Monday, April 8, 2013
THRIVING: Toward The Cutting Edge of “Health”
Painting: Ricardo Shavez-Mndez
Our Sense Of The Nature Of Health And Our Health
Interventions Are Dramatically Transforming
THE DEEP “WELL” OF WELLNESS
THE CURRENT HIGH-END standard-bearer for health is “WELLNESS.” It is wonderful but not complete, and somewhat “retro,” in that remains strongly physical fitness oriented.
What if we were to approach “wellness” as a deep well?
When health/wellness is truly a deep well, there is more to be discovered, and only the surface and near depths have been scratched. Going deep in the well of wellness may heal depression and anxiety and stimulate creativity, intuition, mega-motivation, optimization and thriving rather than compensation.
And there is this opportunity to find and optimize an inherent wellness, when, in reality, we tend to concentrate on illness or limits to be overcome. Popular “health work” is typically not about health, but rather, about deficits. Medicine and mental “health” focus on disorder. We are skilled at exploring what is wrong [e.g., illness, disorders], but are deficit in describing health.
Optimal/Authentic health may not, primarily, be a muscularly taut aerobic/anaerobic-tolerant, “uber-fit” body. In fact, such a body may be wrought with anxiety and stress and even physical injury [How so? initially, in the sense of being physically inflexible and muscularly over-tight and psychologically either rushed or anxious, and later, hobbled due to accrued injuries as well as from lack of development of body mobility and lack of autogenic [self-generating] skills for relaxation and de-stressing].
Optimal Health is comprehensive and likely begins more as psycho-spiritual [Viktor Frankl, Man’s Search For Meaning] rather than as physical. A wondrous metaphor for this rich health is that which Thomas Merton named “a hidden wholeness.” Optimal health enhances an interior mental flexibility. It involves characteristics of graced movement and luminous eyes of spirit that favor adaptation to the changing conditions of existence, both externally and internally.
Even in addressing the physical debilitation of our dying, from which no one escapes and in this sense is a natural process, we can be optimally health or authentically “well” and thriving. And we are all likely to know examples of this optimal health within dying:
Such attributes are achievable without facing a life-threatening illness or injury. And they typically have a strong sense of physical self-care or “body practice” as a significant piece of a more comprehensive, harmonious blend of multifold practices that are creative, productive, socially connected, and so forth.
And physically, we can anticipate remarkable changes in longevity that would go deep into the “well” of wellness and health. AND most of these advancements may have more to do with nutrition, anti-aging substances, gene therapy, safety improvements/regulations, early screening, and stress-reducing activities—really lifestyle changes and proactive medical opportunities—that have little to do directly with physical fitness. Unsafe living and working conditions, influenza and other diseases, less social control/violence are really crucial health dynamics that are really attitudes and disorganization and knowledge limits that really affect health. The maximum human lifespan has been increased across time from changes that are not primarily physical fitness based.
II. A Brief History:
THE ONGOING EVOLUTION OF “HEALTH”
“HEALTH” HAS REFERENCED different things, and has, perhaps, evolved through stages even in modern life:
· pre-fitness [absence of illness],
· wellness, and
The way in which we reference health directs “health interventions.” It becomes our “philosophy of care.” Simply, how you describe “health” determines what you do to realize it.
If “health” references as the absence of illness, then you might do very little, unless you are ill. Obesity might even be attractive as a stalwart against famine.
If health references physical fitness or lower blood pressure and heart rate and lactic threshold and strength, then you might be regularly engaged in “exercise.”
Currently, health tends to popularly reference “wellness” that is “holistic.” Attitudes plays the critical role, so that for some individuals, “holistic” can only reference “New Age” and perhaps be proscribed as a threat.
“Wellness” has overcome many of its critics, and now references a more neutral “life fitness,” involving components such as nutrition and an absence of stress and physical fitness in the form of aerobics to reduce fat and improve cardiovascular function, with a nod to strength for muscles and bone density. Occasionally, “Wellenss” maa additionally offer a nod to components such as social wellness [i.e., social interaction], intellectual wellness [i.e., mental nourishment], creativity annd—quite new—environmental or ecological wellness.
