Healthy Interactions

Today's posting is focused on our interactions with others and how they lead or don't lead to health, wellness and wholeness (HW2). Think back to the last time that you interacted with another human. Was the interaction positive (i.e., did it give life) or was it negative or neutral? Where were your head and heart as you had that interaction? Were you fully present to the person, or were you already on to the next thing that you needed to say or to do?

Our body language gives at least 50% to our verbal interactions; in fact, there are some who suggest that body language determines the outcome of the interaction before the first word is spoken. People can tell when you're not fully with them - consider your last interaction, was the person there for you? Now consider your last interaction with a health care professional (physician, PA, NP, pharmacist, whoever). Did that person really listen to what you had to say? Did they appear hurried, distracted, frustrated - or did they nod, lean forward, engage in reflective listening? It makes a difference to how you feel and to whether you are going to "buy in" to what is being said, doesn't it?!

Our healthcare systems model our other human systems. Everything appears to be on overload at this point. It is only a matter of time until a "Gulf Oil Spill" occurs in our lives and our systems. Something will break deep down inside of them or us, and there won't be the people and technology around to cap off the leak that ensues. Also, there won't be an understanding of how to "fix" the leak, as there won't be an understanding of us, or a true understanding of how the system is supposed to work. Why not? The answer is because we don't "know" the systems as we don't know ourselves. How can we get to a different place...prevention of the leak comes through reflectively listening and unconditional love and acceptance - creation of true community.

We need to hear the brokenness in each of us that contributes to the brokenness of the systems. In order to do this, we must encounter a loving presence that will allow us to get in touch with that in each of us that needs healing. We need to heal our individual selves in order to see what needs healing between us and around us. Loving our neighbors as ourselves can only happen after we first experience unconditional love and acceptance. Only this will lead to healing and healthy interactions.

Peace and an end to all wars, just and unjust.

Dan

Individualism and its Impact on Health, Wellness and Wholeness

Today's posting has to do with rampant individualism and the impact that those ego-based decisions have on health, wellness and wholeness (HW2). Americans pride themselves on many things (in fact, it is our pride that gets in the way of doing much of what both the Constitution and Religion suggest we should be doing). Historically, "rugged individualism" (ala John Wayne) of the frontier life meant you created what you needed or you did without. That worldview continues in modern days as an unhealthy dose of egotism that states boldly that healthcare is a right, and I'm entitled to as much of it as the country can afford to pay.
Note that I wrote, "that the country can afford to pay", because this is where our "rugged individualism" plays out, isn't it. Our forefathers and mothers made do or did without, we borrow way past our credit limits and then file bankruptcy and ask for forgiveness. We live without limits, eating and frolicking to our hearts content (or discontent in this case) and then expect our technology-laden healthcare system to save us - only so we can go back and do it all over again.
My life in the intensive care units (ICUs) of many hospitals over 20+ years can attest to this philosophy. It is enabled by a healthcare training process which teaches all health professionals to do "everything possible" to "save lives". So, even though someone has abused themselves for decades, and presents to the ICU in all manner of distress, the ICU team dutifully puts them back together (better than "all the King's horses and all the King's men") fully knowing that they will be back. I've often quipped that the doors on both Emergency Departments and on ICUs should be revolving, and that we should give out frequent visitor points ("be readmitted within 30 days and receive half off your next bill!").
In order to have HW2, we need a new worldview - one that is less ego driven. All the Abrahamic faiths believe in a redeeming God and in a God that forgives us our human frailties. However, that redemption and forgiveness need to be humbly asked for (truly repentant). Our current worldview in the U.S. does not allow for this. We are so thoroughly taken with ourselves and our superiority over the rest of the world, that it shouldn't surprise anyone that we are disliked by most of the world. Recovering some sense of humility and that "God is God and we're not", will require a lot of interior work (read as prayer and discernment). Our houses (read bodies and healthcare systems) can be fixed, but first we have to admit that there's a problem. Possibilities Journey, Inc., (www.possjrny.org) is focused on this problem and on returning faith communities to the discussion about, and transformation of, ourselves and our behaviors so that we can reach HW2.

Peace,
Dan

Health Discernment

Today's posting has to do with the process of health discernment. Discernment is a centuries old process of listening for God's desire for us. Merriam-Webster's Dictionary defines it this way, "the quality of being able to grasp and comprehend what is obscure". Synonyms include discrimination, perception, penetration, insight and acumen. Certainly, these synonyms add depth to the term discernment, but I really want to spend my time with you today focusing on the process of discerning.

