A Note on the Genesis of Illness: A New Direction for Healthcare Practice

As a practitioner of integrative healthcare, I apply the term “integrative” to pertain to a different model of understanding of how human experience works. My use of “integrative” means bringing into balance the 5 significant areas of our functioning making up our experience and existence in this world: physical, emotional, mental, social, and moral. The term integrative is in contrast to the common current use of
the term meaning mixing, eg, natural medicine with conventional medicine or chemotherapy with herbs.

The current concept underlying medicine, natural science, and psychology is that of cause and effect, or what is known as “determinism.” For example, the conventional medical framework posits that the pneumococcus causes pneumonia. This is a straightforward cause-effect statement blithely accepted without question by the general populace, as well as by other natural scientists who champion this model. However, what if the response of the patient upon hearing this “authoritative” statement was, “By the way, doctor, my dog died this week, my wife left me, I lost my job, and my stock portfolio crashed. I have been in shock and have been weeping at all these losses. Don’t they have something to do with the onset of this pneumonia I am suffering from?” The doctor’s rejoinder is usually peremptorily, “That’s ridiculous. I told you what the cause is: it’s the pneumococcus!” The response of the “patient” highlights the different model I alluded to above. This paradigm is an acausal, non-deterministic model of healthcare, where conclusions are not drawn. Rather, the parts are put together to form a whole picture, where the pieces are integrated, like a mosaic where the different elements are brought together to form a whole. The consequence of this approach promotes healing and overall health benefits.

THESIS
I have written about this healthcare model in other articles, but I have introduced it sketchily here as a backdrop to the major thrust of this paper. The thesis here is that doubt is a seed planted in consciousness out of which emerge all the disturbances suffered by us in the course of our lives. It manifests in all the 5 areas of our existence: doubt is the mental component; guilt feeling, the emotional component; physical imbalances, the physical component; ambivalence, the social component; and lying, the moral component. Over my many years in clinical practice, I have been struck by the insidiousness of doubt in its contribution to the development and perpetuation of imbalances in people. In my quest to understand this phenomenon, I discovered that the ancient wisdom texts of the West are healing manuals replete with information about the sources of illness and imbalance. One such text is the Sermon on the Mount. In it, the Master of Christianity identifies doubt as the source of evil (ie, falsehood) and ill health and provides an elegant prescription for eliminating them from our lives.

Again you have heard that it was said to the men of old: You shall not swear falsely but shall perform to the Lord what you have sworn. But I say to you: Do not swear at all . . . And do not swear by your head [logic], for you cannot make one hair white or black. Let what you say be simply “Yes” or “No”; anything more than this comes from evil [falsehood].

Matthew 5: 33-37.
The significant words here are “Yes or No,” “anything more,” and “evil.” For the words “anything more” I shall use a synonymous term—surplus—which means an excess. These words contain the seed for creating a model of healthcare consonant with western spirituality. As we delve more deeply, we may find the basis for a modern mindbody* healthcare paradigm as well. How is “Yes or No” connected to mindbody phenomena?
Here is the tie-in. The action of “yes” can be seen as being connected with the first cervical vertebra, known as the atlas. The free movement of this vertebra allows us to nod “yes.” The second cervical vertebra is called the axis. The free movement of this vertebra allows us to move our heads from side to side to indicate “no.”1 The atlas is what holds up the world. The axis relates to how the world spins. On the micro-anatomical level these 2 vertebrae represent the macro-existence of this planet. When there is a disorder, displacement, or derangement of these Gerald Epstein, MD, is in the private practice of psychiatry and integrative healthcare in New York City, an assistant clinical professor of psychiatry at Mt Sinai Medical Center, and director of The American Institute for Mental Imagery, a postgraduate training center for healthcare practitioners.