A wellness approach seems to be obvious, and far-reaching enough to fully describe “health.” And yet, a crucial vision may be missing. And this missing cutting-edge of health is not something easily described, because it is likely still in genesis.
Taking a little journey back in how we reference health is informative, especially to sense the ways in which we have envisioned health differently even in modern life. And rather than finally define explicitly what health really is, perhaps the real value of looking back at the evolution of our sense of health is a better understanding of how our sense of health changes, how it is malleable, and sometimes dead-wrong. This might lead us to approach health with a little less righteousness and really see what it might become.
If we were really open, what might “health” really be? We are wont to think of health as something inside our bodies. But with our view of Earthrise over the moonscape in the Apollo missions in 1970, the Earth was not the same one that we had on our maps and globes. It was a biosphere that our satellites now monitor in a quite detailed way. And seeing this, we become not only ecological, but also somewhat “spiritual.” Recall Viktor Frankl, in his writing following his internment in Nazi concentration camps and his subsequent life as a psychiatrist, and his sense that health was psycho-spiritual.
Recalling a line from a poem, “If holy water—the rivers, lakes, oceans,” [Ganga White, Yoga Beyond Belief] as a sense of optimal health as involving treating our immanent landscape as if it was precious and, therefore, prioritizing efforts to make these waters close to “pristine” (even if just for our own immediate life quality).
A. HEALTH AS ABSENCE OF ILLNESS / “PRE-FITNESS” [pre-1950’s]
Health as absence of illness [e.g., calming benefits of smoking]
A functional aspect of health as the absence of illness is a sense of health as inherent rather than as something that needs to be developed. However, especially with increasing urbanization and consumerism, work was transitioning from persistent physical labor to more sedentary activity and food was abundant and reasonably cheap and, increasingly, more “processed” / “convenient.”
B. HEALTH AS FITNESS [1960’s]
Health: non-ill can still have poor health
Health is physical fitness: Strength, Flexibility, Cardio [aerobic/anaerobic]
Uber fitness: endurance
Survival Orientation: overcoming limits, identify & correct what is wrong (i.e., what is deficient)
Medical—Disease Model / compensation for most people
“Gym and swim Y’s”
One of the limits of a fitness orientation is a new understanding that sport may actually injure the body. Specific sport training tends to tighten the body and make it more susceptible to injury. “Cross-training” likely will not balance the body, and will either reinforce tightening or be in conflict, so that one regimen will almost shock the other regimen.
C. HEALTH AS WELLNESS / “LIFE FITNESS” [1990’s]
It makes more sense in the modern world. It links our sense of maximum lifespan as coming from non-physical actions and physical fitness. And it has lead to an explosion of participation. It aspires to be holistic: nutrition, exercise. And it adds a new dimensions: attention to an heretofore elusive concept: “body-mind.”
Importantly, it acknowledges the importance of “self-care,” and “care” implies a more comprehensive reach into, not only exercise, but also nutrition and genetics and “lifestyle.” Further, wellness emphasizes something new: “stress reduction.” And this “dip” into stress reduction in a world that seems to be “hyper” and “stress-filled” at every turn, lead investigation into a new world: into biochemistry and its role in regulating/restoring physical and psychological health. Physiology began to shift from muscular kinesthetic to a micro-level, measuring blood chemistry, brain waves, and brain scans.
“Wellness” seems to cover nearly everything related to health. However, its limit comes in continuing to be largely a medical model, looking at physical limits and trying to overcome them, aspiring eradicate a problem (similar to a pre-fitness model and a fitness model), continuing to centralize a physical fitness emphasis or “body emphasis”—pushing the body and mind to challenge limits. “No pain, no gain.” How physically far can you go, how high can you go. And alternative idea such as “No pain, gain” is likely to be met with obtuse stares.
