I see a patient in the office for follow up. She has been seen at the last visit by a partner and has been treated for a mixture of stress incontinence with urge incontinence. Stress incontinence is leakage with coughing and urge incontinence is leakage occurring when the patient is unable to hold with an overwhelming urge to go. She has been treated with a medication that which affects the muscle tone at the neck of the bladder. She is here for reassessment to see whether or not there is any improvement. She says to me right off the bat that she did not take the medicine. She tells me that she read on the internet that one of her three medicines for hypertension, the hydrochlorothiazide might itself cause these symptoms, so she stopped it. When she stopped it, her symptoms of leaking when she coughed, and the symptoms of leaking when she had the strong urge to urinate, both had completely stopped. She, therefore, never started the medication she was given. Her blood pressure that day in the office is excellent at 130/70.

We begin to discuss her blood pressure and her other problems. During the conversation I point out to her that we could use a black box analogy to describe how the body works. What happens in the black box is that energy is taken in transported, utilized and the energy used to drive an adaptive response to a signal given to the black box. She is told every adaptive response in nature or in a man-made machine is driven in exactly the same way. She is told that the emotional input determines which adaptive response that is driven. She is told that, if she selects the emotional input that is designed for the adaptive response to a bear stalking her, when she finds that she is responding to a neighbor spilling oil on her lawn, she will create a mismatch. This will result in an excess of fuel (blood sugar), transport (blood pressure, heart rate) and re-storage of the excess fuel (sugar to fat from cortisol). If this happens frequently the system will adapt to these conditions by keeping the blood pressure high. I tell her this adaptive response is a choice and she can choose to respond differently. At this point she show me a typed list from her therapist, who has her on Effexor, which also lists that she needs to change her response to how she sees things.

She says to me she can’t because her fear is well founded as her husband tried to kill her. She thinks it is reasonable to fear that he will try again. I point out to her that the choices in any moment come from the moment itself, and have nothing to do with another moment, past or future, unless that moment is itself brought into it. Each moment, I tell her has the potential to be different experiences, based on the perspective that you choose and the way you see it affecting you.

She still finds this a difficult concept to accept. I say to her let me show you what I mean. I use my stethoscope as a pendulum by balancint it on her finger, and touch her lightly with a Bic ballpoint pen  intending for the stethoscope pendulum to move (see intent and intent II) in a particular pattern and it does. I ask her to intend for it to cease moving and demonstrate for her the ability she has to affect the outcome of any experience with intent. I ask her also to introduce doubt, which affects her ability to affect the outcome then I ask her to relaease it, initially difficult but she is able to again changing her effect on outcome.

She breaks down crying and says that she understands. She asks me, how did I know that she would come today?  And how did I know that I would need to tell her that? I point out that it is always as it should be.

She turns around to leave and as she is leaving I say see you then to which she replies probably not, as she does not now  think she will need to return for anything as she is now able to see things differently.

Insight: When persons are able to see the true relationship that exists with everything else, they are then able to see how they could create their results and their reality.