От ПАФОСА к ЭМПАТИИ: антропология изменений" (Является ли мировоззрение человека фатальным? Как феномен "сожительства с болезнью" в медицинской антропологии позволяет нам пересматривать природу персональности: болезнь как идеология; идеология как болезнь):





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Maxim Miransky


“From P’ATHOS to EMP’ATHEIA: anthropology of change”


October 14th, 2011.



In memory of Mrs. Elena G. Bonner (15.02.1923, Turkmenistan - 18.06.2011, Boston, US), for making me believe
One may or even must free oneself,
In spite everything around to the contrary.

“Unstable condition,
A symptom of life,
Of mental and environmental change.
Atmospheric disturbance,
The feverish flux
Of human interface and interchange.

The impulse is pure;
Sometimes our circuits get shorted
By external interference.
Signals get crossed
And the balance distorted
By internal incoherence.

A tired mind, become a shape shifter,
Everybody need a mood lifter,
Everybody need reverse polarity.
Everybody got mixed feelings
About the function and the form.
Everybody got to deviate from the norm.

An ounce of perception,
A pound of obscure.
Process information at half speed.
Pause, rewind, replay,
Warm memory chip,
Random sample, hold the one you need.

Leave out the fiction,
The fact is, this friction
Will only be won by persistence.
Leave out conditions,
Courageous convictions
Will drag the dream into existence.

A tired mind, become a shape shifter,
Everybody need a soft filter,
Everybody need reverse polarity.
Everybody got mixed feelings
About the function and the form.
Everybody got to elevate from the norm...”

Neil Peart,
Canadian poet, composer and musician,

”And in a time that's closer, life will be even bolder then.
Souls will be complicated, life will be consummated then.
Hearts will be brought together soon in our minds forever then.
As long as we see there's only us, who can change it -
Only us to rearrange it at the start of a new kind of day.
And in a time that's closer, life will be even bolder then.
Love is the only answer - hate is the root of cancer then.
Thoughts will be thought together, soon in our minds forever then.

Love is the only answer - hate is the root of cancer then.
Truth is just for the being and there's the sight for seeing then.
Thoughts will be brought together soon in our minds forever then.
As long as we see there's only us, who can change it -
Only us to rearrange it at the start of a new kind of day.
And in a time that's closer, life will be even bolder then.
Love is the only answer - hate is the root of cancer then.
Thoughts will be thought together, soon in our minds forever then”.

Jon Anderson,
British composer, singer, musician and poet,
1970.back to top
The content

  1. P’ATHOS: medical anthropology of cohabitation with illness.
  2. Typology of medical and socio-psychological matrixes: illness as ideology; ideology as illness.
  3. There is no such thing as norm? Role of substance and role of symbolical substitutes.    
  4. Does system nature of personality make its forming fatal? Nature of personality: personality as ultra-complex constellation of factors.
  5. Is there some X Factor? Anthropology of change (EMP’ATHEIA).














From p’athos to emp’atheia: anthropology of change.   

Is world outlook fatal: how medical anthropology of cohabitation with illness may alter our view on nature of personality?        

