The Importance of The Connection Between the Body, The Mind, And the Spirit in Medicine

What Is Holistic Health and Why Is It Different From Standard Symptom Analysis

The predominant delivery form of medicine is that a patient brings a list of symptoms to a physician and it is the physician’s job to respond. This is often done in two ways. One way is that the physician analyzes and understands what causes the collective symptoms and treats the underlying cause, which would eventually lead to the symptoms fading. The other option is that the physician looks at the symptoms as individual problems. In this case, a physician might prescribe medication or suggest alternatives to simply diminish or eliminate the symptoms. In this approach, the physical symptoms might fade but the root of the symptoms has not been addressed, which risks the symptoms reappearing. However, holistic medicine is a form of treatment where all aspects of the individual are considered when determining the best method of treatment. Holistic medicine focuses on the uniqueness of the individual instead of grouping and comparing their symptoms with a range of other patients [1]. This means that individuals presenting with extremely similar symptoms may need different courses of treatment depending on their lifestyle, diet, and other personal factors. When this idea is coupled with utilizing alternative treatment approaches before medications, it results in treatment plans ranging from group therapy to dietary changes for patients with similar symptoms. This principle is the defining characteristic of holistic health.

Shift Away From Holistic Care

Centuries ago, before many groundbreaking discoveries and technological developments, a correlation was observed between physical and emotional health. This concept of holistic health is seen in Traditional Chinese Medicine (TCM) and Ayurveda. Traditional Chinese medicine began 5,000 years ago and was primarily focused on examining the body as an entire planet and then determining how everything inside is interconnected. This concept also takes other elements into account, such as “qi” the energy of life, and “shen” which is defined as spirit. On the other hand, Ayurveda originated in India in the 6th century B.C [2]. Ayurveda looks at the balance between three core elements - fire, water, and air. If a person is ill, it must be determined what part is out of balance. In Ayurveda, common treatment options are changes in the diet, acupuncture, and herbal medicine [3].

The shift away from holistic healing started when early physicians desired a more active solution for illnesses. This developed into the debate between support versus intervention which continued until the 19th century. However, an overwhelming drive to accept intervention was made when germs were better understood as having the ability to cause diseases and when it was determined that medications, such as penicillin, were able to destroy bacteria. At that time, the impact of the medication was so profound that the results of healthy lifestyle choices, environmental factors, and emotional health were seen as less important because these new medications were fast-acting, so the results were quickly observable [2].

A century later the limitations of simply prescribing medications to fix all medical concerns became evident. It was consistently seen that these medications could not eliminate chronic illnesses. The benefits could be seen while taking the medication, but the patient became dependent on the medication in order to be free of symptoms, such as pain. Many medications are also associated with an abundance of side effects which has the potential of making medication more harmful than its intended benefit [4].

Overall, medicine is now split into two trains of thought - western medicine and eastern medicine. Western medicine is the generic allopathic practice that consists of medical professionals, such as nurses, pharmacists, and physicians who solely aim to treat symptoms using medications, surgeries, and more [5]. On the other hand, Eastern medicine adapts different techniques to create a healthy body and to prevent future illness. The techniques are broken down into five big categories - acupuncture, herbal medicine, dietary therapy, oriental bodywork, and mind-body bodyspirit practice [5]. These practices can increase the quality of life for patients since they are in control of their outlook without relying on consistent usage of the medicine.

How Are The Body, Mind, And Spirit Connected

Holistic health is assessed by analyzing the health of three main categories - the body, the mind, and the spirit. The connection between the body, mind, and spirit can simply be understood as considering a patient’s mental, physical, and emotional/spiritual state. These categories are imperative in holistic health because these three subsections are extremely dependent on each other. This means that if the overall health of one of the categories begins diminishing, it will also impact another. Thus, the overall health of the individual decreases. For example, when an individual is mentally stressed, their body might show physical symptoms such as sweating and a rapid heartbeat. These physical symptoms might then manifest into having an emotional impact, such as an overwhelming lethargic notion. On the other hand, a link has been noted that mentally happy individuals tend to be kinder and more grateful [6].