“Healthy Living Centers” are examples of an evolution from a “gym and swim” model to a center that incorporates nutrition, exercise and body-mind. Exercise classes, machines, mats alter the physical space. What you eat, your activity level, and your coping mechanisms [that tend to be almost over-active and stressed [anxious/depressed] begin to be addressed. These centers are oriented toward a unique range of participants, including the general public, those with special medical needs, and performance sport training. The spaces tend to be architecturally different as well: more windows, carpeting, body-mind and group class spaces, possibly the absence of gyms and courts, the presence of lap pools and special water exercise pools, saunas, steam rooms and whirlpools, massage rooms, conference rooms (both general and with, a demonstration kitchen), and in-building affiliations with physical therapy programs and performance assessment programs, and weight reduction programs, and open space with tables for beverages/snacks/lunch to encourage people to socialize and locker TV lounges. Staff provide classes, individual wellness assessment and coaching, and therapeutic and exercise services to individuals to address specific medical issues such as cancer, MD, strokes, obesity, etc.
D. HEALTH AS “OPTIMAL HEALTH” / “THRIVING” / “WHOLE LIFE” 
When you authentically open the “well” of wellness, something remarkably different occurs. Because you begin to go “deep into the well,” the “well” is no longer exclusively cellular or something inside your mind that is holding you back. It is a radical shift. Pre-fitness, fitness, and wellness have tended to look outside the well, and to aspire to bring this wellness inside. In a shift to “thriving,” there is an intentional effort to focus on inherent health. And a central theme is likely to involve a shift to FREEDOM vs. control. Paying homage to their supporters, even body-mind practices tend to aspire to control the body and mind, to make it do what it is not doing, rather than to encourage what it is already doing well (and far beyond our limited thinking). The body will optimize. It is our attitude that limits us.
When you open the “well” of wellness, at some point the focus will begin to radically shift from aspiring to correct what is wrong and absent and missing [as if we really knew any more than cutting edge science “knows,” which is the focus of most fitness/wellness orientations] to:
· WHAT IS NOT WRONG [Thich Nhat Hanh]. Health is viewed as “inherent.” And what this means is that health comes from a place of strength rather than loss. In a thriving/optimal health model, not only is health inherent or already present, but also “problems”/adversity transform to opportunity and information. In fact, “problems” can provide a meta-motivator (equivalent to the meta-motivation of going to the moon) rather than be a grueling deficit to be overcome;
· Rather than stressing the body in exercise [which mimics what we do in the fast pace of everyday life and that essentially continues this stress], RELAXATION becomes crucial to access, and then trigger, a highly active restorative/healing physiological process. Relaxation/calmness allows one to cut through the high-paced chatter of everyday life and listen to the body and to intuition. [This process can occur in high-intensity performance practices found in ultimate athletic training and, to a lesser degree, in intensive interval training in activities such as spin cycling, but it is typically absent.]
· Focusing on the positive opens a META-MOTIVATOR to stimulate a transformation to health. Physical self-care becomes integral rather than being a problem; so too, nutrition changes, because we listen to the body rather than detach from it, becoming a face and our thinking [but often, physical training is so fast that it cannot consciously listen to the body or use breath];
· TRANSFORMATION OF EVERYDAY LIFE: optimizing, expansive, flowing, with gratitude changing from possibilities or options to everyday attributes;
· LIFE IS ENRICHED as attributes that once seemed to be special and exclusive and end-achievements of one’s life become a part of daily life in, heretofore, earlier stages of life: No longer just some post-endorphin “rewards,” but now, integrative experiences such as eloquence, grace, wonder, contentment, humor, compassion, gratitude are expressions. New metaphors may open that are aspects of a new “optimal health literacy,” such as “flow,” “intuition,” and other concepts yet to be named. And what they do practically, is make some process of being physically active something to be desired rather than something to be “required”;
· THRIVING /optimizing/transforming vs. surviving [a really new word here that can open new concepts];
· Rather than concentrating on symptom as barrier, ASPIRING to open a “block in holistic body” TO GO DEEPER INTO THIS “WELL” of “wellness,” opening an “unbreakable space” within [that even though we are breakable” in the sense that we do not escape death, we are an expression of more than we allow ourselves to imagine];
· Health is primarily PSYCHO-SPIRITUAL [Viktor Frankl, Man’s Search For Meaning] rather than physical: Optimal health can be found in terminal illness [You can experience the joy, humor and courage of a support group of, for example, “cancer patients”];
· Awareness of SOMETHING SHARED / INSEPARABLE AND SACRED/DIVINE: Namaste: “The light in me bows to the light in you, and together we are one in that light,” [the everyday chatter is overwhelmed by something far more eternal and inseparable for which there is, really, no name, and yet, it is as concrete as sand and leaf and wind once you taste it].
