Treating the Whole Person

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Somewhere in the search to understand the biology, chemistry, mechanics, physics and mathematics of the universe, Western medicine became too focused on "the body" as a singular, machine-like object.  In the fight for dominion over disease, and perhaps caused in part by the growing divide between religion and science, conventional Western medicine elevated the measurable, physical aspects of a person over those harder to measure, unseen aspects such as mind—beliefs, emotions, intentions and unconscious influences—and soul, the aspect of ourselves that is transcendent.  Further, Western medicine came to treat people as isolated entities, when in fact people exist within a matrix of family, friends, jobs, homes, neighborhoods, geographical areas, and psychological and cultural environments, all of which can influence health and disease.

Integrative medicine seeks to embrace a more comprehensive view of healing and to see and care for individuals in their completeness. This approach has been informed by medical systems from many other cultures.  For example, the ancient Greeks practiced both sacred and scientific medicine in a dynamic partnership. "The original therapists were priests, physicians and psychotherapists in one," explains Ed Tick, PhD, an expert on Asklepian healing. Tibetan Medicine—which is more than 4,000 years old—embraces and utilizes the key Buddhist spiritual principles of altruism and compassion, karma and ethics in the quest for health and wellness. And anthroposophical medicine promotes a human-centered approach to health and illness, one that treats the patient as an integrated individual being of body, soul, and spirit, instead of simply treating the disease or symptom in isolation.

Since the 1970s, due in part to increasing dissatisfaction with the American health care system, interest in an integrative approach to medicine has been growing.  In 1977, psychiatrist George Engel, MD, published an article in Science in which he proposed the "biopsychosocial model of medicine."  This theory is now considered one of the founding principles of the modern field of integrative care. (1)

Engel's biopsychosocial model treats biological, psychological and social issues as systems of the body, similar to the traditional medical systems such as the respiratory and cardiovascular systems. These systems, Engel said, were interlinked.  His model also draws a distinction between the actual pathological processes that cause disease and the patient's perception of his or her health, called the illness.

As more and more research demonstrates that integrative care results in improved health outcomes, it has become a core value for practitioners.  "We conceptualize symptoms and manifestations of illness within the context of the person's physiology, diet, activity level, sleep, hygiene, stress levels, support system, and internal beliefs," explains Daniel Monti, MD, Director of the Jefferson-Myrna Brind Center for Integrative Medicine at Thomas Jefferson University. "Our intake forms provide cues for the doctor to ask about these different domains and to consider as many of them as possible when customizing the treatment plan. The goal is to provide a thoughtful, comprehensive healing approach that considers the whole person—body, mind and spirit."

An excellent example of the effectiveness of this type of care comes from Benjamin Kligler, MD, of the Continuum Center for Health and Healing at Beth Israel Medical Center in New York City.  In the Curriculum in Integrative Medicine, he notes that, "One concept that informs the integrative approach to problems of respiration, regardless of the specific disease, is the notion from East Asian medicine that the lungs are the seat of the emotion of grief. Thus the integrative approach to many pulmonary disorders incorporates an examination of unresolved grief in the patient's life and the possible impact of that on their health."

"One of the many studies from the Western literature that reflects this convergence of thinking is the work by Smyth et al on using writing as a therapy for asthma and rheumatoid arthritis," explains Kligler.  "In this study, patients with one or the other of these conditions were asked to write for an hour on three successive days about their most painful past experience. Controls wrote about a non-traumatic memory or life event. Treatment and control groups were similar in all important respects. The authors found that the treatment group had a reduction in medication use and symptom scores that lasted through the six-month follow-up period." (2)

As Joshua Freeman, MD, so eloquently states the case in the British Journal of General Practice, "We are not doctors for particular diseases or particular organs or particular stages in the life cycle—we are doctors for people." (3)

 

References
1. Engel, George L. The need for a new medical model, Science 196:129-136, 1977. PMID 847460.

2. Kligler B. Lecture Notes: Integrative Approach to Asthma, Curriculum in Integrative Medicine: A Guide for Medical Educators, Consortium of Academic Health Centers for Integrative Medicine, 2004.

3. Freeman J. Toward a Definition of Holism, British Journal of General Practice, February 2005