 Individuals strive to have good health, which is an absence of disease but it also includes wellness. Wellness is reflected through a balance of the body, mind, and spirit. In other words, a healthy body does refer to lack of disease, illness, and pain, but also takes other factors into account, such as a balanced diet, proper nutrition, and regular exercise. A healthy body includes the interaction with a primary care doctor to address seemingly minuscule problems as they arise and take the appropriate steps if there is an illness. This also includes preventative measures such as screening and vaccines. A healthy mind means managing stress and worry. Since it is impossible to completely cut out stress, this aspect focuses on the ability to recognize and accept that stress is inherently part of life. Once someone can accept the presence of stress, they can find a way to best manage their stress, which is likely to be individualized. It also includes having positive thoughts and feelings of happiness. Other characteristics are sufficient amounts of sleep and the choice to think, analyze, and reflect, which ensures that the brain is active. A healthy spirit is one’s sense of their place in the universe. For many, this includes the notion that there are larger influences that impact life, which is usually determined by religion. Others who do not follow a religion might believe they are completely free to choose what they want to do with their life. They are content living a lifestyle where they believe that there is no higher power. Overall, it provides an explanation for who you are and why you are here [6].

 While the body, mind, and spirit are the main branches of holistic health, the branches can be more closely analyzed by looking at the eight subgroups - physical, emotional/mental, spiritual, environmental, socio-cultural, occupational, intellectual, and financial/wealth. Physical means the observable characteristics of a person. In a cancer patient undergoing chemotherapy, the physical characteristics would be the side effects such as nausea and pain. The emotional/mental state would relate to their mental state. If this individual is completely shocked by their diagnosis or surgery and is struggling to mentally cope with the incident, they will not be able to fully recover. Spiritual health is determining your values and committing to practices that are associated with the selected faith. If the religion followed by an individual who is recovering from chemotherapy states that it is important to always support your neighbor, the individual might put in extra effort to interact with their neighbor. Unknowingly, this interaction has benefited the patient and potentially even the neighbor because both parties socialized. Interactions with friends and family can often benefit the mind since they provide a sense of belonging and a support system [7]. The next category, the environment, has two parts - what you can control and what you cannot control. Some people enjoy surrounding themselves in an organized area while others say that their productivity is increased when they are surrounded by an “organized clutter.” This is something that the individual has control over because they can choose how clean their personal space is. However, if an individual’s living space is surrounded by loud noises or large amounts of pollution, there is not much individual control over the situation. Even though these living conditions are not desirable, the rent might be lower due to the residence being close to a loud or polluted area. If the lower price is the only way the individual is able to afford a house, then the individual does not have control over their living environment. On the other hand, a positive example of the environment would be a good view. If the individual likes flowers and trees and has a good view of them outside their house, they are more likely to be happy. Socio-cultural health is determined by the values of the community. For example, a community that identifies with a culture that values its elders is more likely to provide better support and resources to their elders. Thus, this support might help the elderly maintain better health and even a longer life expectancy. In the context of holistic health, occupational health is determining if the individual gains satisfaction from their primary work. Most people spend the majority of their time at their workplace. If an individual does not feel happy or proud of what they do, it will pose negative consequences to other characteristics of health. Passions and activities that specifically engage and challenge your mind are part of intellectual health. For example, if the individual recovering from chemotherapy only sits by themselves all day, they will not be intellectually stimulated and the disconnect from their passions will starve the mind. The last category is financial wealth which pertains to their economic standard. Individuals who are working hard to make ends meet would rather focus on getting their family food, rather than spend their time and money at a hospital to check on the slight cough or stomach pain they have felt recently. Thus, it can be concluded that ongoing financial instability affects mental and emotional health. Decreased financial health is correlated with lower occupational health because minimum-wage jobs are extremely unlikely to provide sufficient support and insurance. Intellectual health would also decrease because any free time after work would quickly be spread across other responsibilities, such as cooking and cleaning. Lastly, the decreased financial health will also affect environmental health because the house might be cheaper if it is located in a less safe area with improper amenities [7].

