Health & Spirituality

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Health, both mental and physical, has both a moral and a social dimension that is often underplayed in modern health care systems and policy. Integrative and holistic approaches to (mental) health need to take into account both the social, economic and political aspects of health and health care, and related ethical questions — do we address health problems collectively or not, which problems do we consider 'health' problems or not, who gets what kind of help, how do we organise and finance health care equitably etc. as well as its subjective dimensions, how do we experience sickness and health, how do we deal with these things, what resources do individuals have to deal with health, what do health and sickness 'mean' etc.

Engaging with these questions in any depth will eventually expose some very serious flaws in the way we deal with (mental) health, both at the individual level and collectively. I am not arguing that healthcare or medicines are ineffective or that they are organised badly: in some instances this is certainly valid. Rather, certain problems arise from treating (health) as a scientific or medical problem, rather than considering it from the perspective of 'well-being' and treating the wellbeing of individuals, society and environment as overlapping, mutually dependent domains.

Holistic and integrative approaches to health yield an understanding that takes into account both the domain of the subjective, the individuals beliefs, values, expectations and experiences, and social, political, economic and environmental conditions. Within such a broader conception of health, the problems of individuals are problems of society and the problems of society are problems of individuals. In some instances, this conception will not yield useful solutions, in others, it will provide powerful incentives and solutions. For example, a broken leg does not necessarily require a society wide change, although as work safety laws suggest, some sorts of accidents that affect individuals are best tackled collectively. On the other hand, the spread of viral infections such as the bubonic plague could not be halted until we collectively identified the source of contagion and began to alter the way we build cities and how we drain them and get rid of our garbage.

The key to successful implementation of integrative and holistic understandings of health is therefore to grasp how the health and well-being of individuals connects them to their surroundings. Since health and wellbeing are not just conditions we are subject to, but conditions in which we participate, and in which our perceptions and behaviour play a significant role, holistic solutions to health must also address the subjective dimensions of human behaviour and take into account how these implicate us in outcomes we refer to as health, well-being or illness.

The subject we have broached above is far too extensive to discuss in full on this page, save to say that the mapping out of the vast number of relations that add to our understanding of "health" is both the domain of medical-anthropology which seeks to understand how different people's conceive of health and what strategies they employ to deal with "illness" or "disease" (which my editor Casey William Hardison always reminds me also refers to the notion of "dis-ease" i.e. discomfort). It also belongs to the domain of Critical Discourse Analysis since, as Korzybski suggests, so much of what we define health or illness, sanity or insanity, treatment, medicine, etc. is in some manner determined by language and the meanings and values encoded within it.

Take for instance the case of "drug addiction" which has gone through several stages of redefinition as it has gone from being literally a "moral perversion", to a "mental health" problem and hence to a "brain disease" and now, most recently, to a social phenomenon reflecting the quality or our relationships to each other and the society we live in.

How is it possible that our understanding of such a phenomenon has undergone such dramatic changes? How is it possible that there are so many different ways of understanding "drug use"? What to one might be a medicine, may be a magical substance to another. In Entheogens, Society & Law, Casey William Hardison and I catalogued not merely one or two different beliefs about psychoactive substances but hundreds. CDA proposes that to understand these differences we need to ask questions like — who says what, why, when, under which conditions, what it their 'interest', what are their beliefs and aims, etc etc.

Integrative and holistic understandings of health need to account for differences in our understanding of health, well-being, sanity and possible 'remedies' or strategies for dealing with these things as well as taking into account the subjective behaviours and experiences of individuals and external conditions.

It is in this sense that questions of health and wellbeing are also continuous with beliefs and ideal about the type of society we are, or should be choosing. By investing in health as a 'personal choice' as we do in a privatised health care system (what has been referred to as a 'privatisation of suffering' system) the health and wellbeing of individuals becomes a product of the economic system, something to be bought and sold, an investment, a source of profit, and under these conditions, individuals may suffer ill-health as a consequence of the way health is concieved, understood, and treated, and others may suffer ill-health due to not having enough money to pay for expensive treatments. In other words, the choice for this or that health care system is itself a potential outcome of the way we perceive and understand health. It will yield very different diagnoses, different methods or treatment, and different outcomes than say the choice for a health care service that is collectively financed and free at the point of delivery (e.g. the UKs NHS).

Holistic and integrative approaches to health, through formulating health and its treatment as broadly as possible, offer many possibilities that are unavailable when health is approached and treated as a condition of individuals. Moreover, these approaches significantly broaden the question of health by exploring its subjective sources and including these in possible treatment or prevention strategies. Consider, for example, how someone whose work is boring and repetitive might develop depressive symptoms, receive psychopharmacological medication to 'relieve' those symptoms and develop a physical condition instead. How are we to understand the latter condition? Is it a completely new condition, unrelated to the individual's work? Is it collateral damage, an outcome of the psychopharmacological medication? Or is there some ethical imperative, not only to acknowledge the working conditions of this individual as the de facto cause of their illness, or to acknowledge a systemic problem, namely the injustice and stupidity of forcing people to work meaningless repetitive jobs that make them sick?

I hope to hear more on the subjects raised above during our conference.

— Daniel Waterman, Mar. 2018.

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