Painting: Ricardo Shavez-Mndez
Our Sense Of The
Nature Of Health And Our Health
Interventions Are
Dramatically Transforming
I. Overview
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:
Graced,
Luminous,
Whole.
“Well.”
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],
· fitness,
· wellness, and
· thriving.
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” [2000]
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.
FURTHER REFLECTIONS:
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.
