HOLISTIC CARE - THE P.E.R.M.S. ACRONYM

To kickstart this section I would like to give just a short summary on what I am trying to accomplish here. 

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I feel that nurses are given a fairly well rounded education on the holistic approach to medicine in general. That is, we are trained to see someone with illness not only as an organism that needs fixing but as a human being who needs love, understanding, and an empathetic ear. The nursing model is often called a “care” model as opposed to a “cure” model. I feel this has produced in me a desire to know and see a person as a whole being with every part interconnected and reliant on the others. We are physical beings. Yes, but we are also mental, emotional and spiritual beings as well. Not to mention relational: our lives are built on and around relationships. 

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In my own practice and work in the mental health field I have adopted an acronym, not entirely original with me, called PERMS. The P in PERMS stands for physical, the E for emotional, the R for relational, M for mental and the S for spiritual. This acronym can provide a framework for better understanding our illness, for example, in relation to all of our parts. I often use it in supplying a client with a care or treatment plan. Each part is considered from its own perspective, whether it’s a child exhibiting disruptive and aggressive behaviors in school or an adult suffering from emotional or mental distress. Let’s use anxiety as an example: Someone suffering from anxiety, which could be both a mental and an emotional malady, experiences physical symptoms as a result. Anxiety can also produce relationship difficulties and we may avoid certain situations due to our angst. To say then that our anxiety could also produce a spiritual problem is not out of the question. 

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All this to say that I want to see, consider, and understand health and wellness from not only a physical or mental perspective, but a relational and spiritual one as well. Whether we like it or not, we are the sum of all these parts and seldom can we, or should we, separate them when considering our overall health. They depend on each other. They affect each other. Sometimes in ways we don’t expect and in ways we had not thought of. 

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PERMS outline example:

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• P – Physical: This includes anything from obtaining lab work and reviewing dietary practices to how well a person is sleeping.

• E – Emotional – This part addresses how well a person is managing and expressing their emotions and feelings. It takes a deeper look at factors that influence emotions. Coping mechanisms, self-soothing behaviors, and psychological reactions are all a part of emotional make-up.

• R – Relational – Here we dive into the dynamics of a person’s relationships: how well does they initiate, maintain, and sustain friendships, connection, and intimacy. We become curious and reflect on any relational barriers or difficulties.

• M – Mental – The mental is difficult to separate from the emotional and they often go hand in hand. In short, the mental part of our brains have more to do with clear thinking and decision making. Schizophrenia and bipolar disorders are examples of mental illness. Depression and anxiety can be both a mental and an emotional illness.

• S – Spiritual – At our core we are spiritual beings and this must be considered seriously in any malady or illness we face. We must take an honest look at the place and position God plays in our lives. Forgiveness, acceptance, and surrender are major parts of this facet of our beings.