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Integral Health Model
 
THE INTEGRAL HEALTH MODEL

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Introduction

For the past decade or so, it has become obvious for many of us in medicine that a new model is needed. A model that will assist us in dealing with the ever increasing incidence of chronic disease, that acknowledges the multidimensional nature of the human being, and at the same time embraces alternative systems of health delivery that are often less invasive and more effective.

George Engel writing in Science in 1977 wrote that psychiatry and biomedicine were in a crisis because they both adhere to a model of disease no longer adequate for the scientific tasks and social responsibilities of either medicine or psychiatry. Engel proposed a new "biopsychosocial" model that takes account of the patient as a person as well as of the illness.

The Integral Health model we wish to present here extends Engel's model and is patterned after works of Ken Wilber, Jean Gebser and others.

Humanity has evolved from a simple consciousness to self-consciousness and is now ready for its next major transition: from self-consciousness to integral consciousness. Integral consciousness is an emergent psycho-historical development of humans. With this awareness, the interaction between physician and patient changes; we can no longer adhere to the mechanistic "fix it" mentality of the disease model.

Integral Health here means integrative, inclusive, comprehensive, and balanced. As Wilber writes "To understand the whole, it is necessary to understand the parts. To understand the parts, it is necessary to understand the whole. Such is the circle of understanding."

The value of any model lies in how useful it is. We have been using this Integral Health model with increasing success and would like to invite feedback from other health practitioners engaged in similar practices and clients who share a similar experience in their lives. As Wilber points out, any phenomenon can be approached in an interior and exterior fashion and also as an individual and as a member of a collective. In the following table, we have included a key theorist in each of the four quadrants that makes up the Integral Health model.

Before discussing these in detail, it is important to recognize the power of the Internet in the future of medicine. In conventional medicine, hospitals and doctors were responsible for the medical environment. Now the consumer is in the driver's seat. Much of what people want -- and can have because of the Internet - is self service. We would like to provide a new platform (context) for individuals to serve themselves with coaching from EM.com. By integrating the best of conventional and alternative medicine, we can delay, prevent, and in some cases, actually reverse the diseases associated with aging - you can now "live better longer."

We believe that these preventative medicine oriented physicians, chiropractors and other health professionals can best deliver this model. Certain Medi-Spas, especially Day Spas and Destination Resort-Spas, are ideal locations for people interested in incorporating this model into their lives. Moreover, Lifelong learning and useful products can be provided with the help of the Internet, and the EM.com team of health professionals.

Integral Health Model of Wellness

Table 1
Until recently, most of what we know as medicine was largely confined to the upper right quadrant. In fact, most medicine practiced today is still predominantly from this quadrant. About 25 years ago, wellness medicine and mind-body practices began to be appreciated (upper left quadrant) but this too is incomplete. As Antonovsky (1994) wrote, "And yet, the voluminous writing of - shall we call it the holistic approach to health? - as far as I can tell shows a near total absence of reference to or awareness of the larger social system in which the mind-body relationship operates."

History, culture, world view, and social structure are all vital (lower quadrants) in understanding the roots of health and well-being.

Systems theory (lower right quadrant) gives us a framework for alternative medicine. As Ranjan pointed out in Advances in Mind-Body Medicine (1998), "The notion of relativity, that the same element can assume a different identity according to the context on which it operates, points to one of the most salient differences between biomedicine and other medical systems. In biomedicine, pharmacology, for example, emphasizes an "active ingredient" regardless of context. Herbalism, on the other hand, emphasizes context, with the impact of the whole not only being greater but even being different from the sum of the individual parts."

Von Bertalanffy writes, "The existence of laws of similar structures in different fields enables the use of systems which are simpler or better known as models for more complicated and less manageable systems."

Ranjan concludes that it is precisely within this kind of conceptual scheme that Ayurveda and Traditional Chinese Medicine, and other alternative medical systems have been developed. In Ayurveda, the simpler and better known model is called the "doshas"." In Chinese Medicine, there is the model of the "5 elements" and "yin and yang," in Homeopathy, the "law of similars."

