1- Editorial

The meaning of holistic

Said Shahtahmasebi, PhD.

editor@journalofhealth.co.nz

The term holistic means different things to different people.  The Cambridge Dictionary defines holistic as dealing with or treating the whole of something or someone and not just a part. For example, in holistic medicine, the body and the mind are considered to make the whole, therefore, holistic medicine looks for causes of ill health both mentally and physically rather than treating presented symptoms.

Certainly, some life stressors can be due to deficiencies in our diets leading to both physical and mental issues such as ‘feeling’ down, headaches, lethargy, which can overlap with depressive disorders. Clearly, a course of psychiatric treatment alone would not yield the desired outcome because following treatment the patient would be facing the same problems as before. Often such symptoms can be remedied by behaviour modification such a change in diet and exercise or appropriate physical activities.

For example, common stressors that cause symptoms of mental stress may be influenced by life events and circumstances e.g. economic hardship and food security which then may lead to physical health problems such as headaches, chest and abdominal pains. Treating the physical symptoms alone without addressing the mental stressors may not cure the illness. This is because following treatment the individual still has to face the predicament that led to ill health in the first place. Furthermore, if economic hardship and food security are part of the problem then behaviour modification would be a difficult challenge to achieve. In other words, we continually suffer from an ‘ill’ society.

In my opinion treating body and mind is not really holistic medicine.

For this reason, some medical professions and charitable entities attempt to provide services over and above body-mind medicine by providing financial advice, help with housing, nutritional advice and so on. But, there is no evidence to suggest that information or financial expertise can remove external and internal stressors. Learning how to do creative accounting does not necessarily lead to increased resources. This will involve giving up certain activities or stop funding other activities to which resources have already been allocated. Additional external stressors include individuals facing increased pressure from social expectations and perceptions from advertising campaigns to buy consumer goods. For example, on average after the essential outgoings such as rent/mortgage and power bills are paid for there is little left  of the family income to fund nutritional needs, clothing, schooling, etc. And on average, other expenses are prioritised with nutrition being at the bottom of the list. Therefore, most families on low incomes find that fast food is cheaper and more filling. As a result, the geo-environmental and geo-economic landscape have changed with the expansion of  the fast food industry replacing fresh produce in lower socio-economic areas (Shahtahmasebi, 2006).

The complex dynamics of human behaviour in a global context can be visualised once the mind-body context is viewed as part of the global community. There are economic, environmental, social, cultural traditions, resources, education, nutritional perceptions and expectations that translate into political activities and decision making at a local, national and global level (Shahtahmasebi, 2006).

It may seem simple to understand that, e.g. a budgetary decision at a national level to positively change economic outcomes would affect social, health and other outcomes, and itself will be subject to influence by international economic conditions and decisions made by other governments.

Some authors have applied a reductionist approach by studying behaviour in decision making or choice at an individual level, whilst others have identified human activities that can be regarded as a whole system, e.g. organisational activities, education, health, and food/agriculture (Shahtahmasebi, 2006). Such a model simplifies the understanding of dynamics within individual systems. The problem with this approach is that dynamics is limited to the system being studied and insight maybe biased and partial as often it excludes the impact of interactions between systems on their outcomes (Shahtahmasebi, 2006).

Moreover, due to the feedback effect these systems also have perceptions and expectations of human behaviour. For example, in isolation and without any influence from other systems an increase in disposable income would be  expected to improve food security, in particular in lower socio-economic areas, it is expected to contribute to the local economy. Within the economic system such policies will also coincide with rising living standards from accommodation, to power and transport including fuel. So, partial and biased systematic knowledge, as mentioned above can lead to undesired behaviour modification and changes to the geo-economic landscape, e.g. fresh fruit and produce being replaced by fast food outlets (Shahtahmasebi, 2006).

Governments across the world and universities are in the best position to develop new approaches to fill the information gap in order to lead to holistic decision making.

However, holistic thinking is misunderstood and we are still limited to the best scenario of mind-body approach. The irony of it all is that whilst technology is moving faster than ever in all aspects of society in particular in medicine, we still see on a daily basis governments brandishing poor public health outcome statistics, e.g. heart disease,  cancer and suicide are still the top killers.

Unfortunately, the exclusion of human dynamics within dynamic systems has meant no tangible return in improving public health outcomes from taxpayer investing $billions on health.

Holistic means the influence on an individual who is linked to other individuals (family), who are then linked to others (friends and community) who are then connected to other communities and other systems such as environment, and are all affected by politics.

References

Shahtahmasebi, S. (2006). The good life: A holistic approach to the health of the population. ScientificWorldJournal, 6, 2117-2132.