Impact Of A Strong Mind On How To Manage Chronic Diseases

The importance of an individual’s mental state on their health is astounding. Neurobiologically, the impact of the mind is categorized as the Placebo effect [8]. The placebo effect can be understood by a trial in which a sample population is taken of people suffering from the same illness. Many criteria are used to make sure the individuals in the sample are similar. Next, the sample is divided into two groups. One group receives the medication being studied which is effective for the illness present in the group and the other group receives a sugar pill, otherwise known as a placebo. The important aspect is that neither group knows whether they received the real medication or the placebo. This phenomenon states that when an individual believes they are given a real medication, even if they actually took a placebo, they will claim that the medication is effective and that they feel better. Even though the placebo did not correct any symptoms nor provide a cure, the patient’s belief that they should feel better is sometimes strong enough to benefit the patient. It should be noted that this phenomenon cannot be applied to all scenarios of health care. It is most often seen in terms of diminishing pain, stress-related insomnia, and side effects, such as fatigue and nausea [9]. A study from 2016 showed that there were even physical changes in the brains of individuals who claimed to have decreased pain after taking a placebo. Functional magnetic resonance imaging (fMRI) showed that there was greater activity in the middle frontal gyrus brain region, which is a large part of the frontal lobe [9]. It is thought that the changes noted in the fMRI are a result of expectations and psychosocial conditioning (Figure 1) [10].

Figure 1:fMRI reflects changes in the brain with placebo effect [4].

The strength of the mind can make a big impact once an individual is diagnosed with a certain disease. Chronic illness is generally defined as a disease that lasts for more than a year. These may impede the individual’s daily lifestyle and/or require persistent medical attention. Examples of chronic diseases include heart disease, cancer, and diabetes [11]. The prevalence of chronic illnesses is extremely high; 60% of adults in the United States have one chronic illness, while 40% have two or more [12]. While an allopathic approach can be used, there is often much trial and error in medications and treatment plans to see what helps the patient. Even if this results in physicians successfully finding a treatment plan, it would be associated with a higher price than an acute illness. This idea can be taken one step further by looking at how the cost increases for every additional chronic illness that an individual has (Figure 2) [13].

Figure 2:Average healthcare cost per person and the increase based on the number of chronic illnesses [3].

A strong mind means that the individual can cope with their diagnosis in a healthy manner. This does not simply mean “positive thinking.” Positive thinking usually consists of maintaining hope that everything will be okay or even return to how the individual’s lifestyle was prior to the diagnosis. However, this notion essentially ignores the information presented to the individual and suppresses any reaction the patient might have. In terms of behavior, an individual might strive to fully act as they did prior to the diagnosis which may end up harming them even more. On the other hand, a better response would be to engage with the diagnosis and for the patient to communicate their fears and uncertainties. It is much more likely that the individual will be able to cope with their diagnosis in a healthy manner if they can even slightly adjust to a new way of living as opposed to continuing with previous lifestyles. Furthermore, slight adjustments may make the symptoms slightly easier to manage since the patient would be working with the symptoms that their body is presenting instead of simply ignoring them [14].

Another aspect of a strong mind is that an individual should see themselves in a positive light. Oftentimes, when an individual is given a certain diagnosis, they begin to think differently of themselves - usually in a negative manner. For example, a study showed that men with prostate cancer saw themselves as being “less manly.” With a thought of lower self-worth, an individual’s mental health might further decline [15]. If an individual is embarrassed by their diagnosis, they will be more reluctant to get help from medical professionals or ask for emotional support from friends and family. These actions will then further negatively influence the individual’s physical and emotional health. On the other hand, there have been many accounts of individuals having a “wake-up call” when diagnosed with a chronic illness, such as cancer. At that moment, they tend to realize what matters most to them and how to potentially change their lifestyle to what makes them happy [15].