1. P’ATHOS: medical anthropology of cohabitation with illness.

Chief Inspector of Scotland Yard Mr. James Harold Jap – as surely any devotee of immortal Agatha Christie remembers – had a theory (if any), according to which if Mr. Hercule Poirot was involved in any case, there must be a murder, even though in the beginning everything told otherwise. For he believed Mr. Poirot, in a way, attracted murderers – metaphysically in order to defeat them.
Could he be kind of Jesuitical instrument of providential punishment? Hardly so, since there were cases when victims were hardly better than criminals and there were cases, albeit very special, when Mr. Poirot, just like Mr. Sherlock Holmes before him, decided to let murderers go, without letting police know. So it was mostly about restoring some ontological balance of justice rather than about legist formalities (no matter how important) or lex talionis (no matter how ancient). And justice presupposed conscience of course, rooted deeply in his personality. (In Christianity, let me remind, only personality may be saved, not groups or states!)
Being one of the greatest Goodness Knights world literature has ever invented, he was also extremely, even painfully sensitive personality, which allowed him to see that every detail matters here on Earth (as hologram of the whole, so world itself talks and prompts to Poirot), and a man of unprecedented inner strength, camouflaged under outer subtlety. That inner strength so valued by ancient Greeks who named it differently from time to time, speaking about their heroes, and one of famous names was P’ATHOS.         
Greeks invented the conception of P’ATHOS – still key one in modern anthropology – in a very special way and characteristically so. Its deep ambivalence was clearly seen right from the beginning. Its very origin was that of duality. Emotional health and illness (suffering) coexisted and still coexist in its content. But, as language as well as philosophy tells us, duality and dualism is not the same thing.
What’s dual in ontology (duality as normal feature, which you may find anywhere in biology, in philosophy etc.) becomes dualistic in epistemology (in which duality is conceptualized). For example, what’s normally dual yet intertwined in human behavior (body and psyche), in the history of psychology led to the famous and famously misleading Cartesian dualism, overcome only by 1970s! The same we see in the destiny of P’ATHOS. For Greeks and in Greek P’ATHOS means and is “suffering” but at the same time just “emotion”/ feeling (see Onions, [657]). Of course, the latter term is broader and includes the former. But if we remember that, in a way, all feelings mean suffering or at least overcoming, we understand that there is no dualism between 2 concepts. We can even go further if we remember that in pedagogy (so important for Greeks!) upbringing and education are always twofold: with one world being one to be interiorized (when we accept/react to the outer world, world of parents, world of society) and the other being one to be exteriorized (when we try to change/overcome the outer world or describe it in our not others’ terms). So overcoming is absolutely natural, part of the process of socialization.    
Once we remember this, we see it all in P’ATHOS. P’ATHOS tells us not only that to feel is to suffer but moreover: that to suffer is not necessarily to lose and to go wrong but rather and even primarily to learn, to know and to overcome, and to persist. Hence we still have P’ATHOS as suffering (hence pathology and all medical terms of this kind: neuropathy, homeopathy, psychopath, morpho-pathology –in all European or Europe-influenced languages) and P’ATHOS as feeling (as in modern English we have such words as pathos, pathetic, pathetical, patience, of course all of them Greek by origin). English language also has saved for the word “pathos” such meanings as “sensitivity” and “something which makes you sad or merciful”. Pathematic means just “emotional” (it is also the second meaning of the word pathological – sic!). “Patient” is too from this etymological nest, and below during talk about iatrogenic therapy we will see how important it is. 
For Aristotle P’ATHOS, along with ETHOS and LOGOS, was a mode of persuasion in his “Rhetoric”. And it was equally significant. Moreover, whereas ETHOS was a result and feature of moral identity and LOGOS of intellectual identity, P’ATHOS was a result and feature of self-identity. Below we will see that in postulating this Aristotle foresaw the ultramodern theory of pathology, according to which namely self-identity, if overstressed or misled, may become destructive to one’s health. For me the very sequence inside the triad is something most interesting, too: it is no use to go down to arguments themselves without first having persuaded the audience that you’re to be trusted and that you’re emotionally close to them. That’s how elegantly Aristotle showed that emotions are so worthy not only because they make us human but because of quite rational reasons, too. But does it narrow the art of persuasion as much as only imaginable?
Or is it just realistic?
According to recent researches, human reasoning, far from being solely rational and truth seeking driven, is based on mental models, probabilities assessments, memory, knowledge of contexts, emotionality and desire to win rather than on strictest formal rules as such, however universal and intact the latter logically are.
Vide: “Mental models and human reasoning”, by Philip N. Johnson-Laird, PNAS, October 26, 2010, vol. 107, number 43, pp. 18243-18250.