We are bombarded by health information - specifically, information intended to "fix" what we have allowed to become broken in our health. Websites advertise the newest weight loss ideas, "new age" programs, 12-steps, herbals and nutraceuticals, etc., all aimed at undoing what we have done to ourselves. Certainly, many adults (and now children) have gotten away from healthy habits such as diets that are life giving, and getting enough exercise. A few posts ago, I posited this as a loss of the idea that our main stewardship focus is caring for our bodies the way God intends, rather than in the way that feeds our consumeristic and egotistic culture.

So, how do we discern what God might be saying to us? It is hard to hear God with all the noise of the world. Maybe that's why Moses had to go to the top of a mountain, or Elijah to a cave. In both instances, God's voice came in the silence of the place - not in the middle of an over crowded market. Thus, we must remove ourselves from the noise and distractions of the world in order to put ourselves in a position to hear what God has to say.

Even though we find our way into a less distracted place and frame of mind, God does not always show up right away. The first few things that always pop into my mind are usually ego driven, trying to get the answer and get out. Patience and persistence will allow these voices to disappear, and allow me the space to encounter the "nudge". I never actually hear a voice - but I often get a nagging thought that just won't go away. This thought tends to be filled with a sense of purpose and rightness (agency and blessing). I've found by following these leads, I'm able to move forward in peace.

Ask God what God wants you to do about your health choices. Maybe it is to change your diet, maybe it is to get more sleep or a better quality of sleep, maybe it is to find a less stressful job or living situation, only God knows what is best for you. So ask, just ask. Spend time quietly discerning what is best for your health, wellness and wholeness. You can find a spiritual director in your area at Spiritual Directors International (www.sdiworld.org) to aid you in your discernment. I've had one for more than 3 years, and she's been terrific in helping me experience God in the everyday. Find a spiritual or faith community in your area that promotes wholeness of body, mind and spirit. Engage us in a discussion of how we can aid your search (www.possjrny.org). As the Nike advertisement says, "Just Do It!" Health discernment can transform your life.

Peace,
Dan

Apatheia - A way to Heal

Today's posting has to do with the ability to let things go - like water off a duck's back. Our ability to ignore that which is not important (a popular writer wrote a book entitled, "Don't Sweat the Small Stuff: And it's all Small Stuff") frees us to be in community with one another. Without the ability to ignore the common infractions towards each other, we escalate the violence inherent in each of us to the point of "road rage" and other similar issues.

So, how does one learn to ignore the "disrespecting" that happens so often in today's life? The Desert Fathers and Mothers of the early part of the last millenia, chose life in the desert to help them focus on what was important in life. Spiritual practice in post-Constantinian Christianity focused on a self-centered prosperity gospel that mirrored a consumeristic, egotistic and militaristic societal viewpoint (sound familiar?). Life in the harsh climate of the desert fostered "apatheia" - the removal of those things which got in the way of acting out of God's love for them. This is different from "acedia" which is the listless perception of just not caring about anything - modern day "whatever!".

Through daily prayer and work with a focus on God, the people of the desert were able to sustain a spiritual indifference to worldly things, that placed God at the center. Though life was anything but easy, they found reward beyond measure. They also practiced self-ridicule, which allowed them to continually prick their over-inflated sense of self to foster the humility that it takes to live only for God. By doing this they were able to live out of a love for others and develop remarkable compassion.

In order to right the ship of health care, all persons engaged in caring for others need to practice apatheia. We need to poke holes in the self agrandizement that comes from being "doctors" (of any shape, size and profession) and get back to being in true service. We can only do this when we put off the trappings of society and the desire to be recognized for our "greatness" and "wisdom" and begin to cultivate humility. Once this begins to happen, we can truly enter into caring relationships with one another to hear waht is needed from the other and to respond as we are called and with what knowledge and wisdom we have acquired.

Apatheia is only found in true prayer, however. Prayer that puts God first and others second, with our needs and desires a distant third. Without this practice in our daily lives, we fall into acedia and treat every person who comes to us as another disorder to be "cured" rather than another human to be with in communion and relation. This is a way forward to heal waht ails us all.

Peace,
Dan

Patient versus Steward or What's in a Name?

Friends:

A while back I wrote about my fascination with the new (relatively) movement of e-patients (such as at e-Patients.net). One thing has troubled me, however, and that is that this movement still labels itself as "patients", though they are looking to take over their care and become partners. Let's explore some definitions to see if a different term might be more freeing.

From Merriam-Webster's on-line Dictionary, the word "patient" when used as a noun has as a second definition, "one who is acted upon". Another dictionary also lists the definition (attributed to archaic usage) "one who suffers". The term "steward" has as its fifth definition, "one who actively directs affairs". Which term appears to be more empowering? Is it time to change the way we name persons who are actively engaged in the search for health, wellness and wholeness? In my mind, the answer is a resounding YES!

