Blood-letting was a common practice up to the late 19th Century, and doctors were depicted smoking cigarettes well into the 20th Century. Can you imagine what current medical practices we’ll shake our heads in disbelief at 50 years from now?
As the subjective experience of patients – their concerns, hopes, fears, beliefs and desires – begins to be more deeply taken into account by healthcare practitioners, a revolution in healthcare is occurring. It is not so much coming from within the medical establishment, as it is from within the people though.
Power to the People
People are becoming more empowered in the way they view and experience their bodies and their healthcare choices. It is with this in mind that I explore the differences between the conventional Restorative Therapeutic and newly emerging Reorganizational Healing approaches in this post.
Instead of being meaningless, peoples problems become diseases of meaning, enabling people to see that things are not necessarily going wrong but are, in fact, helping them become stronger, to live more fully and with more understanding.
Jobst, Shostak, and Whitehouse, 19991
Most people visit a doctor or health care provider because they have a growing concern. They are experiencing a symptom or a variety of symptoms that feel unfamiliar to them, and they want to make sure theres nothing really wrong.
Depending on the philosophy and training of the practitioner they visit however, what happens during that interaction can vary dramatically.
The objective of this post is to give you a better understanding of the underlying assumptions a practitioner might be making when it comes to addressing you and your symptom patterns. The practitioners assumptions about you, your condition and your possible outcomes stem from their background, beliefs and experience working with patients.
Im going to contrast the two extreme ends of the spectrum when it comes to healthcare. Many practitioners fall somewhere in between.
Restorative Therapeutics (RET)
The common paradigm in health, medicine and surgery (generally associated with the Western medical model whereby one party, the healer/therapist/professional does something to restore the other the patient to a prior state of functioning), can be called Restorative Therapeutics (RET).
The extreme version of the RET approach views diseases as problems that must be fixed, while usually at the same time isolating these problems from the rest of life, and denying their depth of meaning.
The goal of RET even in a moderate form (which can include many Complementary and Alternative Medicine methods) is to restore the person to where (and who) they were before the problem.
If a practitioner fully subscribes to the RET approach, their sole objective is to stabilize, reduce, control or eradicate a symptom pattern so that the patient can return to the lifestyle they were living with as little inconvenience as possible.
The role of the patients subject, or inner experience is not considered, or is considered to be of much less importance than the measurable/objective symptoms or condition.
Reorganizational Healing (ROH)
A newly emerging paradigm in health and wellness care, called Reorganizational (ROH), contrasts with RET. The ROH approach views diseases as representations of various aspects in an individuals life and as a manifestation of health in that these aspects can be seen and can serve as a source of growth, understanding and opportunity for greater awareness, all ultimately reflections of the meaning attributed to the event or phenomenon.
When exploration of depth of meaning is encouraged, disease can become a catalyst for people to grow, and in so doing, to heal themselves.
In the ROH approach diseases of meaning are diseases attributed to and arising from an individuals or societys perspectives, worldviews, and overall life stressors. Thus problems can be viewed as calls to know the self, the bodymind, more intimately in order to facilitate change and to grow stronger, healthier and wiser.
These “diseases” inextricably link the individuals self-perception and meaning to the problem.
What Does Better Really Mean?
Few would argue that almost all healthcare practitioners genuinely want to help their patients feel better. As a patient however, it is critically important for you to understand what better means to both you and your practitioner.
Does it mean that you feel less of the symptoms that you came in with?
Does is mean that you now have a treatment that helps you be less irritated or inconvenienced by the symptoms or condition?
Does it mean that you are stabilized, meaning that at least you arent getting worse?
Does it mean that your subjective experience (how you feel about the way you feel) is also improving?
Better is qualitative term that means a lot of different things depending on what outcomes a practitioner is actually measuring, so it is important to ask your practitioner: What are you actually measuring? How will you know when Im better? What is your definition of better?
ROH Is An Inside-Job
One of the benefits of the ROH approach is that beyond the practitioners own view, ROH also takes the patients inner-experience of better or worse into consideration.
From the ROH perspective, it is essential that individuals have mechanisms by which they can have an awareness of the present time; how they drop to a lower level of functioning, behavior, and perception in the face of disease, problems, or life stressors; and what they can do to function at a higher level, a new baseline of well-being, in spite of lifes challenges.”
In this context, reorganization relates to the increasing ability to thrive in the face of greater demands in every domain (physical, biologic, emotional, mental, spiritual, social, and cultural).
There are times when procedures that address the mechanical structures of the body without extensive consideration of a persons internal state of awareness are necessary (someone rushed to ER in an unconscious state, for example).
But in most cases – especially in cases of chronic disease – the proposition that disease can be viewed as manifestation of health (that it can bring about positive changes in understanding and perception and consequently changes in behavior, relationships, and physiology) brings an entirely new perspective and new set of possibilities for an individual to grow and thrive.
To learn more about ROH download the entire 2009 Article published in JACM.
Want to experience the ROH approach? Learn how to make an appointment.