hank you for publishing the obituary for my mentor and friend Dr. Simonton. Let me take this opportunity to rectify some common misconceptions about his work. Since Dr Simonton first published the results of his work there were four randomized clinical trials (David Spiegel, Fawzy Fawzy, Thomas Kuchler and Barbara Andersen) showing improved survival for cancer patients receiving appropriate psychotherapy in conjunction with conventional cancer treatment. Frequently his contribution to medicine is identified with a corrupted form of simplistic understanding of visualization or mental imagery. As a matter of fact I don't ever remember him using the word "visualization" since we first met in 1990. For Dr Simonton imagery was a natural process occurring in our minds all the time. His most frequent example of imagery was asking the audience "what did you have for breakfast?" He emphasized that we are all experts at using our imagery in our own way. Try to sit for a few seconds and not to imagine anything - impossible (unless you are a master of particular meditative practices with dozens of years of daily multihour experience). Carl considered the content and quality of these continues cognitions to be the key for health. He developed a very sophisticated approach to shift these thoughts in a healthy direction and refined imagery exercises that were individualized to the particular style, symbolism and needs of a person. His patients are becoming experts at using their continuous natural imagery in healthy ways that promote getting well. Furthermore, the Simonton Program as it is taught in USA, Japan, Poland, Germany, Italy and Holland is a very comprehensive approach and goes far beyond use of imagery. Dr. Simonton was the first one to introduce cognitive-behavior therapy (cbt) to psychosocial oncology (with the help of Dr Maxie C. Maultsby) and now cbt is a standard part of the of treatment in psycho-oncology. The Simonton Program systematically addresses multiple issues that cancer patients and their families deal with like fatigue and low energy, relationships and communication problems, recognizing patterns of stress and secondary gains, resolving spiritual and personally philosophical challenges, as well as integrating life with death and maintaining healthy hope in all stages of treatment. The Program employs multiple therapeutic modalities including individual, group and family therapies, behavioral (relaxation, balancing a healthy lifestyle with exercise, nutrition and play), cognitive (cbt and education), mindfulness, resolving guilt and resentment, improving compliance with cancer treatments by developing healthier beliefs about them and seeing them as friends and allies. This is the only psychosocial oncology program in continuous operation since 1971. Dr Simonton kept at advancing and refining his approach to the last day of his life so, let's not limit it just to imagery and peg it into old cliches. I hope you will receive this not as a criticism but as a contribution to fact finding and deepening the understanding of this complex man and his complex work. With best regards, Mariusz Wirga, M.D.

Posted by: Mariusz    July 10, 2009