Psychological tools for wellness / Category / Emile Du Toit / November 9th 2015
Total health is arguably the single most important concept for you to understand and adopt if you wish to live a happy and deeply fulfilling life. This health article examines what is meant by total health and why it is especially important for us in today’s highly demanding environment. We examine how the concept of the mind-body link is inextricably interwoven in total health, and how even ‘western’ modern medicine is now building upon its foundations and sometimes actually becoming the primary protagonist of the mind body link. A great example of this is the placebo effect and how this is becoming far more acknowledged in ‘modern’ medical trials of pharmaceuticals than in studies of ‘traditional’ alternative health supplements. Here at Tools for Health and Wellness we are not only interest in writing fascinating healh articles, but also in maintaining a practical self-help wellness component to our health and wellness blog. Therefore, we also list vital health and wellness components in total health, and begin to steer the reader towards a practical application of total health in the form of adopting a healthy lifestyle program and practical implementation of a health care plan.
The concept of total health is absolutely crucial to your health and happiness. This is especially true in today’s society.
This article explores what total health really means, as well as how it is built upon the foundation of the mind-body link. It explores 10 components of health, and also reminds you how and why you are responsible for your own health and wellness. We explore how there has been a strong blurring between the once iron curtain of ‘western’ and ‘eastern’ (alternative) medicine, often without the practitioners themselves even recognising this. As an example of this we take a quick look at a few of the ironies mired in the use of medical pharmaceuticals versus ‘natural’ supplements, and also take a brief look at the placebo effect.
Total health means slightly different things to different people, but the core concepts are ultimately the same.
According to the World Health Organization (WHO),’ total health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’, and ‘It is the extent to which an individual or group is able to realize aspirations and satisfy needs, on the other hand to change or cope with the environment’.
What I love about this definition is that it has both a great objective lens through which to evaluate health and happiness, as well as the allowance that we all need to choose our particular health needs based on our expectations of what ultimately we envisage as a life that will make us happy. Put differently, you need to start by envisaging the life that is congruent with your identity and that will make you happiest and most fulfilled (self-esteem functions), and then balance out the time you prioritise to the various components in order to achieve your lifestyle. It is very much a proactive plan for health and wellness than acknowledges both the need for reactive health care (most of Western modern medicine that treats you generally only once you are ill) and proactive illness prevention and the pursuit of positive health.
The concept of ‘total health’ considers health and happiness as a complex system that is critically interwoven and cannot be un-entangled. Most obviously it acknowledges that when an area of a person’s life is unhealthy (liver problems, bad debt, cranky teenager) these aspects impact on our core construct of general health and wellness and also on other areas of our health. So the cranky teenager might drive one to drink, leading to medical bills from the resultant liver-related health problems, all of which leave one in generally more unhealthy state!
More subtly though, total health also acknowledges (whether with open arms or recalcitrant reluctance) the concept of the mind-body link. Take a look at the physiology of the stress response to get a sense of how hugely psychological distress affects our bodies, both temporarily and permanently! We therefore tacitly have to accept that social, psychological, financial, familial, spiritual and environmental factors can directly affect our health. And our health, in turn affects all these other wellness factors. Much of the stress response cycle occurs pretty automatically, and we can sometime feel powerless to prevent it. And yet relaxation techniques, cognitive-behavioural therapy and other modalities are able to affect all parts of the human condition – thoughts, behaviours, emotions and – most relevant here -physiology/neurochemistry. From here this relative wellness/sickness lows out into all the external areas of our lives. Particular stress relaxation techniques such as biofeedback also clearly demonstrate how it is possible to generate (for example) body heat in a particular body region by consciously willing it (aka getting better at understanding which subtle physiological processes best generate this and stimulating them correctly).
The concept of total health, that many heath departments and corporations are spending so much money on, accepts the mind-body link as one of its underpinnings.
The components of total health are infinite really. They include all our experiences as a total human being! And based on the uniqueness of the human experience some of these component, or at the very least the prioritisation of them, will vary from person to person. Nevertheless, broad categories of total health can probably be mapped out. With that in mind the list below is not exhaustive - I have merely listed the obvious ones, and a few examples:
Many governments and indeed corporations are trying to implement total health policies with their subjects and workforce respectively. Ultimately though, a core construct of total health is that you are responsible for your health and wellness. Tools for Health and Wellness has written several articles that directly speak to this concept, and provide skills for you to begin to sift through the internet to effectively seek out health advice tailored for your particular needs. As an important step in taking responsibility for your life, you might want to take a look at ‘health and wellness blog’ and ‘health articles’. Once you have read these you will probably need to begin to consider a ‘healthy lifestyle program’ and from this construct a ‘health care plan’.
The concept of total health means different things to different people. Unfortunately for some it appears to take on some weird ‘new-agey’ meaning, which cannot be further from the truth. For health care professionals and researchers at the forefront of medical research in pretty much every field, the mind-body link is no longer even interesting to debate and is taken for granted. The more we learn about DNA and genetic expressions, psychiatry, neurochemistry, haemotology and so forth, the more we have realised how integrated our physical and mental health actually are.