If we look at Table 1 again, we can see how a particular medical system will have a strong influence on the cultural world view, which will set limits to the individual thoughts which will register in the brain physiology. And as Wilber points out, we can go around that circle in any direction. They are all interwoven. They are all mutually determining. They all cause, and are caused by, the others, in concentric spheres of context within contexts indefinitely.

The Integral Health Model we have introduced attempts to deliver a new health model that honors all four quadrants.

(1) Exterior Objective
The first step after a client has decided to enroll is to complete a MetaAnalysis. This includes a comprehensive physical exam, fitness test, organ analysis, biomarker analysis together with select laboratory and other objective testing that may be necessary.

After completing the MetaAnalysis, it becomes part of a Lifetime Health Assessment and Monitoring Program (LAMP). A personal wellness and longevity program is designed for each client to complement the LAMP. Nutritional, fitness, detoxification and lifestyle recommendations are also recommended.

(2) Interior Subjective
Self-assessment literature, which includes several hundred studies over the past three decades, indicates that people's reports of their own health are a global measure of the quality of their lives. It more powerfully predicts survival than do clinical assessments based on examinations by physicians and laboratory tests (exterior objective).

Well-being is emerging as the "best measure" of individual health based on the U.S. Surgeon General and the Public Health Services, Healthy People 2,000 (1991). Since well-being is a subjective quality, health under this quadrant also becomes a subjective state.

Ellen Idler and Stanislav Kasl conclude from the Yale Health and Aging Project that self-evaluations of health predict mortality above and beyond the presence of health problems, physical disability, and biological or lifestyle risk factors.

What we have been interested in is what allows individuals to go beyond the physical for their sense of well-being. Our belief is that a sense of the spiritual and an integral worldview are the common sources of inner health and wholeness. Well-being is clearly an interior subjective and intersubjective state.

The fundamental meaning of "spiritual" as taken from the Greek word "pneuma" and the Latin "spiritus" is breath. "Spiritual" is thus anything that gives us a second breath, a feeling of wholeness and being fully alive. This is consistent with the original meaning of "health," which comes from the old English and early German terms for a state of being whole. Meditation, Relaxation, Lifelong learning, Guided imagery, Depth Psychology, and Prayer can be used to assist each client in the individuation process. Individuation, a term coined by Carl Jung, should not be confused with the selfish individualism of the past decade. It is a lifelong process in which a person becomes increasingly whole. Individuation entails the gradual expansion and intensification of consciousness. The individual recognizes that the ego is not the center of ones being, or as Jung writes "One could say, with a little exaggeration, that the persona is that which in reality one is not, but which oneself as well as others think one is." The recognition of the Higher Self or the spiritual is an important part of the Integral Health Model. Various assessments on the interior subjective state and lifestyle pattern of the individual are also done and included as part of the LAMP. Lastly, several mind-body health tools are give to each client as part of their wellness program.

(3) Interior Intersubjective
It is not enough for information to flow through the senses. To make sense of the senses requires a context that organizes the information they convey, that tends it the proper meaning. Cognitive development is cumulative.

The work of Jean Gebser best articulates this context. Gebser in 1943, along with political historian Eric Voeglin and psychoanalyst Carl Jung, independently recognized that the mounting crisis for Western Civilization was in fact a fundamental restructuring (part of the new Integral Health Model). Prior to the initial recognition of perspective in Europe around 1250 AD, the human lacked spatial awareness and thus lacked an ego-consciousness or a definite sense of self. Giotto was one of the first painters in whose work we can see this objectified world. We live today in this modern world or what Gebser terms the "perspectival era" See Table 2. Prior to this time was the "unperspectival era" consisting of the archaic, magical, and mythical periods. Gebser was very aware of the new era dawning for humanity - the "aperspectival era."