And I am talking not only about the famous Mercier – Sperber so-called argumentative theory, according to which conceptualizing powers not searching for truth were and are drivers for progress. Like many allegedly universal theories, it simplifies reality (proudly). Thirst for truth does push us onward but truth is neither given in its pure form (out of history and personality) nor therefore fully attainable. So Sperber and Mercier use a sledgehammer to crack a nut. Vide: “Reason seen more as weapon than path to truth: people argue just to win, scholars assert”, by Patricia Cohen, New York Times, June 14, 2011. 
Aristotle also anticipated the idea of empathy by inventing the conception of catharsis. For him even friendship was a state of shared positive and negative emotions. Theater was a model of such communications, model of “feelings refinement”, as in 18th century they would say.
Apathy means losing both emotionality and health, for health always needs emotionality to maintain and feed itself, so low emotionality (apathy) is as dangerous for health as over-emotionality. Indeed, in modern psychiatry and surely in all organic medicine, too, apathy accompanies number of pathologies (so sorry for my pun!).          
In Greek music too the relations between ETHOS and P’ATHOS was rather functional, for music, which is abstract enough to contain both sources, was viewed as medium for improving one’s character. ETHOS was not only message but primarily behavior music inspires one to, and P’ATHOS (quality of emotions) was judged by practical behavior/training. Practicing ETHOS meant cultivating habits/abilities of emotional control and self-possession. Measure, sense of measure (between Dionysian and Apollonian modes) was highest pedagogical ideal. And music indeed was a part of public pedagogy.
The duality of PATHOS was a duality of Dionysius cult and Dionysius music. Haunted by emotions and desires, one is only partly free and so eventually he/she will have to pay a price, be it excess or even death, thus destroying the very force – vitality – one once chose to rely upon. Remember Solon’s “nothing in excess”.
On the other hand, as epicureans told stoics while criticizing the latter, to over-control emotions is no less dangerous, for through emotions, namely through letting them freely go sometimes we are likely to grasp our own primary nature. Moreover: such attempts to leave one’s frontiers for a while are of key importance for any personal development.     
The very fact that in modern music P’ATHOS gets much greater role than and at the cost of ETHOS is not that bad as it seems, for is it not true that to understand and even accept others’ emotions is to be human, ethical? Hardly would Greeks invent the concept of P’ATHOS, albeit in unity with LOGOS and ETHOS, had they not put so much faith in personality and its freedom, freedom so often expressed namely in the uniqueness of individual P’ATHOS. For Greeks, let us remember, any mortal being was a bearer of Divine spirit.    
For one thing, laws of dialectics are still in force, so to overstress ETHOS in music is to put it at risk, for too easily it will degrade into sort of moralist music, in which stilted content absorbs the grandeur/beauty of style. Too often we saw it in the history of music, especially in totalitarian states. Reversely, stylistics provoke emotions, and, being perhaps the quickest way of learning and recognizing others’ feelings (EMPATHY), music of P’ATHOS helps us deviate a bit from our self-control, self-identification, helps us open ourselves not only to ourselves but also to His/Her Majesty The Other.
However, for Plato in his “The Republic” to build a character (ETHOS) was par excellence to learn how to resist emotions that is P’ATHOS. Both Plato and Aristotle believed music directly affected/produced/trained emotions so must be controlled in its forms/pitches/motives. Plato was just more pro-state in his advises. However, this key element of resistance/persistence, as we have seen above, was included into the meaning of P’ATHOS, too, and from the very beginning. But since Greek youngsters were supposed to learn how to resist emotions, P’ATHOS might be seen as power to be re-directed to itself!    
Vide idem: Gertsman E. “Modern perception of ancient Greek and Byzantine music”, in ORBIS MUSICAE, 10, 1990-1991; Герцман Евгений «Античное музыкальное мышление» [Antic musical thinking; in Russian], Ленинград, 1986; он же «Языческие и христианские музыкальные древности» [Pagan and Christian musical antiquities; in Russian], СПб., Лебёдушка, 2006, стр. 15-334, 440-598; он же «Тайны истории древней музыки» [Mysteries of ancient music history; in Russian], СПб., Невская нота, 2004.
And it takes us directly to perhaps the most mysterious derivates of P’ATHOS, namely to the grand triad of sympathy, antipathy and empathy… For Greeks if people have the similar P’ATHOS (= the way they feel the world), there must be some sympathy between them. If they have different P’ATHOS, antagonism may appear between them, i.e. antipathy. But the third variant is much more interesting, being integrative. If one tries to feel what others feel, tries to understand them and place oneself in their boots, empathy comes into existence (the conception still central both for modern psychotherapy and psycho-diagnostics of mental states and types, which differ by the level of empathy, amongst other criteria). Antipathy and sympathy are static, being just acknowledgments of facts. Empathy is dynamic, being a driving yet changing-reality force.    