Now, steward in church-speak usually denotes one who pays (as in the annual Stewardship drives in my Methodist church), but in reality, a steward is one to whom something has been entrusted to care for (as in the manager of an estate). Patients are acted upon, stewards actively manage something. In the case of health care, all people can become actively involved in their care, thus taking on the role of steward. After all, our bodies are entrusted to us at birth, and we are free to choose how we manage this most precious resource. Our ability to manage not only own health, wellness and wholeness, but that of those around us, is what will ultimately determine our way out of the episodic and individualistic (silo health care) morass that we have created.

Active management requires state-of-the-art information and analysis, combined with an outlook that places just as much value on my body as it does on yours. No one has primacy, and everyone understands the stewardship needs of their body and the health of the surrounding community. Thus, stewardship is not just a one month event to raise funds for a church, it is a whole lifestyle approach to our lives.

Become stewards. Possibilities Journey, Inc. (www.possjrny.org) can help you on your way, and support you on your trip. We have educational, individual, community programming and support to transform the way that you view and manage your health, wellness and wholeness.

Peace and grace,
Dan

Meaning as a source of health

Friends:

In my last post I wrote about resilience - that ability to transcend even the worst that life can throw at a person; Hamlet's "slings and arrows of outrageous fortune". Today I want to spend some time with the term "meaning", and relate it to health and wholeness.

In "Making Health Care Whole", by Puchalski and Ferrell, meaning is defined as, "the worth of life". It is characterized by a "sense of accomplishment; creative activities or vocational roles; is fundamental to a coherent sense of feeling whole." Thus, without some form of meaning in one's life, there is a lack of wholeness and sense of worth.

Often, people find meaning in relationships - especially family and close friends. People in this day-and-age will often find meaning in their work - in fact, over-identifying with their job to the point that when they retire or get fired, they suffer from depression and loss of self-worth. They have lost the ability to understand who and what they are (coherence), thus they have lost the fundamental element that provides meaning in their lives. So, they search for a replacement - this can take positive or negative forms.

Often, when life is at its most challenging (and usually out of control), people begin to search for meaning beyond themselves. Chronic illnesses or life-limiting diagnoses, in my experience, have lead many people to formal religion or spirituality in order to make some sense (find coherence) in their life in relation to something beyond themselves.

The spiritual search for meaning (often termed discernment) incorporates the active process of "looking" for the Other - most often termed God, Adonai or I Am, Allah, etc. There are many paths, both Eastern and Western, new age and timeless, that can lead a person to the inner self (inner teacher or soul in Parker Palmer's terminology). Father Richard Rohr speaks of it as the "true self" versus the hypocritical (false self) that we show to the world. However, one searches, the putting off of falseness and finding our way to truth and thus to meaning, is healing and wholesome.

Once true self is discovered, then the falseness recedes and is replaced by calm and comfort. Wholeness has returned to the person, as it was in the beginning of life. A person's outlook improves, and resilience is manifested. Most of the time, this discernment requires some help - usually a strong and supportive community of spiritual persons who allow the index person space and unconditional love and acceptance to find their way to their soul.

Thus, Possibilities Journey, Inc. (www.possjrny.org) believes that without a spiritual or faith community to support a person, there can be no real health, because there is no wholeness. A person can be in the best physicial shape, perform all the necessary wellness behaviors, but still be nothing but dead on the inside - a broken vessel due to a lack of meaning. Thus, our strong belief that spiritual and faith communities need to regain their historic role in enabling and empowering spiritual growth (the serach for meaning) that allows all persons to discover their true life. Once this happens, we will get the balance back into caring for each other, and though we will still get sick and ultimately die, we will die knowing we are whole.

Peace,
Dan

Resilience

Friends:

As we move forward in our discernment about how a return to a re-integration of spirituality (see definition in last post) and health care can improve all aspects of living (i.e., health, wellness and wholeness), we must consider resilience and meaning. We will first cover resilience, and in Thursday's post, we will focus on meaning.

Resilience is that quality of humanity that allows for people to encounter "bad" or negative events in their lives and to positively move through them to a new and better place. Vanistendael and Lecomte in 2000 proposed a model (which looks like a small house or "casita")for the development of resilience. The foundation is built on basic physical health, and then on top of that comes networks of informal relationships (family, friends, etc) and fundamental acceptance of person (not behavior(s)). Built on the foundation is the "ground floor" of the capacity to discover sense, meaning and coherence (shared vision). The "first floor" is characterized by self esteem, skills competences and constructive humor. The "attic" is a place of discovery, with no set pieces - it is the place of Shalom (wholeness as envisioned by God). [Note: The last piece is my interpretation, not the authors.] Thus, it appears from this research that unless there is basic physical health and an acceptance of the person, there can be no resilience.