There are no longer the same de facto clear cut distinctions between ‘Western’ and ‘Alternative’ medicine, and in fact both have become a mish-mash of the two, without many practitioners even noticing. In fact it is ironic that what is often perceived as the more ‘Eastern’ or alternative’ discipline of using natural supplements tends to be the one that in practical terms falls short in their understanding and identification of the mind-body link, as opposed to those rooted in ‘modern Western Medicine’, who are often unaware of the extent to which their medical system has bought in to the mind body link.
What do I mean here – and how do I avoid getting shot by the many followers of supplementation and/both those ‘modern medicine’ stalwarts who see ‘alternative medicine’ as unbelievable as dryads and pixies. Well let me start by saying that I am a firm believer in supplements, when they have actual statistical data behind their efficacy. However, despite all the talk about mind-body links and proactive health it is an industry that very seldom has controlled clinical trials of products compared to placebo in a standardized, double-blind manner. So if ‘natural product ABC‘reduces anxiety by 18%’, suddenly the theory of mind-body quite often goes straight out the window. If the same subjects were to take a sugar coated pill that they were told would flatten their anxiety, their average anxiety might well reduce by 25% -30% (as is not uncommon for anxiolytic placebo effects). What then do we do with the information about the aforementioned supplement, and what conclusions should we actually be drawing about its alleged efficacy?!
In contrast, Western pharmaceutical research companies are forced to spend (literally) billions of dollars on research and inevitably double-blind placebo controlled studies. Without these placebo-controlled trials that acknowledge the huge link between mind and body, it is impossible for a company to get a new drug approved by the FDA, and therefore to market it. Similarly, cognitive-behavioural therapists have the closest we can get to a ‘placebo group’ in detailing the efficacy of our therapeutic interventions for different types of disorders. We might compare our treatment effect with a group of similar demographic and symptoms severity who are awaiting treatment (also known to have a positive effect), or doing a course on relaxation techniques, or better yet those engaged in certain other ‘talk therapies’ where we believe the positive outcome is (at least largely) due to placebo. Yet ‘natural supplements’ are rarely compared to placebo groups, and the same is true of many other forms of ‘natural therapies’.
For those of you who are unfamiliar with the placebo effect, it merely means that the belief that someone is receiving something to help their condition in many cases will alleviate some symptoms or even cure the condition (without any active drug or supplement being given). With this in mind, pharmaceutical companies are legally forced to always have a ‘placebo’ group as well as the standard treatment group in their trial, so that the effect size of the placebo group can be subtracted from the effect size of the treatment group to determine the actual efficacy (effect size) of the drug itself (without the placebo). So if 50% of people improve significantly on a blood thinning tablet, and 30% of those in the placebo group also improved significantly, then the effect size of the actual clinical effect of the medication would be 20%. ‘Double blind’ means that in order for this to be calculated effectively, neither the placebo/control groups or those conducting the experiments must know which group any particular subject belongs to, as this would clearly affect the outcome of the experiment. Yes, there has been a strong body of research to demonstrate that if an experimenter / teacher / examiner is aware of the status of a subject (consider the teacher who believes their student to be gifted), their belief in the expected outcome translates unconsciously (and often consciously) into behaviour change with the subject, which in turn influences the subjects belief about the likelihood of them being positively affected by the ‘treatment’ (and therefore they are more likely to improve). And yes, this flies totally in the face of the bedside manner of many doctors…! For more information on the placebo effect you might want to read ‘Comparing clinical effects with placebo effects’ and ‘Placebo effects are increasing over time’ for more in-depth information on the subject.
Now I am in no way having a dig at alternative therapeutic modalities, many of which grew out of Eastern medical philosophy. These philosophies are largely responsible for the initial conceptualizations and growing acceptance of the mind-body link. I am merely attempting to point out:
The placebo effect is no longer even a debatable phenomenon in modern western medicine and pharmacology. It is now broadly accepted that:
1. That the placebo effect is now common across most medical and psychological illnesses.
2. Medical treatment studies now have to have a placebo group to work out the size of this placebo effect, and whether the actual ‘clinical’ effect of the treatment is thus actually significant once the placebo response has been taken in to account.
3. These placebo-controlled trials have to be ‘double-blind’ – meaning that neither subjects nor clinicians administering the treatments are aware of which subjects are in the treatment versus placebo group – as this too alters the placebo response.
4. That in many cases the placebo effect is actually the same size as, or even larger than the treatments ‘clinical’ effect (i.e. the effect of the medicine or procedure minus the placebo effect).
5. And that the placebo effect actually appears to be increasing rather rapidly over time!
I once again strongly urge you to read these articles on the placebo effect versus treatment effect, and how and why the placebo effect is increasing over time.
In synthesis, your health and wellness is a complex, multi-directional tapestry of all the many components that health can be broken down into. Luckily, we live in an age where health articles and health and wellness blogs are littered about the internet, and once you have a good grasp of how to extract academically sound information you are in a position to truly take charge of your health. Here at Tools for Health and Wellness we will teach you how to practically apply the concept of total health by getting a sense of your own, unique healthy lifestyle program, and how to use this to derive a health care plan for all aspects of your life.
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