First published in the Journal of Holistic Healthcare — May/June 2010
Its Political not Scientific!
Holistic health practitioners know that an essential part of wellbeing is our connection with the wonder and energy of nature and all life. But they are often excluded from mainstream medicine due to accusations of ‘bad science’ especially when mentioning energy, qi or prana. This paper suggests that practitioners move on from that debate and be encouraged by the NHS’s full support of spirituality in best practice. It encourages practitioners to write HOLISTIC whenever they are asked to fill in a form with a religion box.
There is an elephant in the holistic healthcare room. It causes embarrassment. It triggers intellectual sneers. The most experienced of practitioners and teachers may have trouble talking about it. This creature is sometimes known as vitality, or prana, qi, or just energy. The challenge of bringing together mechanistic medicine with the more subtle aspects of life, is a big one. One worldview — contemporary mechanistic western medical science — finds the idea of prana preposterous. The other — the complementary, holistic, integrative approach — uses it as a foundation for many of its healing models.
My own first skirmishes in this paradigm war took place decades ago with my father, a medical doctor and Freudian psychiatrist. When arguing with me, his intellectual outrage at the idea of a healing energy became sublimated into a passive aggressive dismissal, suggesting (I am serious) that I might need psychoanalytic therapy to help me overcome this infantile delusion. For many years I felt diminished and infantilised by his patronising putdown; and I see that same anxiety in many of my complementary friends who want the approval of their mainstream colleagues — as if their mainstream colleagues represented parental love, safety and acceptance.
Decades on, however, I understand my father’s behaviour. His demeaning putdown was actually the defensiveness of a man looking down a barrel at a different perspective that, if admitted, would dismantle his paradigm, his sense of identity, his status and the way he lived. The concept of prana attacked his worldview. He hid from the threat behind a smokescreen of pomposity and regal certainty. Enough! I know that you know what I’m writing about here.
When opposing paradigms clash, the fury of the disagreements is not simply fuelled by logic and methodology. It is not just ‘good science’ versus ‘bad science’. The fury is fuelled by the emotional and psychological investments made by the parties. For a while I was an academic social theorist and I was particularly attracted to the Frankfurt school of critical theory, which uses Marxism and psychoanalysis as a method for deconstructing the internal drives that glue us to our worldviews. In sociology there is a concept called Mannheim’s Paradox, which asks whether it is possible ever to think oneself out of one’s paradigm, because we are trapped by the very patterns of our thought process, and they themselves belong to our prevailing paradigm. It is the snake swallowing its own tail.
The laboured point that I am making is that the business of transforming a paradigm — in this case the prevailing clunky model of western medical science — is not simple. It is charged and it is complex. It is a psychological and a political process. Medical scholars in particular are rarely going to jump ship unless their status is maintained. With decades of neural grooves embedded in habitual, unconscious survival drives, what possible motivation could make losing their status feel okay? I remember reading the Hansard reports of debates around complementary medicine. Apparently many MPs and peers who supported it had a personal experience of how holistic medicine had helped them or a loved one through a crisis. But otherwise, failing a moment of crisis or epiphany, people will hang on to their identities and worldviews for dear life.
Before looking more closely at the political dynamics, let us ask an important question.
What do we really want? And is what we want radically different from the mainstream model?
In answering these questions, I suggest that it is helpful to expand the argument away from the academic domain, outwards towards government policy and NHS management. Best practice in UK personal and community healthcare is already explicitly seeking to be holistic. The policy directives are clear and sing from the same song sheet. The basics include good food, fresh water, safe accommodation, safe streets, education, social acceptance, being valued, harmonious environment, faith, spirituality and religion. In this public health model of healthcare, physical wellbeing is connected to psychological wellbeing, which is linked to social-psychological wellbeing. Social-psychological wellbeing is itself connected to issues of faith and spirituality, and to the existential realities of the surrounding society and culture.
If this is the case, then what makes a complementary practitioner’s holistic approach so different from a governmental holistic approach? It seems to be the elephant in the room again.
The fully holistic model includes the idea that some sort of ‘subtle information’ connects these different levels of wellbeing . All the medical and healing models of the East, particularly Ayurveda and Taoism, but also indigenous traditions the world over include this fundamental notion of connectedness. All of these approaches consider prana, qi, benevolent vitality and healing energy to be an essential component of their thinking and working practice. According to these systems of medicine, being connected with the universe through the benevolent forces of nature is a fundamental aspect of health.
To put it another way, the whole wellbeing project is hopelessly incomplete unless it includes prana, chi, vitality. Yet we know that mechanistic medicine and research are hostile to this notion of subtle information. Government policy, however, is on our side.
We are looking at a paradigm conflict. Let us be realistic. We know from painful experience that until mechanistic medicine has devised some rigorous gizmo that can measure and can manage prana, there will be no transformation of the mechanistic paradigm. So let us forget about winning the academic, scientific argument and focus on the politics and the overarching framework. We should argue holistically, not scientifically. There are lessons to be learnt here from political campaigning, one of which is the art of reframing the argument. In the ongoing US debate over healthcare reform, for example, the Republicans consistently reframe the discussion so that it becomes an issue of patriotism: healthcare reform reflects they say un-American attitudes that would offend the founding fathers. British political campaigning, as we all know, is often not about policies, but about the framework within which the day’s discussion takes place.
Let us therefore avoid the good science versus bad science bickering, and instead think about how to reframe the wellbeing debate so that it works to everyone’s benefit.