The one of divisions which runs between West and East concerns namely P’ATHOS, the way we feel and express it, the way we understand it. But I wonder whether such black-and-white dichotomy of sensualist East and rationalist West might be sufficient to explain everything?  
Sensualistic doctrines flourished in the West in no lesser extent than they did in the East (take only epicureans and British philosophical traditions as examples), and rationalism, this psychologically understandable intention to put human instincts and emotions under some control, came to the East no rarer than it did to the West (take only legists and early Confucians as examples, let alone Muslim Aristotelians of early KALAM and Muslim rationalists MUT’AZILITES).
But of course certain trends exist and continue existing. All I am trying to say is it goes much deeper than to the differences between mentalities, no matter how influential they were and are in behavior building. Human race faced the dilemma of dualistic – monistic ways of understanding or feeling the world at our humans’ very dawn. As history of philosophy (even up to now in Western civilization Aristotle, with all his moralistic views I outlined, embodies monism whereas Plato dualism), religion (magic was much more monist than abstract cults) and medicine (empiricism – spiritualism controversy) shows, we have here one of the most ancient and most rooted problems of trust and control. Both freedom of P’ATHOS and control of P’ATHOS may lead to excesses. But not to trust P’ATHOS is to challenge ontology at its deepest level, since primarily instinctive, sensual, emotional and intuitive ways of dealing with macro- or microcosm are either evolutionally or ontogenetically the oldest. Ratio came much later, and as early as freewill creatures appeared, it was and is ever since used as medium to control and suppress emotions.             
Yet this scenario, as we have already seen referring to the concept of EMPATHY, is neither justified nor necessary at all. EMPATHY’S monism is evident. Not only does EMPATHY let us avoid egocentrism, and does so not by sacrificing emotions before the altar of rationalism but by widening one’s reality to all potential others whose Selves one needs to accept. Rational aspect is one learns how to communicate, how to understand others in the most profound way possible. What’s more EMPATHY widens one’s reality by shifting one’s self-identification. One needs Other/others to be self-identified. One really needs to make one step backward in order to make then 2 steps forward.
Obvious philosophical and cultural parallel is Buddha’s teachings, according to which one is not fully free, healthy and happy unless one is also free from one’s desires and wishes, let alone obsessions or manias. Do YOU wish something, or is it your wish which rules over you? To be is to be as a subject of being, not as sum of dependencies to slave you by eating your Self away. Dependencies lead to permanent disappointments, which lead to permanent frustration, which is a mother of number of pathologies. So P’ATHOS may be either balanced (healthy) or imbalanced (pathological), depending on one’s measure as well as method of self-identification…    
Rationalism, distrusting the frightening world of emotions, is at pains to impose as strict self-control as only possible. Truth, however, is only open self-control works.
Since at least the classical period (5-4 BC) Greeks understood that any illness is a union of corporeal dimension and the way one lives. The latter was especially stressed, being part of education and self-education (self-development, self-improvement). Asclepius (Roman Aesculapius) was an Apollo’s son, but he was born after much suffering (Caesarian operation was in fact made by his father-god himself). The very art of medicine (healing) was taught to him by centaur Chiron. One of Asclepius’ daughters –of central role –was Hygieia (which meant just health); hence the modern word (term) hygienic. Her Roman equivalent was Saluta (salus means health in Latin); hence the modern words “salubrious”, “salubrity”, “salutary”, “salute”, “salutation” and even “salvation” through Latin SALVE (see Onions, [784-785]). And even more: -SALW was shown as proto-Indo-European root, common for at least 11 languages, modern and ancient, ones that are alive and ones dead. See the reference from the academic database (of Russian linguist Professor Sergei A. Starostin).
And what about “to san” that is “to heal”? SAN- too was shown as proto-Indo-European root, albeit with narrower geography. So interesting is the fact its meaning embraces both “healthy” and “happy”.
Besides gods mentioned, though, many gods were seen as responsible for various aspects of health.    
Asclepius cult dates back to 7 BC. The role of water hygienic procedures was especially stressed in Greek temple medicine. Water was considered “the best helper of gods”. Empirical and magical methods were coexisting and even mixing. Syncretism of ancient (not classical) Greek thought therefore medicine was, in a way, a precursor of holism of modern synergetic science. Homeopathy, from my point of view, is more efficient in saving this spirit of Greek thought. We will return to it later.
