When I was healthy, I had the luxury of forgetting that my immune system functioned as a precise, intra-related cellular cascade. Suddenly, at the age of 45, I quickly transformed from a vibrant, high-achieving psychiatrist and ultra-marathoner—running 10 miles during breaks between caring for patients—to a sickly, immunocompromised, and bedridden patient. My illness began when I was engaged in humanitarian work with war victims in Chechnya, where Russian authorities saw aid workers as challenging their Chechen policy and I was poisoned with what I suspect was anthrax.

Through self-directed healthcare that creatively mixed Western and alternative medicine, I became my own health advocate, sleuthing the details of my medical ordeal and paving my own road to recovery. As a result of becoming ill, I also experienced a spiritual awakening, which consisted of an active awareness of transcendent aspects within myself that created a profound interconnectedness with something much larger than myself, be it God or the Cosmos, that was essential to my recovery. Through my spiritual growth, anthrax ironically provided a path, for both myself and my patients, to shift from submission (signified by the need to either acquiesce or rebel) to surrender (signified by being open to and expanded by the subjectivity of the other). In this journey, we become able to uncover our authentic souls.

In 2005, Chechnya was a volatile region marked by armed conflict between Russia and Chechens fighting for independence. Prior to our arrival, Doctors Without Borders abandoned the area, after one of their doctors was kidnapped and killed. Because of concern about retaliation, I will not describe the circumstances of my trip, such as specific names and dates, and the places we visited. Suffice it to say that, because we were in a war-torn area where Russian approval was required, we were constantly “escorted” by a Russian Federal Security Service (FSB) agent. While on my trip there to work with children, I developed flu-like symptoms—fever and muscle soreness. Days later, my symptoms included nausea, vomiting, lethargy, dizziness, diarrhea, and extreme weakness. I was delirious and unable to move out of bed for three days. Immediately after becoming sick, given the severity of my symptoms, I knew that I had been poisoned. The poison had probably been in my food, but at the time I did not know the specific poison. I later learned that many of my symptoms were consistent with acute gastrointestinal (GI) anthrax exposure. At the time, I realized it was not just food poisoning, as out of our group of seven adults and three children—all of whom were eating the same food—I was the only person to fall ill. After my initial symptoms, I subsequently developed chronic inflammation, recurrent pneumonia and GI parasitic infections, arthralgia, autoimmune disorder, and some 20 food allergies.

For five years, I sought help through traditional Western medicine, while my immune system became weaker. It was not until 2010, after biological testing on a Rife machine, that results confirmed that I had been poisoned with a derivative of man-made anthrax. A subsequent combination of treatment on the Rife machineFootnote ¹ and homeopathic and Western treatments strengthened my immune system, putting me on the road to recovery. It is not specifically my intention to recommend alternative care to others, but to acknowledge that I no longer was one of the fortunate who responded solely to Western medicine.

While struggling to understand these physical symptoms, I began to learn the value of “surrender,” a term I frame as a positive alternative to “submission.” Ghent (Reference Ghent1990) understood that surrender has nothing to do with hoisting a white flag. He and I use “surrender” in an Eastern philosophic sense, as an antithesis to submission and masochism and in contrast to the traditional English definition of the word. Rather than carrying a connotation of defeat, surrender enables the liberation and expansion of the self by lowering one's defensive barriers. In successful surrender, acceptance occurs, and one transcends the condition that evoked the surrender. Rather than being a loss, surrender is joyous in spirit, fulfilling what Winnicott (Reference Winnicott1954) describes as the yearning to give up the false self in order to find fulfillment. Submission, by contrast, is a defensive mutant of surrender, a giving up of agency by either seeking approval or rebelling against another's wishes.

While those with chronic illness will have different manifestations than my own, key to our recoveries is learning the lesson of surrender, which involves the discovery of one's wholeness and unity with other living beings, and letting go of submission, which involves the feeling of being a puppet. In my own case, anthrax both laid me low and humanized me, stripping me of the ability to use athletics as a way to feel invincible and prevent others from getting close. No longer able to exhaust my body through physical exercise, I found that spiritual parts of myself that had been closed off were gradually aroused. Anthrax was the nuclear bomb that shattered my defensive and false sense as warrior king. My assumed invincibility was stripped away by becoming ill, and I began to embrace the beauty of my vulnerabilities. This recognition catalyzed my shift into a higher spiritual state of enhanced love, with a previously unknown sense of limitlessness.

With certain patients, somehow, our therapeutic dyad also shifted as a result of my transformation. Our interactions moved away from dealing with concrete issues to engaging with more meaning in their lives. As I saw the numinous in my patients' struggles, our work delved more into healing their fragmented souls. These patients, after my epiphany, became more able to surrender to the psychotherapeutic process. Their surrendering was not to me, but was a further opening of their unconscious to meet my unconscious, which created an expansion of new heights of faith and inspiration. Their surrendering allowed them to no longer submit to their false sense of self and be reborn into a richness of new outcomes and possibilities.

An example is the transformation of Ben, who was controlling and demanding, feeling enraged and abandoned if I glanced away from him or went on vacation. His anxiety was overwhelming, in part because he felt unable to process his emotions until our next session. He placed me and others in rigid representations of authority figures, which were modeled after his relationship with his mother, to keep himself from surrendering to embrace me as a person with feelings and thoughts that were separate from his own. In therapy, Ben only made room for his own feelings, which is exactly what his mother had done to him as a child. In our relationship, Ben put himself in the role of his mother, with there being only room for her emotionally, and tried to make me little Ben, who was not allowed any feelings.

As my own transformation occurred, our relationship shifted from a hostile dependency to a working therapeutic alliance. Around this time, Ben commented that I seemed “more serene,” and he began to no longer see me as the fearsome creature that had to be swallowed up. He slowly let me in, without fearing being obliterated or needing to engulf me. Now feeling buoyed by a greater power, Ben and I were able to talk about his desperate need to be in control, rather than enacting it. He began to take agency over his life, interestingly, by surrendering to feeling “held” in our relationship. Ben discovered joy in being a grandparent and more fully developed his significant artistic talents with less of the paralyzing fear of needing to be perfect. He transitioned from submitting to living in the limited reality of his mind and mother's world to finding his heart and discovering the ways in which he had been starving his soul.

Perhaps, in a parallel process between Ben and myself, as I shifted to being more in my heart and less in my head, Ben also became more able to surrender to the psychotherapeutic process. As I submitted less to feeling responsible for Ben's emotional paralysis, I was able to move him into surrendering, to have more faith in his ability to change. Previously, Ben had been like a rebellious teenager, not knowing how to get authentically involved. But by our becoming less enmeshed, he could now empathize with me as a separate object, which allowed for cocreating “the third space” between us. As I learned how to play with being vulnerable, we more deeply engaged with metaphor to embrace the context of his greater wholeness, without self-judgment. While I had previously felt engulfed by Ben, I experienced this third, newly cocreated space within the therapeutic dyad as a source of inspiration for both of us.

My struggle with anthrax gave me a glimpse of the divine, a connection to something greater than myself. This spiritual epiphany allowed me to experience deeper meaning in my own life, a lesson that engendered a parallel process with some of my patients, so they too could move from submission to surrender.