*The author prefers to combine the words “mind” and “body” to preserve the unity of the relationship between mind and body. Genesis of Illness 17 2 vertebrae, the entire spinal column can be thrown out of order, creating all sorts of faulty curvatures and postural disturbances. It is well known, especially among osteopaths and chiropractors,how central and seminal the spinal column is in terms of connecting to health or illness physically. Many nerves pass through the spinal column. The impingement on them created by the distortions of vertebral malformations has profound effects on the rest of the body, ie, the musculature and organ systems. Added to this is the torque produced by postural compensations effected by spinal column displacements, reflected in muscle spasms and constrictions of arteries flowing through the affected muscles, subsequently cutting off the blood supply to various organs, resulting in organ pathology, perhaps all the way to cancer eventually.

What is the source of this bodily breakdown? The answer resides in the “yes or no.” When “yes or no” is replaced by “yes and no,” we have discovered the source for the mental/emotional and physical disturbances besetting us. In the Western tradition, it is said that the mental activity of doubt is the seed source of all our difficulties. This point is highlighted in the story of Adam and Eve. In the Garden of Eden, Eve is told by God to listen to His voice alone, the One voice. However, the serpent appears as the voice of doubt in the Garden and whispers in Eve’s ear to eat the fruit of the tree of the knowledge of good and evil to become as gods. This is the tree whose fruit God explicitly warned Eve and Adam against ingesting lest they should die. The serpent’s seduction and suggestion, however, is quite persuasive. Eve now hears the second voice, the voice of doubt. The word doubt means 2, a number that represents conflict in the numerical system of the Western wisdom. Eve now begins to doubt whose voice to obey. The word obey means “to give ear to.” She is torn, in angst, and grave doubt, in the throes of “yes and no” before she finally succumbs.

This story represents the struggle of human beings, faced with choices on a day-to-day basis. Many of us are in a constant state of doubt, indecision, ambivalence, afraid to choose, maintaining “yes and no” almost perpetually. Try moving your head yes and no at the same time. What do you experience? This is the effect of doubt on our biomental system—the intimate relationship between mental and physical functioning.

IMPLICATIONS
As doubt continues and expands we can begin to see a whole host of emotional/mental and physical reverberations. In the emotional/mental realm, obsessional-compulsive activity, phobias and tics, are all examples of the struggle of “yes and no” trying to become “yes or no.” The exaggeration of “yes and no” becomes manic-depressive illness, the constant alternation of “yes and no” manifested as elation and depression. If we extend this exaggeration further, we come to the most severe ambivalence imaginable: schizophrenia. Within that description we find its culmination in catatonia, the epitome of “yes and no” brought to its most “exquisite” expression, virtually to a standstill. This is not to say that in any one individual there is a continuum from doubt through various physical ailments (for, after all, according to this view, physical imbalance reflects our being in doubt), emotional/mental aberrations all the way to schizophrenia.

What strikes a particular person will be quite different from the next, but, in my experience, the common denominator for everyone is “yes and no”! I would now like to discuss the word surplus (anything more). This translates into moving from “yes or no” to “yes and no” through the morass of the surplus or excess of mental machinations— reflected by rationalizations, justifications, explanations, defensiveness, excuses, opinions, attempts to convince, and all other sorts of stories that are constructed to maintain the state of indecision that paralyzes action—which reflects as stasis, stoppage of movement, and immobility in us both physically and mentally. These are but some of the surpluses alluded to in the Sermon on the Mount. They are all distortions created to support “yes and no,” diverting us from the perfection “yes or no” can lead us to. After all, God enjoined us in Deuteronomy 30 to choose constantly between life and death, good (truth) and evil (fabrication, falsehood). The struggle is to choose. From this
choice emerge the great existential struggles we face on earth.

Healthcare public relations firms allow new practitioners to get a leg up on the competition

These days, college graduates have a multitude of options when choosing a career. More often than not, young upstarts want to have good benefits, a steady salary, and room to move up the corporate ladder. With these fundamentals securely in place, anything is possible and the sky is most certainly the limit. Some recent college graduates might have a different set of priorities, however. They still want to be able to make a living, but they also might want to try and make a difference in the world. This may seem a little trite and corny, but that does not make the pursuit of said goals any less noble. Many of these individuals choose a profession that will allow them a certain amount of financial freedom, but they want to ensure that they will be able to help people. It is this type of thinking that leads people to become doctors, clergymen and women, social workers, advocates, and activists of all stripes and persuasion.

