"The penalty good men pay for indifference to public affairs is to be ruled by evil men." attributed to Plato

"Bad men need nothing more to compass their ends, than that good men should look on and do nothing." attributed to Edmund Burke

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Thursday, 20 February 2014

Healthcare and the incredible reinvention of medicine

In these musings of mine around the subject of healthcare we must not forget to give proper credit for the many wonderful advances that are being made in medical science; the technological achievements, the surgical and clinical skills, the development of ever more efficacious drugs and the efforts of the very many health care professionals working competently and tirelessly using best knowledge, experience and facilities for the benefit of the patient.
Lyme Regis February 2014
Perhaps more doctors than we realize do understand and practice the philosophy of holistic health care, with due regard to the full impact of body, mind and spirit in considering the ‘wellness’ of the person. Even so it is unlikely that this can often be realistically achieved within the normal time constraints of a busy practice. Nevertheless there is an opportunity here that should not be ignored; indeed we may not be able to ignore it for much longer, given the escalating costs of traditional healthcare.

Several years ago I picked up in our local library a very battered secondhand copy of Healing Words: The Power of Prayer and the Practice of Medicine by Larry Dossey. I hadn't heard of Dossey at that time, and I was intrigued by the book’s title. Now I realize that Dossey has been in the vanguard of mind body healing for some time and is even sometimes credited with being the father of this genre of medicine with which so many are still uncomfortable. His influence was perhaps first felt in the 1990s with Healing Words. Upon reading further, I was immediately fascinated by Dossey’s division of the history of medicine, from when it first became scientific in the mid 1800s, into three Eras.
Studland Bay January 2014
The first 100 years or so from around the time of the American Civil War of Independence up until around 1950 he calls Era I, the rise of ‘mechanical medicine’, because, he says, ‘of its adherence to classical, mechanical physics.’ Era II from then until the first publication of his book in 1993 and still developing to this day he described as the age of mind/body medicine. During that period there was an increasing recognition that the state of a person’s mind, their thoughts and emotions can affect the physical body and cause what is usually described as psychosomatic illness. Such illnesses are often unfairly misrepresented, by being thought of as imaginary, or ‘all in the mind’, a misnomer that is unhelpful to the further study of this important phenomenon. Dossey now says that he prefers to look at this concept the other way around: that it is better to show how positive feelings keep us healthy, or whole.

Both Era I and Era II medicine remain, he says, ‘wholly devoted to the tenets of classical science as an explanation for all events, including the actions of the mind.’ Dossey also talks of an Era III, the era of non-local mind medicine. But that is for a later post…

If you are finding this series of blogs interesting, I have treated other vital aspects of our lives to a similar analysis - always urging spirit over matter - spirituality and healing over materialism and curing, bringing a more holistic lens to our economy, creativity, creation, pastoral issues, and so on… 
All in Healing This Wounded Earth: with Compassion, Spirit and the Power of Hope.

What readers are saying about Healing This Wounded Earth:
"Within a few pages ... I was making a mental list of all the friends and colleagues I wanted to give or lend this book to. I loved reading this book and am sure will turn to it again in the future."
From review by Dr Yvonneke Roe GP in London, in Network Review, Journal of the Scientific and Medical Network 

Saturday, 1 February 2014

Mindfulness and Mental Health

I wrote in this series on 31 December last year, perhaps a little optimistically, that we are seeing the dawning of a new paradigm in the history of medicine, entering an era where the spiritual healing needs of the patient can be met alongside both alternative and complementary therapies and the very best of the latest clinical medicine. I said that there are certainly pockets of excellence across the healthcare establishments, for example the Integrative Medical Clinic, of Santa Rosa, California, at the very forefront of this exciting new world of enlightened healthcare.
But this dawning is truly only a glimmer at the moment.
As in so many fields the UK will in due course follow the lead of America in the full recognition of truly holistic healthcare that is available for all.
But a great deal of work needs to be done
on both sides of the Atlantic.
This is made very clear as far as the UK is concerned in an interesting recent post in the Webzine Bidushi, "Mindfulness for mental health: snail’s pace provisioning in the NHS." This article emphasizes just how poor the provisioning still is for mindfulness-based therapies for mental health in the UK, in spite of the recognition of its benefits by many, including many doctors, and in spite of its recommendation by NICE, the National Institute for Health and Care Excellence. "On 20th January the UK’s Deputy Prime Minister Nick Clegg gave a speech to launch the government’s “Mental Health Action Plan”, a speech that makes no secret of how
the importance of mental health has been consistently marginalised in society, policy and National Health Service (NHS) provisioning
till now."
The article in Bidushi makes particular reference to Mindfulness Based Cognitive Therapy MBCT, acknowledged to be extremely effective for the treatment and cure of depression and anxiety, yet still woefully unavailable for most patients. Instead antidepressants and other drugs are doled out time and time again, drugs with known and indeed unknown side effects,
drugs which cost far more than the cost of MBCT sessions,
and drugs which effect no cure, only mask the symptoms.
The article has some fascinating statistics about the disparities in mindfulness availability across the country and in the understanding among health care professionals of both its effectiveness and availability. It also highlights the tireless efforts being made by John Kapp who for 4 years now has been campaigning for much greater access to mindfulness techniques in his own Brighton and Hove health area.
Why does our healthcare system seem so reluctant to extend the availability of mindfulness based treatments for sufferers of depression and anxiety: when we know these treatments work and when so much money could be saved by the cash strapped NHS? Could there be vested interests at play here, from "Big Pharma," the pharmacological companies who have so much to lose from the drop in sales of antidepressants and other drugs to treat depression and anxiety?


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