There is a heightened interest in integrative care – the blending of complementary/ alternative medicine (CAM) with conventional medical practice. On the one hand this is motivated by patients’ demands for services that complement conventional medical care, and on the other hand by health care providers’ awareness of economic opportunities and to a lesser extent by their awareness of the benefits of complementary therapies.
Wholistic approaches consider the person who has the illness rather than upon the illness the person has. Wholistic approaches empower patients to participate in their own health care. They enhance the integrity and the spirit of dignity in the healing encounter between careseekers and caregivers – who are increasingly under pressures of time and monetary constraints that are eroding their roles as caregivers. Complementary therapies introduce philosophies and methods of health care that promote whole-person care and acknowledge the place and needs of the caregiver in this process.
CAM introduces five broad themes
1. CAM therapies are potent interventions that can enhance health and help to treat many illnesses that conventional medicine has limited means to treat. Illnesses that can be helped include allergies; arthritis; asthma; heart disease; backaches, headaches, and other pains; irritable bowel syndromes; menopausal problems, urinary tract dysfunctions; neurological disorders (including post- traumatic brain disorders, such as cerebral palsy and strokes); cancers; AIDS; chronic fatigue syndrome; and many more.
Members of the public are rapidly learning the benefits of complementary therapies and are voting for them with their dollars in a big way. Several surveys have shown that just about as many dollars are paid (out of pocket) for complementary therapies as are paid (mostly out of insurance) for conventional medical care.
2. Wholistic and CAM therapies offer ways to humanize medical care.
a. Patients are dehumanized by conventional medical care. People are choosing complementary therapists because they feel that doctors focus too much on their diseases and too little on themselves as people. CAM therapists spend 30-120 minutes per session with their clients, compared to 10 minutes for visits to family doctors. Conventional medicine focuses on your symptom and disease management of your medical or surgical problems, while CAM therapies focus on you as the person who has the problems.
b. Health care professionals are dehumanized by conventional medical care. Medical and nursing students very frequently complain that their professional studies discourage and squelch their idealism and sensitivity to feelings in themselves and in their patients. Excuses are given by medical educators that the enormous load of information that must be studied in medical and nursing school leaves no time for “inessentials” such as discussions of stresses and feelings. Nursing and medical students are expected to ignore their own feelings about patients, such as anxieties about caring adequately for their patients, dealing with patients’ grief, and dealing with stresses of caring for dying patients.
The same applies to doctors and nurses after graduation. The pressures of heavy workloads and clinical responsibilities are taken as excuses for not budgeting time for self-care. This is certainly a major reason why medicine as a profession has one of the highest rates of burnout, depression, alcohol and drug abuse, and suicide.
Wholistic healing emphasizes self-care of the cargiver as a preventiion to such problems. Self-care that includes wholistic integrative care introduces health care practitioners experientially to these approaches.
3. Wholistic, integrative care empowers you to assume greater responsibility for your self-care. Wholistic care – addressing people rather than diseases, caring rather than curing, using all possible therapeutic modalities rather than a limited few, and empowering careseekers wherever possible to use self-care approaches and to be active participants in decisions regarding their health.
The very word ‘patient’ suggests a passive person who patiently waits for treatment. Bernie Siegel proposes that we use the word respant, designating people with problems as responsible participants in their own care.
4. Wholistic integrative care awakens and nurtures intuitive and spiritual awarenesses.The western medical model is mechanistic and assumes that physical causes will eventually be identified for all illnesses, just as they have been with infectious diseases, hormonal, and genetic disorders. It is a linear, either-or model.
Wholistic and integrative approaches are both-and models. While they acknowledge the contributions of conventional western medicine, they also include contributions of emotions, mind, relationships (with people and the environment), and spirit as vital factors in health and illness. Wholistic care introduces concepts and practices that include the body-mind and person-spirit aspects of health and illness.