We need to notice that the current language and priorities of the NHS explicitly support, encourage and insist upon including the spiritual dimension. (If you just google ‘NHS Faith and Spirituality Action Plan’ you will immediately find dozens of reports from NHS trusts on how they are putting the plan into action). It is also, for example, explicit in The Revised Guidance on Spiritual Care and Chaplaincy in NHS Scotland 2008, which states that, ‘NHS Scotland is committed to providing or facilitating spiritual and religious care with equal commitment to any within its care’. And best practice in psychiatric care increasingly allows space for the patient’s own beliefs and spiritual story. (For more on this, visit the Royal College of Psychiatrist’s Spirituality and Psychiatry Special Interest Group.)
Professor Dawkins’ god-free ideas have no influence within healthcare provision. Politically this pluralism is partly due to the government’s need to avoid inflaming religious and racial conflict, and to integrate the Muslim community into UK citizenship. But it is also undeniable that the faith communities have a deep heritage of service ethos. Whatever your wider opinion of religion, in the past it has very often been a force for good in developing humane treatment and good care in medicine. As for its future role, I see a dynamically new (or maybe it is ancient) model of spirituality fast emerging. The statistics and the general evidence are clear: although a substantial proportion of people in the developed world have moved on from being aligned with one particular religion, they have not become atheistic. Many have adopted a more general view of spirituality, understanding it as a personal experience of the wonder and energy of life, and sensing that this connectedness is good for our health and wellbeing. See for example, the ongoing World Values Survey Project located in the University of Michigan and headed up by Ronald Inglehart www.worldvaluessurvey.org)
That health and wellbeing are positively affected by spirituality, can even be validated using theories borrowed from atheistic socio-biology and evolutionary psychology. In fact it was the father of socio-biology E.O. Wilson, who put forward the theory of biophilia. Pointing out that humans are hard-wired for affiliation with the natural world, from a grain of sand through to the night sky and mystery of the cosmos, and that this is good and uplifting for us. This connectedness he believed to be the primal source of the religious instinct, in that we feel good when we connect and are in rapport with the natural world. (E.O. Wilson, Biophilia, Harvard University Press, 1990.) His explanation for this deep sense of belonging to the natural world is that all that we are made of the same stuff that came from the Big Bang. This is not rigorous socio-biological theory, but it is a clear philosophical proposition and surely looks like spirituality masquerading under other name.
This then is the reframe. Stop having the scientific argument. It is a waste of time and energy. Reframe it as a simple statement: ‘spirituality is an essential part of wellbeing’. And take note that this statement, as well as the notion of spirituality as a natural sense of connectedness, has some serious scientific foundations. Then notice too that we have already won the debate and paradigm war. Wellbeing is already part of the government’s health policy package, and Concern for Spirituality is clearly named as a marker of best practice in the NHS.
So we can take the high ground, stop the futile scientific debate and assert that the fully holistic approach includes levels of analysis beyond the mechanistic model, and that is already supported by NHS directives on best practice.
This level of political activity, managing the framework within which the discourse happens, also has to be grounded in real life one-to-one activity. Let me give a relevant example from my own work. For the last decade I have been facilitating workshops and trainings, which begin with a simple question.
‘What circumstances most easily connect you with the wonder and energy of life?’
The answers that come from the participants cover a wide spectrum. They include, for example: nature, art, relationships, hobbies, dance, meditation and pets.
I then ask a second question, which is rhetorical, but helps people to remember the value of connecting.
‘Is it good for you to connect with the wonder and energy of life?’
Please note that these questions can be addressed to anyone. Professor Dawkins, when you look through your telescope at the magnificence of the cosmos or walk through nature, is that good for you? Of course, it is. Why? What are the mechanics of your biophilic response? In this context, a simple phrase — not intellectualised — such as ‘connecting with the wonder and energy of nature and life’ is understandable and acceptable. It has no immediate connotations of faith and religion; nor does it directly imply the existence of prana. Yet this sense of connectedness and its benefits to wellbeing resist explanation by coherent and rigorous scientific methodology. The NHS is not bothered by this lack of theory and requires no explanation for what is self-evident, simply and clearly asserting that the inclusion of spirituality is best practice. And even the most hardened mechanistic cynics can sense that it is indeed good for them too.
There is then a third question that I pose to my groups.
‘˜Do you know how to turn the volume up on your experience of the wonder and energy? Do you know the skills for anchoring the consequent sense of wellbeing into your ongoing health?’ This then leads us into a discussion about breath, relaxation, mindfulness, an open heart and gratitude. What are we talking about here? Is it spirituality? Is it scientific? What matters is that it provides a foundation for wellbeing, and in one way or another complementary practitioners have a feeling that this is exactly what they are doing: reconnecting their clients/patients with the natural flow of life.
We have here the beginning of a political logic. Think globally. Act Locally. We start with ourselves. Then clients/friends/patients. Then the polity. Locally, it starts with each of us looking after ourselves properly. Part of this requires regular and ongoing connection with the wonder and energy of life — in whatever way works best and most easily for you. Most of us would if we knew how to, like to spend some time every day soaking in that experience of connection. We know how good it is for us, and we need to do it for our health’s sake.
Then with our friends, clients and students, we can practise our particular healing art and enable them to come into more fluid connection with the benevolent dynamics of the natural world. And this congruence of personal and professional practice can give us greater integrity, maturity and confidence. From that foundation we can confidently ignore or transcend or marginalise the good science versus bad science debate, because the real issue is whether are we enabling our patients/clients/friends to make more full and wholesome connections with the wonder and energy of life, which is the foundation, the fuel and the joy of wellbeing.
We then, I suggest, need to expand this work into society in general. One way of doing this is to give wider and deeper meaning to the word ‘holistic’, fully acknowledging that holistic healthcare has to include all aspects of mainstream healthcare. This can be supported too by writing HOLISTIC whenever you have to fill in a form which has a religion box, especially in the UK Census March 2011. This will help to integrate the emerging 21st century spirituality — connection with wonder and energy of life — into a medical paradigm that includes both the mechanistic and the subtle.