· HEALING vs. curing/excising illness/disorder [Curing is an end, and there is no end. Life is a beautiful roller coaster of ups and downs. Read any bio of a famous person that seemed to have the very best of life and you are likely to find an account of the loss of children, depressive self-doubts, eccentricities]. Healing is ongoing, like the ecosystem replenishing itself, or like a cut healing itself on your arm.
· Physical exercise, diet, activities, not primarily motivated by themselves but driven, motivated, by a deeper process beyond technique, by LISTENING TO INHERENT HEALTH, to that which is already possessed, to see what is needed rather than by trying to fill in gaps to gain health AND THEN INTUITIVELY RESPONDING [“intuition,” an ambiguous even scary word for many, but practically actualized as a deep intentional listening];
· “Health” involves a COMPREHENSIVE “MULTI-FOLD” PATHWAY: body, art, contemplation/philosophy [This is CORE to any authentic body-mind-spirit practice or to a “profession,” for that matter—In health, what is your underlying “philosophy of care?” It guides any technique, and it is likely, in the modern world, to be very obscure, where it is all about technique.
· RESILIENCE [This concept needs a lot of practical application, but it is not something obscure.] Being open, active vs. meeting an impasse, but not having to just challenge it physically, as is often the case in athletics or “health.”
· SPIRIT-BODY-MIND CENTERS [The drawing board for design is open here.] It is not just a wellness center, not just a 24-hour fitness center. Something happens in such a center, where you just might be making a radical shift in where you find health [inherent] and go from compensation to transformation. If you think only attending to the everyday as the way forward, you are simply not very healthy. Structurally, there may even be an intentional quiet space, areas with soft lighting and natural elements, reading space, art space, outdoor natural space, etc.
In The Science of Yoga: Risks and Rewards, William Broad argues that the health effects of such “thriving” practices are likely to be brought to center stage in the next few decades as primary health interventions, just as elliptical machines [as “fitness”] and so forth seem to catch it in the present moment. Now you come to the “wellness center” after work, and you “work out” on the machines or swim [but not just “swim,” do serious laps for fitness] or take a class on “core” or “abs and back” or “spin” or perhaps even do “boot camp.” It is a lot like your daily work. Statistically, perhaps 80 percent will cease coming after two months at best. If you continue, you are a rarity, and you are like to feel good, like you are doing what you are supposed to be doing. We are very social animals, and some of us, respond to the hype of “fitness” and it does us good, but also is likely somewhat harmful. You spend your time on the machine or stationary suave bike, but you stretch for 5 minutes at best. You feel best when you quit the exercise and let the endorphins kick in. But your long time spent in essentially tightening the muscles may cripple you across the long run. Plus, such exercise is, typically, quite specific to certain muscles, and these muscles are tightening and, in this process, reducing suppleness and flexibility. The most “uber-fit” persons, in terms of strength and speed and endurance are likely to become almost “cripples” when it comes down to that which in fitness is termed “flexibility” or, in optimal health, perhaps will come to be termed “suppleness.”
Modern yoga, as a practice that aspires to overcome some of these limits of physicality, often mimics this “fitness,” and, therefore, is derivative and degraded form the longstanding goals. But when it is “optimal,” yoga can integrate some of the emerging principles of optimal health [as it has likely often done in its development in the past and not be just another branch of fitness.]