The importance of intuitive and spiritual awarenesses extend far beyond the therapeutic encounters of individuals. These awarenesses are vitally needed to address the ills of society and of Gaia, our planet.
5. The philosophies of wholistic integrative care enrich the lives of health carergivers and respants. Wholistic care includes the cultural traditions and philosophies that accompany the complementary therapies. In many cases these suggest lifestyle changes – such as diet, meditation, yoga, and the like – that you may find pleasant and helpful.
Guiding philosophy for Wholistic Integrative Care
Terminology informs, guides, and shapes the actions of therapists and public. Particular attention to terminology will be given to clarifying new ways of conceptualizing and approaching health care.
Integrative Care: Allopathic Medicine combining with CAM Therapies.
Allopathic Medicine: Conventional, Western medical care as provided in the average hospital, medical clinic, and private doctors’ offices.
Complementary Therapies: Term for therapies such as acupuncture, chiropractic, homeopathy, massage, osteopathy, yoga and many more approaches. I prefer this term over the more frequently used Alternative Therapies. Complementary promotes collaboration of colleagues using allopathic and complementary therapy approaches, working as equals for the benefit of people needing help. This term is the essence of a both/ and approach to health care.
Alternative Therapies: Term most commonly used for what we are calling Complementary Therapies. Alternative suggests that people have to choose between types of therapies on an either/ or basis. I feel this term is divisive and promotes competition rather than collaboration. The term is also used to denote methodologies transferred from the various complementary therapies and applied for symptom management within allopathic medical frameworks.
Complementary/ Alternative Medicine (CAM): Synonym for Complementary and Alternative Therapies.
Wholistic Healing Approaches and Therapies: Approaches that seek to bring people to a state of wholeness in body, emotions, mind, relationships (with other people and the environment), and spirit. The “w” is inserted to distinguish these approaches from another usage for holistic therapy — the application of methodologies taken out of context from their rich philosophical and cultural frameworks and applied piecemeal as techniques for symptom management, without acknowledging or applying the guiding theories and philosophies that properly should accompany them.
Body-mind Therapies: Approaches that assume that the mind, emotions, and body are an integral unit in health and illness.
Spirit: That part in each of us that is known (and can only be known) intuitively, with an inner knowing that is immanent and transcends logic, that connects with the vast worlds of material nature and of noetic (beyond words), transpersonal/ Divine realities. The spiritual is invariably distorted when it is translated into words.
Soul: Term used by some to indicate an enduring aspect of life that survives physical death and incorporates the lessons the spirit learned into an enduring consciousness. (Others may reverse the meanings of spirit and soul as defined here.)
Bodyspirit Therapies: Approaches which assume that the soul and spirit incarnate for lessons in the school of physical life, and that illnesses, emotional difficulties, and relational challenges are such lessons.
– Addressing the person rather than merely treating her or his problems
– Including body, emotions, mind, relationships, and spirit
– Dis-ease is addressed along with disease
– Health awareness and prevention of illness
– Caring and curing are emphasized equally
– The person who is the therapist is as important as the therapeutic modality used
– The recipients of care are full participants in their own care and treatment
Wholistic medicine addresses the whole person – body, emotions, mind, relationships (with other people and with the environment), and spirit, assuming that each component may need attention individually but that each is intimately related with all of the others. Emotional or relational problems may bring about stress reactions in the body. Physical conditions may influence psychological states and alter relationships. Spiritual upliftment may make difficult emotional and physical problems more tolerable. We tacitly acknowledge this in our language, as the origins of the word heal are in the Germanic and Old English roots of haelen, “to make whole.”
Wholistic care is much more a set of attitudes and ways of being than a set of methodologies. Those carers who have adopted wholistic approaches usually find that their lives are substantially enriched and their ways of coping with stress are markedly enhanced. However, this approach may not appeal to every health care professional.
© Daniel J. Benor, M.D. 2012
Reprinted with permission of the author, P.O. Box 502 Medford, NJ 08055