved in psychological or spiritual self-help work and changed their whole personality, with or without therapy. During the 17 years he rigorously researched radical remissions with before and after medical records, my partner Jeffrey Rediger, MD, MDiv, Harvard medical school professor and author of CURED, heard the same kinds of stories.

These health outliers simply were not the same people after they recovered from their illnesses. Sometimes, without bypassing, ignoring, or sugar-coating the genuine suffering they experienced, they wound up claiming that getting sick was the best thing that ever happened to them. Because their diagnosis propelled them to psychologically and spiritually heal whatever was interfering with their best potential life, they were grateful for the painful nudge towards healing, even though it often meant their lives and relationships had to undergo significant changes.

The lynchpin to understand this concept is rooted in a paradox. Your disease is not your fault. AND…healing is your responsibility. Even if you’ve made life or health choices from the parts of you that might be trying to avoid feeling the emotional pain of your trauma, by eating poorly, smoking, drinking too much, or avoiding doctors, for example, getting sick is still not your fault. But it takes a conscious choice to embark upon a healing journey.

Nobody can make you decide to enter the cave of healing, and nobody else can do it for you. One of the main limitations I observe with our current medical care system- and the way many patients approach it- is that everybody wants a magic bullet, and nobody wants to feel pain. But expecting to be cured without being willing to do the deep dive of healing simply may not lead to optimal outcomes.

Part of the pushback from the conventional medical system against the world of mind-body or trauma-informed medicine is that patients who are already scared and suffering may mistakenly think we’re saying it’s all in their heads or that they’re in some way to blame for their illnesses or early deaths. And it’s true that some people do feel blamed, no matter how many disclaimers we make, when we share the science linking trauma and disease or tell stories about how some patients took ownership of their healing journeys and had radically different outcomes.

As we prepare to teach IFS As Medical Treatment (register here), Frank and I hope you can feel our sincerest compassion as we share what we’ve learned. We honestly aren’t blaming anyone for tragic diseases that cause unmeasurable suffering, and we also genuinely don’t judge people who either can’t afford trauma treatment, aren’t healed enough to let go of parts that sabotage healing, aren’t interested in making big changes in their lives, can’t get away from the abusers in their spheres, or aren’t willing to dive into the deeper levels of psychological and spiritual healing. We get it. It’s hard, and it hurts to face the past and reckon with what has often been decades of pain.

We really do understand why some people might not be up to the challenge of this kind of soul work, which is why we recommend against ever trying to pressure someone you love who might be sick into doing deep personal work they’re not ready to do. It’s fine to gently invite and educate someone about what you’re learning. But it’s not okay to cross someone’s boundaries or meddle in their business, just because your parts are scared they’re going to stay sick or maybe even die. Trauma survivors have often had their agency stripped from them. They need to be reminded of their agency, their autonomy, and as long as they’re not hurting anybody else’s health by doing so, their right to make choices for themselves.

When we get sick, everyone is entitled to their own journey. 

We do not have to obey the doctor’s orders or do what our families might want us to do. We have every right to control our own choices when our bodies are breaking down. We are not beholden to anyone else to work on ourselves or to stay alive or to listen to any of the bits of unsolicited advice boundaryless people might pile upon us, thinking that they’re helping when they’re actually interfering or trying to control someone who is in a very vulnerable state.

But if someone is curious, open, flexible, and willing to consider getting more involved in their own recovery, if they’re willing to face potentially uncomfortable truths that might have been buried in blind spots, if they’re motivated to learn to set firm, clear boundaries, if they’re willing to work on the parts of them that might not be eating, exercising or sleeping well, if they might consider including cutting edge self-help tools or trauma therapies like IFS as part of a comprehensive, trauma-informed medical regimen, it’s possible that your health condition might have a better outcome than if you only did what your doctor ordered you to do.

Even at medical schools and hospitals as prestigious as Harvard, physicians and even many psychiatrists and psychologists do not understand the degree to which trauma takes residence in our bodies and changes the chemical milieu in which our cells operate. If your beautiful, brilliant trillions of cells are spending much of their time marinating in the neurochemistry of chronically secreted stress hormones like cortisol, norepinephrine, and adrenaline, rather than the healing hormones of the ventral vagal parasympathetic nervous system, like oxytocin, endorphins, serotonin, and dopamine, we know on the basis of both good clinical data and laboratory science that they eventually simply wear out and misfire, attacking the magnificent body they were sworn to protect. Instead of fighting off the mutating cell that will eventually become cancer if not detected and destroyed, instead of going to war with an invading pathogen like a bacteria, virus, or fungus, the body’s natural self-healing mechanisms simply begin to break down and may even attack the body with auto-immune destruction. 

But if we know how to apply the principles of IFS to the healing process, using the symptoms and diseases our bodies might suffer from as a portal to healing our trauma, sometimes those symptoms and diseases disappear. Some kinds of trauma that impact physical health are harder to heal, like social determinants of health, health inequity in our medical system, climate crisis, systemic racism, poverty, food deserts, or the impact of narcissistic leaders who are hurtling our species off the ecocidal cliff for their own self-interested profit motives.  But for those who are motivated to do everything within their power to optimize their health, we sincerely hope learning the practices we’ll be teaching you in IFS As Medical Treatment might help. 

Learn more and register here.

We hope to see you there!

Learn more and register here.