Transcript HEALTH PROMOTION or HEALTH POLICE... WHAT REALLY HELPS?

Healing Healthcare
“Holistic”
Healthcare
Organic Universe
(nature as living, spiritual, dynamic)
Holistic Science
(whole > sum of it’s parts)
Bio/Psycho/Social/Spiritual Model
“WEB OF LIFE”
HEALTH DEFINED
 Absence of disease
 Absence of biomedical risk factors
 Presence of desired set of behaviors
HEALTH DEFINED
 World Health Organization
“ Health is a state of complete
physical, mental and social
well-being.”
OPTIMAL HEALTH??
“ Complete well-being is a fantasy…
health (whatever else it might be)
is something that happens not so
much in the absence of illness
as in its presence.”
David Morris, Illness and Culture in the Postmodern Age
REDEFINING HEALTH
“Health can be redefined as the
manner in which we live well
despite our inescapable illnesses,
disablilities and trauma.”
David Morris
HOLISTIC HEALTHCARE
 Focus = HEALTH
Main objective is to address the web
of genetic, social, emotional, spiritual
and physical factors that contribute
to health
HOLISTIC HEALTHCARE
 Emphasis: SUPORTIVE FACTORS
Meaning in life, relationships & work
and supportive human systems are
considered to be the primary
determinants of health
SUPPORTIVE FACTORS for
HEALTH & HEALING
 purpose in life
 spiritual connections
 social support
 work satisfaction
 emotional health
 optimism / hopefulness
 perceived happiness
 perceived health
 altruism
 intellectual stimulation
 restful sleep
 time alone
 pleasure and play
 financial resources
 laughter / humor
 movement
 normal eating
 contact with nature
“Much illness is a conflict in values
sailing under a physiological flag.”
Rudolph Virchow father of modern pathology
HOLISTIC HEALTHCARE
 Motivation: JOY & PURPOSE
Reason for change is primarily to
enhance a sense of purpose and
enjoyment of life
A SPIRITUAL CALLING
“Every crisis a person has over the
age of 30 is a spiritual crisis.
Spiritual crisis requires
spiritual cures.”
Carl Gustav Jung
A SPIRITUAL CALLING
“The new medicine, like the oldest healing
that humans have known, recognizes that
illness is a teacher on each of our spiritual
journeys, as well as a physical misfortune
and psychological challenge. It insists, as did
the tribal shamans who were our first healers,
that the work, the ‘profession’ of those who
‘provide’ healthcare, is itself a spiritual path.”
James Gordon, Manifesto for A New Medicine
DISEASE
Physical aspects of sickness
Tangible, measurable, treatable events
ILLNESS
Personal experience of sickness
Intangible, invisible, immeasurable
DISEASE vs. ILLNESS
“ Two people with identical diagnoses
share only the physical disorder; the way
they experience that disorder is absolutely
unique to each. They’ll find different
meanings in their sickness, feel different
emotions, respond with different
behaviors.”
Jeff Kane, How To Heal
DISEASE vs. ILLNESS
“Illness, includes, then, the sick person’s
fear, anxiety, depression, anger,
isolation, despair…in other words,
his suffering.
Jeff Kane, How To Heal
DISEASE vs. ILLNESS
“When we’re sick,
we suffer not from our disease,
but from our illness —
what the disease means to us.”
Jeff Kane, How To Heal
SUFFERING
 Is a permanent property of humanity
 Can’t be fixed
 Is exquisitely individual
 Isn’t necessarily entirely tragic
 Is painful to experience
Jeff Kane, How To Heal
HOLISTIC HEALTHCARE
 Assumption: HUMAN NATURE
People have a nature desire
and ability to seek health
(internal wisdom)
HOLISTIC HEALTHCARE
 Assumption: HUMAN NATURE
People are currently doing the
best they can given their
particular circumstances
HOLISTIC HEALTHCARE
 Professional Role: ALLY
Primary job is to facilitate people’s
reconnection with their own internal
wisdom about their body and their
health
HOLISTIC HEALTHCARE
 Change Process: CONSCIOUSNESS
People are assisted in understanding
and healing life issues that underlie
illness and behavioral struggles
ADVERSE CHILDHOOD
EXPERIENCES (ACE) STUDY
 Almost 10,000 adults in an HMO
 7 categories of childhood trauma
 Health risk behaviors & disease
Felitti, Am J Prev Med 1998;14(4):245-258
CAUSES vs. SYMPTOMS
 28% of women reported sexual abuse
 16% of men reported sexual abuse
 25.6% lived with substance abuser
 10.8% reported physical abuse
Felitti, Am J Prev Med 1998;14(4):245-258
CAUSES vs. SYMPTOMS
 50% reported at least one category
 25% reported at least two categories
 6% reported at least 4 categories
Felitti, Am J Prev Med 1998;14(4):245-258
Disease,
Disability
&
Social Problems
Health-Risk Behaviors
Social, Emotional, Cognitive Impairment
Adverse Childhood Experiences
Felitti, Am J Prev Med 1998;14(4):256
Behavioral Coping
Smoking, Drinking, Drugs, Overeating,
Overworking, Sedentary Lifestyle
Suffering
Anxiety, Anger, Fear,
Depression, Hopelessness
Root Causes of Behavior
Poverty, Abuse, Violence, Isolation
Healing Healthcare
A Spiritual Calling
A SPIRITUAL CALLING
 AVOID
 Fixing
FIXING
“Frequently, our reactiveness to suffering
takes the form of having instantly to do
something, do anything. It’s the “we gotta”
syndrome: “We gotta” fix this up right
away…It’s tricky, because this impulse
may arise from genuine empathy, but the
form of action is compulsive.”