THE BASIC SCHEMA*

TimeSpaceSense Organ StructureSpiritEra
5 MIL-
200,000 BC
0Body-Kinesthetic
Smell
ArchaicMystique Unperspectival Era
200,000-
10,000 BC
1 DEarMagicalRitualUnperspectival Era
10,000-
2,000 BC
2 DMouthMythicalGods/SymbolsUnperspectival Era
2,000 BC-Present3 D Eye Mental God/DogmaPerspectival Era
Future 4 DMeta-SenseIntegralOverself/ TranscendentAperspectival Er

Table 2
*Modified after Jean Gebser

Each structure of consciousness has its own understanding of space and time along with a predominate sense organ. The integration of these five copresent structures in each of us prepares the ground for the transformation humanity (and Medicine) so desperately needs at this moment. We need to assimilate the entirety of our human existence into our awareness. With this integration, an integral world view and greater sense of well-being develops. It is in these individuals that we recognize what Aaron Antonovsky called a "sense of coherence," that is, they see the world as comprehensible, meaningful, and manageable. Culture (world view) is nothing more than collective shared meaning.


EXAMPLE OF TWO STRUCTURES OF CONSCIOUSNESS

Mental StructureIntegral Structure
Domination of NatureReverence for Life
PartsWhole
Ego Fulfillment Ego Transcendence
Space Fixity Space Freedom
Obsession with Time Time Freedom
Knowledge Wisdom
DiscussionDialogue
Lack of MeaningMeaning
ScarcityEnoughness
BoredomWonder
Dis-ease Well-being

Table 3

Again, assessments are made to determine the primary structure (world view) of the client and become part of the LAMP.

(4) Exterior Interobjective
This quadrant is about functional fit. It is clear that a systems approach is needed to integrate alternative systems of medical practices with conventional medicine. We incorporate:
o Traditional Oriental Medicine
o Anthroposophic Medicine
o Ayurvedic Medicine
o Environmental Medicine
o Homeopathic Medicine
o Naturopathic Medicine
o Chiropractic Medicine

At times we use these different medical systems to assist the client. Each medical system has its own unique methods.

The Value of Integral Health
We believe that as much as 90% of all illness can be cared for by individuals who understand this new context for health and the transition from our current mental structure to the emerging integral structure of consciousness (Table 3).

The single most important lesson in life is that we are here to learn and grow into whole healthy human beings who are not merely clever or successful but in touch with our deepest roots. These roots are anchored in the Ultimate Reality itself. The institution that is most suited to bring about this transformation, believe it or not, is the health care industry.

The details of the evolution of our species consciousness through the five distinct periods mentioned is well described by Gebser in his 1943 book The Ever Present Origin. A summary of some of his work can be found in the Monograph - Remembering the Future.

These same stages must be integrated into own psychological growth. Of central importance for this "ordering of consciousness" and emergent sense of well-being is anamnesis or "remembering" of both our personal (subjective) and species (intersubjective) psycho-historical development. (Ontogeny recapitulates phylogeny).

The same context that defines the Integral Health model also defines the transformation now occurring in all our institutions and also underlies the deep ecology movement now underway since we recognize that you cannot have well people on a sick planet.

We are now ready to expand this Integral Health Model and invite both health professionals and those interested in learning more about Integral Health to join us. You can best do this by contacting us at EM.com

Bibliography
1. The Evolution of Consciousness, Robert Ornstein (1991, Prentice Hall Press)
2. The Creative Imperative, Charles Johnson, M.D. (1986, Celestial Arts)
3. Multi-Mind Robert Ornstein, (1986, Houghton Mifflin Company)
4. The Ever Present Origin, Jean Gebser (1985, Ohio University Press)
5. Up from Eden, Ken Wilber (1986, Shambala)
6. Frames of Mind, Howard Gardener (1985, Basic Books Inc. New York)
7. Life-Force, Jean Houston (1980, Delacorte Press)
8. LSD Psychotherapy, Stanislav Grof, M.D. (1980, Hunter House Inc.)
9. Art and Physics, Leonard Shlain (1991, William Morrow & Co. Inc.)
10. The Universe Story, Briane Swimme and Thomas Berry (1997)
11. The Five Ages of Man, Gerald Heard (1963, The Julian Press)
12. The Paleolithic Prescription, Boyd Eaton, M.D., Marjorie Shostok, and Melvin Konner, M.D., Ph.D.
13. Unfolding Meaning, David Bohm (1985, Foundation House Publications, England).
14. Carl Jung (Collected Works)
15. Eric Voeglin (Collected Works)

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