Differences In the Strength Of The Mind Based On Gender

Women have a longer life expectancy than men which means that they will often suffer from chronic illness for longer when generally compared to men. In a study conducted to see the lack of support and proper healthcare access for women, it was concluded that women often felt misunderstood. This was due to the responses coming from trusting individuals, such as family. These women were told by individuals close to them that their chronic illness was not real or that they were simply being dramatic. Gender roles can also be influenced by social, economic, political, and cultural factors. Additionally, the amount of care women are expected to provide to others can impact how women manage their chronic illnesses. For example, if the woman is the primary caretaker for children, works around the house, and more, her responsibility to care for others will usually surpass her desire to care for herself. When this notion is coupled with low economic resources, the women’s needs tend to be further ignored and no extra steps are taken to help these female patients. Thus, these patients try to avoid seeking medical help.

However, it should become known that in the holistic approach, and medicine in general, that a physician will never blatantly dismiss concerns and will work with the patient as best as they can to provide the desired result. It is also imperative for physicians to acknowledge that not everyone has the same lifestyle and that different individuals have different levels of other commitments. For example, if a physician recommends that their patient should go on a two-hour walk every day, but the patient has many other responsibilities, the patient will be discouraged from even attempting to meet this expectation if they know it is not possible. However, if a physician says that a 30-minute walk every day is encouraged, an extremely busy patient might be more willing to attempt the goal and might actually go on a walk even if it may not be for the whole 30 minutes. Regardless, consistent attempts made to follow an exercise regimen are much better than giving up from the start [7].

Furthermore, it has been concluded that hormone levels play a role in pain response because pain responses change during menstrual cycles, pregnancy, and with the use of oral contraceptives. Gender norms also play a large role. Masculine men are stereotyped to be tough and resilient to pain, while women are expected to be more sensitive. In other words, it is more socially acceptable for women to talk about their pain instead of men. A study was conducted to show how different expectations correlate to the admittance of pain. In a study, both men and women had to put their hands in a cold pressure tank. When no specific expectation was given, it was found that women had a lower pain tolerance because they removed their hands from the tank faster than the men did. However, the second time, participants were told that the typical man and woman can both keep their hands in the tank for 30 seconds. In this round, there were no longer significant differences in the pain tolerance since both groups kept their hand in the tank for a similar amount of time. It can be inferred that then men took out their hands earlier in this round because they had reached the expected amount of time, so they were confident that they did not give up before everyone else. This study displays the way that gender norms are interrelated with pain levels.

Furthermore, gender bias is also unintentionally prevalent in healthcare. A majority of patients with chronic illnesses are women. However, most medical research is based on studying men. The concept of the overarching, stereotypical men characteristics overshadowing the presence of women and even other men who do not conform to the ideal norms of so-called men is termed hegemonic masculinity [16].

Relationship Between The Patient And Physician

When a patient is diagnosed with an illness, there is an abundance of varying factors and many responsibilities given to the patient. For example, a patient may have to regulate their diet, exercise, take their medication, and regularly follow up with the physician [15]. While a physician can tell a patient what to do, it is ultimately the patient’s responsibility to follow the course of treatment. In other words, the patient’s attitudes and actions can impact their ability to recover. For example, a physician might suggest that a patient will see improvement in the symptoms of their chronic illness if they do one exercise every day. If the patient does the exercises as recommended, then there will likely be an improvement in the symptoms. However, if the patient chooses not to follow the directions, regardless of the reason, there will be no positive change in the patient’s symptoms because they did not care for themselves. The reason could be a lack of time, not understanding the importance, or even believing that there is no benefit from the recommended exercise. There are certain factors that have been identified to influence a patient’s adherence to medication. A high socioeconomic status and a prevalent support group will increase adherence. On the other hand, depression and large co-payments decreased adherence. When analyzing age, it was found that very young and very old patients are least likely to adhere to their course of treatment [17].