Something like yoga, rather than remaining something esoteric or just globally popular, will be an important component to recover attention to flexibility and suppleness. Science continues to demonstrate powerful effects in chemical changes in the brain and blood as well as in nearly any measure of attitudinal change. The comprehensive positive impact on neuro, cardio, endocrine, psychological [counter to disorder and optimal attitude], gross flexibility/mobility and functional strength, and on and on into every subsystem of health, continues to emerge. The effects are both “micro” [physiological] and “macro,” extending into dimensions of life such as enhanced creativity and social “fluidity” that are likely to be increasingly understood as dimensions of health.
Deep physiological changes that have complex outcomes:
Physiological changes—modifying complex body chemistry can ehnance anxiety reduction, reduce stress and anger reactivity—and psychological shifts—such as life satisfaction, self-confidence, social life, and a sense of “hygiene” that it not just physical but attends to “contentment,” “surrender,” and “refuge.”
but not automatic serenity and peace.
The task in optimal health and thriving vs. surviving is in not make body-mind practice a “cure-all,” nor in making physical training a problem. With body-mind practices such as “yoga,” [whatever that is coming to mean now in the world-wide explosive popularity of “yoga”], the task is in confronting the ability of such practices to improve aerobic or weight loss with the same vigor that are applied to making uber-physical fitness into the save-all. We need to “grow up.” For example, aerobic training can be heart saving. But to say that it is health is, really, a form of both ignorance and even harm.
This arena of optimal health and thriving is new turf. Next to nothing has been spent on funding this research to date. And yet, the very little that has been expended in this direction shows nothing but promise.
To date, most of what we have used to build a health model is, paradoxically, a sense of what is wrong, or what is NOT health. And essentially, our models drag forward a mix of the pre-fitness sense of health as non-illness with fitness as a counter. To this mix, the reality that life expectancy increases were likely due to factors such as improving nutrition and hygiene more than to fitness had to be address, and so, the birth of “wellness.” But fitness has continued to hold dominion as the model around which health models are built. Still, however, fitness is a poor draw for the general population. And philosophically, wellness is still guided by a search for what is wrong.
“Health” remains strongly a medical model—a disease and disorder model. We continue to operate from a sense that “if we were only physically fit and would use good nutrition, we would have good health.” But health is larger than this, now just beginning to develop a sense of elements such as environmental quality. Using environmental concerns as a new health element, it is again medical/disorder-oriented that is our first approach. We focus on degradation and we aspire to improve quality by taking away some aspect of quality in people’s lives and, therefore, make few gains. The loss of participants in wellness programs tends to mimic this emphasis on degradation and loss.
We just cannot begin from a stance that people are doing many things environmentally right [such as urbanization that we define as a problem when it is addressing many environmental dilemmas as an efficient adaptation in a now peopled Earth].
When we go to the gym, we focus on faults and limits rather than build on inherent strengths. We carry forward a sense of hard work that is the very thing we are trying to get away from because it is stressful. Body practices are important elements of health, but, as “deficit practices,” we both resist them and we miss the essential nature of health as being something that is right vs. focus on what is wrong. We miss a great peace that is inherent in the physical space of the center and in our condition at that particular moment in time when we come to the center for “health.” Peace is typically held at bay, as if it is a goal rather than something that greeted us in the morning when we awoke.
In Summary, we become our language.
If our language is about power, that is where we go. If our language is about grace, that is where we go. And the difference is qualitatively different.
EVOLVING HEALTH TERMINOLOGY
Fitness Wellness Thriving
Flexibility mobility suppleness
Strength/power/core functionality balance/proportion
A Comparison Of The Terms Flexibility And Suppleness, With Regard To Their Impact On Health : As a term, “flexibility” seems to offer health, but it is ambiguous. What does being more bendable have to do with health? And this ambiguity is a strong part of the reason why it is not really pursued in fitness. Leaping higher seems maybe functional, while being more bendable does what? But “suppleness” very clearly offers us health, and it is explicit: opening, softening the body rather than constraining the body as tightening muscles do and eventually result in stiffing of the body. It may be “cool” to jump higher as a younger or even middle-aged person, perhaps for some functional balance and surely for competition, but, across the long run, suppleness becomes clearly more important for health in a way that tight muscles only secondarily match.