The School of Koss (since 6th BC) was first to deny rather vividly the metaphysical causes for illnesses, insisting instead on physical ones. But from holistic point of view it had ambivalent consequences. In 19th century it was progressive step to acknowledge that mental disorders could be explained biologically and psychologically rather than theologically, which immediately led to a far more humanistic psychiatry than it was before (Pinel, Charcot, others). Exorcism, ships of fools and metal cages had been replaced by introspection and mesmerism. But by fully throwing away immaterial causes, New Age medicine became enchanted by another extreme, no less devastating than natural philosophy – by positivism. Paradox is its pompous and pretentious expectations gave little whereas taking much away: intuitivism flourished till microbiology made medicine real science only by the middle of 20th century, and in several countries psychiatry was ruthlessly used as an ideological weapon up to the fall of communism. Now thanks to system psychophysiology we know that physical and mental causes do not exclude one another in scientific medicine –rather the opposite is the case! And of course medical ethics as well as methodology were undermined: the more elementary etiologies physicians discovered and tried to reduce any disorder to, the less important organism as a whole seemed to be. The golden maxima of the necessity “to heal who is ill not illness” was almost forgotten. Yet both homeopathic and allopathic school shared it as principium sacrum. Or claimed they did…                     
Hippocrates too was from the School of Koss, and characteristically he was allopath, but the difference between him and positivist of 19th century is great, for by the 18th century science lost its ancient syncretic impulse (to regain it only by 1950s).
Greeks were amongst first to discover diagnostics and prognostics, traumatology and desmurgia, the healing force of mineral water, the phenomenon of psychological suggestion, the diet, the pulse, the brain as organ of thinking and the corpse dissection methodology, to name but few.  
The conception of 4 temperaments and their being caused by 4 liquids’ proportions was a precursor of psycho-types and neuro-endocrinology.    
Through Crete, the Mycenae civilization and directly Greeks receipted the vast medical systems of ancient India and Egypt, albeit in a reduced volume.
Yet resulting vectors were not that impressing at all. Neither Hippocrates’ humoral approach (5-4 BC) nor Erasistrates’ discrete approach (4-3 BC), nor Galen’s dualism (2-3 AD) was progressive, for all foretold reductionism. The whole Mesopotamian medicine (Sumerian – early Babylonian civilizations) seems to be dualistic (mystical and empirical explanations were parallel realities for Sumerians, and even later preferences of metaphysical meta-paradigms were hardly models for any serious unification). Then Babylonian and Assyrian syncretism came only to complicate things. Egypt offered an economy of thinking. And for the very first time it was in Egypt when medicine started differentiating by illnesses/objects of treating.
Vide: Sorokina T.S. “A History of Medicine”/ “Istoriya meditsiny”, in Russian language, Moscow, Academia, 2008, 8th edition, pp. 38-183, idem: bibliography in English language [including Nutton V., Medicine in the Greek World, 800-500 BC, in: Western Medical Tradition, 800 BC to 1800 AD, Cambridge, Cambridge University Press, 1995; Withington E. Th., Medical history from the earliest times, L., 1964]; for the content in English see pages 7-9. 
Generally speaking, since the very dawn of medicine and, perhaps surprisingly but it is not so surprising as it seems to be, even up to now 2 major trends have been clashing in medical science when it comes to understanding the nature of pathology. One approach holds it so that any pathology, however primitive, organic and linearly caused it might be, is indirectly or directly caused by psyche, be it just unhealthy way of life one leads, which, in turn, goes back to some unhealthy way one sees life, or be it direct trauma one’s psyche has got. Another point of view was and is psychology sometimes matters, yes, but psyche is no more than an epiphenomenon of complex biology human brain contains, therefore it is simply to be cut off by Ockham’s razor and all pathologies, being basically organic, have to be cured organically. As a result, they say, psyche too will be returned to normalcy.
Characteristically, other dualistic debates – some no less ancient than those just mentioned – are resonating with them accordingly. I mean policausal theory as well as nervism, stressor (adaptation), biosocial, nosological (etiological) and psychoanalytic theories to adjoin the first approach; monocausal, as well as cellular and syndromatic theories to adjoin the second one.
From the point of view of anthropology, the most interesting thing is these debates are still buoyant (only take holists – reductionists and allopaths – homeopaths debates as examples) in spite of the fact system psychophysiology resolved the problem outlined by 1970s, and not in favor of one of points of view but in favor of their integration. About what are they still so vividly debating? Great inertia and conservatism of traditional allopathic medicine, insufficient attention of homeopaths to microbiological mechanisms of pathologies, as well as insufficient reception of system psychophysiology by both schools matter but these facts do not explain everything. System psychophysiology integrated body and psyche to such an extent many suspect (rightly) that it cancelled the psychophysical problem at all by showing one cannot have purely psychic and purely somatic phenomena separately, whatever the level of integration. Sure, system psychophysiology