Clarifying and Defining Holistic Care
What are good friends for? Well, besides informing me when I have mustard on my beard, they also give me a gentle heads up when I’ve said or written something that may be misleading or taken wrong.
My use of the word “holistic” is one of these times.
Let’s start with the official definition of the word:
Ho·lis·tic (adjective): characterized by the belief that the parts of something are interconnected and can be explained only by reference to the whole.
Usage in medicine: characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of an illness.
There you go. That is the definition of holistic. However, I was made aware that this term may have negative connotations for some. Apparently, it reminds more than a few people of fringe and far-out treatments that are not based in evidence and, in some cases, not even based in common sense. And thus an explanation is in place and well deserved; welcome to the etymological quagmire that is the English language.
When I speak of treating or working with someone from a “holistic” standpoint, I speak to the fact that all things that make us human are interconnected and need to be addressed from that consideration. We are not only physical beings but emotional, relational, mental, and spiritual beings as well and none of these parts operate, for the most part, in isolation. No part of one’s being is an island unto itself, so to speak.
In spite of this truth, modern medicine has become a world of fragmented islands. Here is one example: the other day I had a patient with a swollen and painful wrist. As he had other upper extremity joints that were causing him discomfort, I reached out to an orthopedic surgeon for some advice. My message to this doctor specified the wrist. A few minutes later I received a typically succinct two-word message: “That’s hand.” I interpreted this cryptic message, correctly as it turned out, as this: “The wrist is not my problem, it belongs to a hand specialist.”
The point here is not specialization, which is important and plays a critical role in care. The point rather is that this fragmentation can result in a narrowing of vision, focus, and practice. We as health care providers can fall into this trap of seeing our patients as the heart failure, the pneumonia, or the sepsis without considering all the other important parts that make them who they are.
As I stated in the beginning, there was some concern that a holistic approach carried connotations and undertones of alternative and naturopathic treatments. A simple search revealed to me that the word does sometimes stand in for exactly that, the opposite approach to conventional and mainstream medicine. So, a word on those methods.
Even though I do have concerns about many aspects of alternative and naturopathic medicine, I respect some approaches and feel they have a place. It is only common sense to try and find a more natural approach to treating something before starting a medication or proceeding to surgery. High blood pressure and obesity are two examples of this: both would benefit from the natural approach of changing nutrition and engaging in physical exercise before other measures are pursued. Naturopathic medicine also includes herbal remedies, supplements, and massage, all of which have their place.
Alternative medicine differs slightly from naturopathic, although there is some overlap. Some examples of alternative approaches are practices such as neurofeedback, magnet therapy, Reiki, acupuncture, chelation, guided imagery, and hypnotherapy. Many, if not all of these, have little evidence to support their practice. Most of these treatment approaches are harmless to all but the bank account. Occasionally one may find help through an approach like this, and I do not wish to disparage them entirely. For one thing, to discredit or disprove something, one should be educated and familiar with said practice, at least to a point. With most of these examples, I am not, and thus will comment no further.
I mentioned a holistic approach to high blood pressure and obesity. Here is another example. If we looked at the challenging malady of depression only from the aspect of mental health (or brain chemistry) and ignored the physical or spiritual elements we would be doing our clients a disservice. We would simply prescribe an anti-depressant and see them in a month. Rather a far more effective approach is to evaluate nutrition, sleep cycles, current circumstances, and relationships, not to mention the important aspect of one’s spiritual standing with the Divine. Everything is interconnected and should be viewed from that vantage point. That is what I mean by holistic.
The words Physical, Emotional, Relational, Mental, and Spiritual make up the acronym PERMS, which I use often. Everyone is made up of these five parts, and it is important to view every individual from that perspective, irrespective of what we are trying to treat.
I hope this explanation has been enlightening and will put minds at ease. And I hope the mustard is off my beard.
BF
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Wishing everyone a very happy and blessed Christmas season.
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