However, in recent years, there has been a unique trend for a certain type of individual to join the ranks of a corporation or other business entity that specializes in the field of healthcare public relations. Now the public relations part of the name might set off more than a few alarm bells in prospective graduates. Images of smarmy, inconsiderate individuals in ponytails who drive convertibles and cut people off discriminately might come to mind, but in reality, this could not be further removed from the truth. Many individuals who practice the fine art of healthcare public relations view their work as a service to the community. These unique practitioners of healthcare public relations want to be able to help the community by allowing doctors to practice their craft, without worrying about putting people in the seats, so to speak. They want doctors to focus on medicine, and not worry about all the excess baggage that comes with running a small business, especially one that is so emotionally charged and can directly affect the quality of people’s lives. Employees of a firm that specializes in the field of healthcare public relations view themselves as modern day knights, fighting for the rights of doctors and for the ability of these doctors to continue to practice the fine art of medicine.

So what are the qualifications to work in a healthcare public relations office? For starters, one of the most important attributes of a prospective healthcare public relations employee is a passion for helping people. The need to help people will drive a healthcare public relations employee to vigorously defend his or her client’s reputation. In doing so, he or she will be allowing the medical practitioner to successfully enrich the lives of their patient. So in a way, the healthcare public relations employee is just as important as the doctor. While one may require years of training, and actually does the hard work, the healthcare public relations employee has to do all he or she can to enable the medicinal practitioner to be able to do their work. If the physician or hospital administrator just focused on medicine and not how they are being perceived, then the quality of care would most definitely increase, but the mechanics of the medical office would be in tatters. Therefore, it falls under the purview of the healthcare public relations employee to assist the doctors, surgeons, nurses, dentist, orthodontists, and medical practitioners of the world do their jobs.

Health Care Public Relations: Still a Pitch and Place Game

Media relations remains a core competency for those engaged in the practice of health care public relations. Health care public relations efforts are fueled by effective pitching and generating top tier media coverage. Through developing relationships with targeted reporters and news outlets, healthcare companies and organizations can better inform the public of their mission, policies and practices. Here is some advice on effectively pitching to health and healthcare reporters. The advice comes from a health care public relations professional, seasoned through years of experience.

Target: Find the most relevant person at the most relevant outlet. Targeting specific media outlets and specific journalists for each pitch increases the likelihood of landing coverage and is a major reason for success in health care public relations. Honing in this way allows for you to take a step back and really consider your audience. Who is this pitch intended to reach? What media outlets do these people pay attention to? What journalists have recently covered this topic? These are all good questions for health care public relations practitioners to ask themselves before pitching.

Check editorial calendars: Editorial calendars inform health care public relations practitioners when and what publications will be writing about. These should always be checked before pitching because they will be beneficial in coming up with the best pitching angles. To illustrate, perhaps a top healthcare trade publication is doing a special feature on heart disease. As the health care public relations representative for a company that specializes in treatment options for heart disease, this is the perfect opportunity to have a spokesperson provide commentary.

Breakthrough the noise. Journalists receive numerous email and phone pitches daily. In order to stand out, your pitch needs to be creative, different and memorable, a critical skill possessed by most health care public relations pros. Entice journalists by playing to their interests. The reader should be instantly engaged in your pitch and want to read on. Any pitch that seems too much like an ad will likely be disregarded by journalists. To avoid having a pitch that is too self-promotional, it is important to stretch beyond and tie to a larger issue or event.

Simplicity is key. When pitching to the media, keep pitches short and to the point. The point of utilizing pitching for your health care public relations efforts is to get the media hooked and make them want more information from you. Therefore, there is no need to include every detail in your pitch. This also sets the stage for you to develop two-way communication and relationships with these journalists.

By using the above tips, healthcare companies and organizations should be able to pitch more effectively and see an increase in generating placements in key media outlets. This will not only increase media coverage, but position health care companies and organizations ahead of the competition.