Ram Dass, How Can I Help?
A SPIRITUAL CALLING
 AVOID
- Fixing
- Reductionism
“MEDICAL TERRORISM”
“ The important point is that worrying too
much about anything--be it calories,
salt, cancer or cholesterol--is bad for
you, and that living optimistically, with
pleasure, zest and commitment is good.
Medical terrorism shouldn’t attack life’s
pleasures.”
Ornstein & Sobel, Healthy Pleasures
A SPIRITUAL CALLING
 AVOID
- Fixing
- Reductionism
- Blame and Shame
HEALTH & GUILT
“ In nature, the occurrence of disease
is considered a part of the natural
order, not a sign of ethical, moral, or
spiritual weakness.”
Dossey, Healing Words, p.17
BLAME & SHAME
personal focus
hopelessness
failure
helplessness
shame
?
decreased self-esteem
A SPIRITUAL CALLING
 AVOID
- Fixing
- Reductionism
- Blame and Shame
- Judgment
NONJUDGMENT
“ When we have for so long been
judged by everyone we meet, just to
look into the eyes of another who does
not judge can be extraordinarily
healing.”
Dr. Jack Kornfield, A Path With Heart
A SPIRITUAL CALLING
 INSTEAD
- Listen
LISTENING
“ Now we can begin, perhaps for the first time, to
hear them. Less busy pushing away suffering,
less frenzied having to do something about it,
we’re able to get a sense of what they’re feeling,
of what they feel they need. We may be startled
to discover that what they’ve been asking for all
along is entirely different from what we’ve been
so busy offering”
Ram Dass, How Can I Help?
LISTENING
“Begin by ignoring her disease and
concentrating instead on her illness. Listen
well, and she’ll enter her suffering, explore
it, know it, and unfold it for you. Listen even
more deeply and she’ll comprehend her
story and act accordingly.”
Jeff Kane, How To Heal
A SPIRITUAL CALLING
 INSTEAD
- Listen
- Acknowledge & Validate
Support & Encourage
WHAT REALLY HELPS?
What We Do
or
Who We Are
WHAT REALLY HELPS?
“ We can, of course, help through all
that we do. But at the deepest level
we help through who we are..”
Ram Dass, How Can I Help? `
“Health care in the final analysis,
is not about results...
Health care is about being with people in
their finitude and doubt, in their pain and
uncertainty, respecting each one and saying
that one cares, and showing by one’s deeds
that one really does care in all the ways that
one can. Such caring does mean acting in a
way that promotes the best results possible.
But the results, ultimately, are really
Someone Else’s business.”
Daniel Sulmasy, The Healers Calling
“Healing is a process, not a goal.
It’s all voyage and no destination.
Your task is only to be present to the sick
person. The moment you begin contemplating
the encounter’s outcome--whether he’ll attain
serenity or not--whether you’ll succeed or fail-your no longer with him but wandering in
your own mind, oriented toward the future
rather than the present. All you can ever do is
your best; what is to be is out of your hands.”
Jeff Kane, How To Heal
A SPIRITUAL CALLING
 INSTEAD
- Listen
- Acknowledge & Validate
- Support & Encourage
- Be Aware of Our Own Issues
WHAT REALLY HELPS?
“We work on ourselves, then, in
order to help others. And we help
others as a vehicle for working on
ourselves.”
Ram Dass, How Can I Help? `
A SPIRITUAL CALLING
“ Placing service in a spiritual perspective in
no way diminishes what we have to offer
through training, experience, individuality,
special skills, or sense of humor. Quite the
reverse. Our particular talents and unique
qualities are likely to come forth more
reliably when we have a richer and more
spacious sense of who we are.”
Ram Dass