I’m a doctor. I used to be a “family doctor”, a “GP”. Now it’s harder to explain what kind of doctor I am. I work at the Centre for Integrative Care, Glasgow Homeopathic Hospital. We see patients of all ages, either sex, and with any diagnosis whatsoever. That much is similar to my previous work as a GP. However, as a “secondary care” service, we only see people with chronic problems, not acute ones. But that’s not the real difference between being a GP, and being an “integrative” doctor.
Why did I choose the word “integrative” there, and not “holistic”? Because I think good General Practice is holistic. That’s not what really makes our service different. It’s the “integrative” bit.
What’s “integrative”? Simply stated I’d say it’s the intention to aid the integration of what’s become disintegrated in a patient’s life, and/or the intention to release a person from stuckness, or rigidity. Those are the two common patterns of ill health – chaos and rigidity.
So, my question to myself, is how do I know I’m on the right path? How do I know that I’m achieving what I’m intending to achieve? If I was primarily concerned with disease, with what can be objectively seen and measured, with pathology, then I’d know I was achieving what I was intending to achieve pretty simply. I’d compare the measurements. For example, if I was intending to lower someone’s blood pressure, then I’d measure their blood pressure. The trouble is that what I’m intending to achieve is better health. Disease is an objective, measurable phenomenon. Health, on the other hand, is subjective. It’s an experience. It is lived by a person. It can’t be directly measured. But I must have some way of assessing someone’s health, mustn’t I?
Here are four ways to think about health.
ONE. (in one word) HARMONY.
Health is a state of harmony. As complex organisms, our multiple cells, organs and systems all need to be in harmony with each other for our condition to be a healthy one. We need to be “in tune”. In fact, we need to have not only inner harmony, but harmony between ourselves and both the networks of relationships and the environmental contexts to which we belong, or in which we are embedded. This is both a new concept, and an old one. As we better understand the extended and embedded natures of the mind, and the irreducible nature of whole, which is greater than the sum of the parts, complexity science and chaos theory are amongst our newest scientific tools. But an ancient way of understanding health was based on the concept of the four humours, which not only had to be in balance within the person, but could only be in balance, if the person was in harmony with the cosmos (their network of relationships, and the environmental contexts to which they belonged). It’s a nice concept. I like it. It’s musical. It’s intuitive. We know when we are in harmony, and we know when we are experiencing disharmony. The concept of health as harmony, places the subject at the heart of health care. Only the person themselves can tell their state of harmony.
TWO. (in two words) VITALITY and RESILIENCE.
Everyone understands the concept of vitality. It’s energy. It’s well-being. It can be measured using a visual analogue scale. Draw a line, with “0″ at one end, and “100″ at the other. Zero is a the lowest vitality, and one hundred is the greatest. Now place a cross on the line where you are today. Self-rate your vitality. I find people can do this instantly. It’s holistic and intuitive. You don’t have to measure your blood pressure, or your blood sugar, or anything else. You are the judge. Only you can say what your current level of vitality is. The greater your vitality, the greater your resilience. When your vitality is low, you catch everything that’s going, and you probably take longer to get over it. A healthy condition, comprising good vitality, results in better defences, and faster recovery. I like this concept. The concept of health as vitality and resilience, places the subject at the heart of health care. Only the person themselves can tell their state of vitality.
THREE. (in three words) ADAPT. CREATE. ENGAGE
Complex adaptive systems, a biological description of all life forms, can detect changes and respond to them positively. They can adapt. They can cope. But they don’t just maintain some balance, or status quo. They grow, mature and develop. This is creativity. Creativity isn’t just the capacity to be expressive, of the practice of an art. It’s the capacity to evolve, to solve problems in new ways, to self-actualise (in the words of Jung). Thirdly, healthy complex adaptive systems are embedded in their contexts, environments, and networks. They are engaged. When unwell, the world shrinks. It becomes the size of a house, a room, or just a bed. Illness can bring isolation – from friends and family. Health, on the other hand, involves a full engagement of the individual with others. As someone becomes healthier, their world expands. I like this concept. The concept of health as ACE – Adaptability, Creativity and Engagement, places the subject at the heart of health care, but introduces some objective elements too. Behaviours can be observed. Levels of engagement can be seen by others.
FOUR. (in four words) I, We, It, Its.
This needs a little explanation. This is a concept of health built on the framework of integral theory. Have a look here if you don’t know what that’s about. Orthodox biomedicine, tends to only consider one of the four quadrants – the objective one of lesions, “surrogate measures” of health, descriptions of behaviours compared to culturally determined norms. At a Public Health level, it also considers, the quadrant of “its” – the shared, or plural, objective – the ecology, environment, social situation and so on. Mind-body medicine considers both the singular subjective of a person’s mind, and the singular objective of the person’s body. Sometimes, it also considers the shared, or plural, subjective – the “we” of health, the shared values, beliefs etc (especially in the triad of mind, body, spirit). But an integrative, and integral, concept of health considers the person from all four perspectives – all combinations of subjective, objective, individual and shared. I like this concept. The concept of health with an integral framework considers the person, their body, their shared existence, their place in society and in the world.
So, how about you? Do you find any of these four ways of thinking about health helpful? Do prefer any of them over the others? Or do you have yet another way to think about health?
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