These "foundations" are what is missing in so much of our world today - including the U.S. We are not providing for basic physical health for all persons (and the new health insurance reform package does little or nothing to provide this), and relationship webs and acceptance are more fractured than ever. Thus, it appears that the first initiatives to moving towards Shalom are to rebuild these foundations. Because, without resilience, we as a people are unequipped to handle the "slings and arrows or outrageous fortune" that life throws at us.

So, how do spiritual or faith communities play a role in building capacity for resilience in all persons? They do so, as they have done historically, by creating a welcoming community that accepts all persons unconditionally and loves them in the same manner. Following the tenets of loving others as ourselves and sharing equally among the "body" one creates a network that promotes healthy behaviors and practices, creates friendships and support systems, and is accepting of persons where they are at. Thus, faith communities might just be the answer for the poor health and declining resilience that is seen in our world today.

A return to resilient persons...spirituality can create the space for the foundations to be re-built.

Peace,
Dan

Spirituality

Friends:

It strikes me that I've been throwing about the term "spirituality" yet have not offered a definition to help us ground our experience together. I offer this definition of spirituality from a book entitled, "Making Healthcare Whole" by Puchalski and Rennell, page 192:
"Spirituality provides a source of meaning and a way to understand the significance of living. Aspects of spirituality include the need for purpose and meaning, forgiveness, love, relatedness, hope and creativity and its expression. It may include rituals, music, prayer, and symbolic representations to help understand or interpret what it means to be human and to reckon with things greater than us."

So, by this definition then, a spiritual person would employ some or all of the listed aspects as well as rituals and representations in order to aid in the search for meaning and cosmic place. I think this is a very workable definition (BTW, one of 14 definitions of spirituality in this book - not to mention another 6 for religion.)

How can we then meld health and wellness with spirituality (that purpose for Possibilities Journey)? If one discerns upon the aspects of spirituality: love, forgiveness, need for purpose and meaning to life, creative expression; I think that it becomes clear that focusing only on the bio-medical aspects of disease leaves a whole lot to be desired. Thus, as Rachel Naomi Remen has stated, "We thought we could cure everything, but it turns out we can only cure a small amount of human suffering. The rest of it needs to be healed." (Puchalski and Rennell, pg 106)

Spirituality's addition to the healthcare model, therefore, offers an addition that no medicine or medical provider can offer - that of healing human suffering. No cures are offered, but the opportunity to be truly compassionate (definition, "to suffer with") in our provision of care, allows for the possibility for God to heal what is in need of healing. What a wonderful way to re-envision healthcare.

Peace,
Dan

Integrative Care vs. Integrative Medicine

Friends:

Before I start today I want to point you to a couple of really cool new websites. The first is "Goodsearch.com" (see at: www.goodsearch.com). Goodsearch, which is powered by Yahoo, puts a portion of the $8 billion geenerated by search engines to work for charities. Possibilities Journey Inc., (www.possjrny.org) is now listed there, so you can donate to us just by searching the Web - check it out. The second is a group called "Freerice.com" (see at: www.freerice.com). This site is great for all ages as it helps people become more literate and generates rice for people to eat. The way it works is that a word is given and you have to pick the correct definition. Each correct answer generates rice grains. It's a great tool, and I'm going to engage my teenagers and church Youth Group in this activity.

Now to the thought for today...integration. The term "integrative medicine" is thrown about a lot nowadays. I think that most people know that these terms mean the integration of complementary (aka alternative)approaches to classic Western medicine (that is herbals, acupuncture, aurvedic, etc). While this may be a step in the right direction, it really still just approaches the person as an entity to treat with medicine, not truly integrating the whole person into the treatment.

Integrative care, however, is an approach that values the whole person (mind, body, spirit) and looks to identify with the person those approaches that are most meaningful to them. Those approaches might be meditation and use of healing services to care for areas of brokenness that are driving pain medication use (as an example). In a new book entitled, "Making Health Care Whole" (by Puchalski and Ferrell) the authors explore this type of holistic approach.

Dr. Puchalski runs the George Washington University's Institute of Spirituality and Health (www.GWiSH.org). She has been a leader in bringing teaching on spirituality and spiritual needs of persons into physician training programs across the U.S. Her goal is to see that physicians are trained to be more understanding of the spiritual aspects of all disease, and to not neglect this in their differential. However, this is an uphill battle to counteract the biomedical diagnostic approach that is drilled into every physician. Also, this type of appraoch is not reimbursed, so busy MD's will find it difficult to do this routinely.

However, by integrating spirituality into the process of care, we now are truly linking all aspects of the disease process. While complementary approaches do offer some benefit, it is still the same "pill for every ill" approach that hasn't addressed the whole person. Only when we integrate the whole person, as well as the support system for that person, into the plan of care will we make significant progress towards Shalom.

Peace,
Dan