The likelihood of a patient following the physician’s recommendations depends on the relationship between them. Ideally, the patient trusts the physician and accepts that the physician is more knowledgeable than the patient. In this case, the patient will likely follow the directions given by the physician. However, if a patient feels unheard or misunderstood, they would likely consider the physician’s directions as more of a suggestion. Therefore, it is imperative to create a positive and understanding relationship between the two parties. In the holistic health approach, the emphasis placed on the importance of forming this relationship increases compliance. Physicians also often encourage the individual to go to a support group for their respective illness. This allows the individual to interact with others and hear about the experiences of others. Most importantly, it would give the individual a sense of community because they would be surrounded by others who can relate to the symptoms and experiences. This support group would allow the individual to build confidence, be proactive in their journey, and benefit mental health [7].

Conclusion

The body produces symptoms to show that there is something that either the body is trying to fix or something that needs to be addressed in the individual’s lifestyle. While allopathic medicine is successful at curing a variety of concerns, via surgery and medications to defeat acute illnesses, it is not always the best approach for addressing chronic illnesses that leave a lasting impact on the individual’s everyday life. The concept of western medicine is reactive to symptoms which makes it extremely difficult to apply these methods to help patients suffering from chronic illness. Thus, it leaves patients with chronic illness fighting for themselves [18]. However, the relevance of interconnectedness between the body, mind, and spirit is highlighted in these chronic illnesses. Compromising the health of one section will either directly or indirectly decrease the health of the other two categories. On the other hand, the opposite can also be true. For example, keeping a strong mind when the health of the body and spirit is decreased,might help to maintain or increase the health of the other two because the stronger health of the mind might have a positive pull on the others. This is demonstrated via the placebo effect. Furthermore, holistic medicine emphasizes that the patient plays a major role in their personal healing, and to some degree, healing is mainly the patient’s responsibility. Part of the responsibility is forming a trusting relationship with the physician so that both parties are fully engaged with coming up with the best treatment plan. Furthermore, a trusting dynamic ensures that the patient is honest with the physician about their pain, their feelings, and their thoughts and commitment to the treatment plan. A vital aspect of the holistic health approach consists of a physician being aware of their patient’s lifestyle in order to suggest achievable goals that can be built upon if the patient is easily and consistently completing the original goals. Furthermore, women often face other obstacles when seeking out medical assistance. Possible barriers are unsuccessful past medical interactions, cultural norms, or financial state. It should also be noted that until recently men were mainly observed in studies so it is harder to gauge the effects of certain things on women. Furthermore, it has also been determined that gender norms have impacted the ability to admit to feeling pain. Overall, holistic health places its emphasis on forming a more transparent relationship with yourself so that you can understand your own needs, which would lead to a happier self.

Future Trends

Training future physicians to only analyze diagnostic tests and symptoms creates a disconnect between the patient and the physician. Instead, an approach that includes training physicians to also observe and examine other characteristics of the patient that may not get noticed through other techniques is extremely important, such as individual characteristics that define the patient. The ability for a physician to make the connection between Western and Eastern medicine would allow for physicians to simultaneously treat patients while also working on future preventative care [5]. For example, if the patient is displaying certain symptoms, Western medicine’s first approach might simply be to diminish the current symptoms. However, utilizing Eastern medicine principles might allow a physician to determine that the symptoms were caused by a diet that does not suit the individual. Altering the diet would prevent the patient from showing similar symptoms in the future.

To benefit the future of patients, it is imperative to use a complementary approach instead of simply defaulting to alternative medicine. Alternative medicine is the use of only non-mainstreams techniques. However, complementary medicine is the integration of mainstream and non-mainstream techniques to allow the patient to have the best possible outcome. The recent increase in adopting more non-mainstream medical practices has caused a shift in terminology from alternative medicine to integrative medicine [19].

A study conducted in South Korea treated patients of a stroke in two ways - only using Western medicine and only using integrative medicine. The patients who received integrative care had a slightly higher cost of care but did have a lower mortality rate than the other group at both check-ins which were conducted three and 12 months after discharge. Similar results were found in a second study done in Texas that determined that implementation of integrative medicine resulted in decreased pain which overall led to a decrease in hospital costs by 4% [20].

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