does not deal with scholastic questions like “does a cell have soul” (any cell has some autonomy, so autonomy may be seen as precursor of regulatory system, nervous including) but equally it does not consider goal of behavioral act (which it showed as a main psychophysical integrating factor) as direct cellular production. Why? Because of system laws, one of which holds that the whole cannot be reduced to the sum of its elements and their functions, and another that any higher level of integration produces new qualities of integration without leaving lower levels intact or dissolved. Take cell again. Whatever the level of its autonomy/structural complexity, it is involved into so many and so complex interactions, it becomes a hologram for the whole organism to mobilize and change, if needs be. So cell cannot become something new without changing all its systems first. We do not consist of amoebas or laboratory neurons. So psychic phenomena like goal, planning, love or consciousness, despite realized only on material substances like cell, tissue or organ, cannot be their by-products. And this is simply because there is no cell, tissue or organ to develop in a linear, isolated and subject-preserving way. In other words: subject of change develops only when it stops being only itself, when it looses its self-identification, if anything. Below we will see just how important it is for understanding the nature of health…
So there is no such thing as material cause and psychic sequence discretely or, reversely, psychic cause and material sequence discretely: so intertwined and interwoven they are. But it does not cancel the problem of personal responsibility. Indeed one gets a cold not because demons haunt her/him but because after bathing she/he just came out when it was wet and windy. Yet in no way it explains WHY she/he did it. That’s how P’ATHOS again comes into picture, for hardly everyone would make such a mistake. Misbehavior is trigger, not biochemical mechanisms themselves. So economy of thinking, with all its progressive potential, is kind of crypto-dualism.                       
Medieval medicine inherited almost all controversies ancient medicine produced and left unresolved. Then it added its own ones. Moreover, not every achievement was mechanically carried into new era. Take hygienic practices, for one. On Crete the sanitary system of water communications was invented in the end of the 3rd millennium BC! In the 8th century BC Assyrians invented the water-providing system of underground and above-ground hydro-technical channels, which not only inspired Romans to build aqueducts 300 years later but also survived… to our very days (sic!)! I find it especially interesting that in comparison with Middle Ages civilizations earlier civilizations had much higher standards regarding hygienic and sanitary culture/practices (compare ancient and medieval Egypt, ancient Mesopotamia and medieval Baghdad Caliphate, ancient Rome and medieval proto-Italian kingdoms – with all corrections concerning Muslim hygienic requirements been taken into account). Only dualism, with its (ontologically deeply naïve) division of the world into higher/sacral one (cultural) and lower/sinful one (physiological) might produce such prolonged effect…    
Yet in no way it was single. Iatro-mechanics of Lamettrie and iatro-chemistry of Paracelsus were representing rather painfully the famous elemental – humoral controversy in medicine, which dated back to antiquity and simultaneously anticipated, albeit only partly, reductionism – systemology controversy of 20th century (accordingly). 
Humanism, however, was slowly gaining its ground…             
If to feel is to suffer, and to suffer is to learn and to know, then the first object to which learning [interpretation or misinterpretation] may be applied is suffering itself that is illness. From 18th century onwards it is called iatrogenic (doctor-caused) illness. Also the modern conception of patient-hood is used, which embraces psychology of patient as well as repertoire of doctor’s influences/attitudes. I deem it useful to distinguish between classical iatrogenic pathologies and positive outcome of doctor-patient relationships. Iatrogenic phenomena in negative sense (sort of psychogenic phenomena in negative sense like Freudian transfer) mean that either doctor’s behavior/attitudes undermine patient’s recovery or patient’s own interpretation of doctor’s attitudes/behavior does so. Taken in positive sense (for example, when it comes to placebo or the factor of trust and faith), iatrogenic phenomena mean that either doctor’s behavior/attitudes facilitate patient’s recovery or patient’s own interpretation of doctor’s attitudes/behavior does so, or, furthermore, patient’s own activity does. The latter includes the very specific strategy of some patients who try hard not only to help doctor do her/his job, by forming positive attitudes and by sticking to all recommendations doctor gives, but also to study medicine to learn more about their illness – and not in a way hypochondriacs do but in a profound and self-reforming way. They may even change the very model of doctor-patient relationships from traditional subject-object to subject-subject one, given doctor is smart, open and responsive. In full variant they do become doctors for themselves, thus realizing an ancient wisdom - or, rather, 2 wisdoms, Biblical one (about healers who must heal themselves first) and Sufi one (about murid, pupil, who must become murad, teacher for himself/herself, true sheikh).