Complementary Approaches to Health

As I mentioned in a recent post, the outer ring of the Wheel of Health focuses on Professional Care, which may include both conventional and complementary approaches to healthcare. A primary goal of integrative medicine is to erase the distinction between conventional and complementary approaches and instead encourage the use of the most effective, evidence-based modalities across the continuum.

 As a public health professional, I absolutely believe in the importance of prevention and primary care services that are typically obtained through more traditional or “Western medicine” practices. However, I also believe in, and have experienced firsthand, the benefits of more complementary approaches, many of which are grounded in more “Eastern medicine” traditions. I have had conversations with many individuals who are skeptical about the effectiveness of complementary approaches. My belief is that if you are open to these approaches and believe they can help you, they will. Whereas if you are skeptical and doubtful of their effectiveness, they likely won’t work for you. I feel fortunate that we all have a choice when it comes to deciding what treatments we seek to help us achieve and maintain our health and wellbeing.

Firsthand experience

I’d like to share my experience with some complementary approaches I have used to help manage anxiety. I have dealt with anxiety since I was a young child. One of the ways my anxiety manifested itself was through a nervous habit of biting the inside of my cheeks. I would chew away as I ruminated on my many worries about school, family, fitting in and all the other concerns of an adolescent trying to find her place in the world. I didn’t think much of it as a kid, but I became more self-conscious about it as I matured. I imagine I looked pretty silly with my mouth contorted to one side or the other. When my husband gently inquired about this habit, it made me realize it was noticeable to others and not something I could keep hidden.

I knew I wanted to break this habit but felt powerless to do so. As anyone who has tried to stop a long-standing habit knows, it can be incredibly difficult to change the behavior. I tried chewing gum to keep my mouth occupied. I tried that bitter tasting chemical that is supposed to help you stop biting your finger nails. I decided to try therapy, to address the underlying issue of anxiety. It helped manage the anxiety to some degree but didn’t break the habit. I eventually decided to see a psychiatrist and try anti-anxiety medication, which to me was a last resort. I try to avoid prescription medications unless absolutely necessary. I started taking a relatively low dose of an SSRI (selective serotonin reuptake inhibitor, a class of drugs commonly used to treat depression and generalized anxiety disorder). I would say it took the edge off a little, but it wasn’t solving the problem I wanted to fix which was the cheek biting. I weaned off the medication after about two years, as it wasn’t doing enough, and I did not feel like trying different medications.

At that point, I felt stuck and resigned myself to living with this habit. Then one day my husband came back from a weekend of camping with some friends and shared some interesting news. A couple of the guys had shared that they were working with a local shaman to help resolve some physical and mental health issues – and that this shaman was essentially a miracle worker, curing their ills. I was somewhat taken aback as these gentlemen are well-educated, highly respected professionals…and the first image conjured up in my mind when I heard the word shaman was “witch doctor.” My curiosity was piqued. My husband gently suggested that perhaps this shaman could help with my cheek biting. I was skeptical at first but willing to try anything to get some relief.

I went for my first visit with the shaman and left feeling like a new person. I had not really experienced energy work before, but I felt like he literally wiped away all negative energy that had been present in my body. It took about three or four sessions to kick the habit, but I did stop biting my cheeks. It felt like a huge weight had been lifted from my shoulders. I did experience an occasional relapse, but I would go in for a booster session and be good as new. The only downside to the experience was the cost – it was several hundred dollars per session and not covered by insurance. For me, it was worth every penny, but I realize I was fortunate that I could afford to seek his services.

I stayed free from my nervous habit for a couple of years but then started to experience more relapses. At this point, our financial situation had changed and we did not have as much disposable income to spend on these services. I sought some less expensive opportunities involving energy work, but they were not as effective at stopping the cheek biting. I felt resigned again to just live with it but knowing that it was possible to break the habit made me continue to seek other options. One day I was doing some internet research about cheek biting and stumbled upon individuals who had success with hypnosis. I was intrigued but skeptical again, as all I knew about hypnosis was the Vegas-style shows where some volunteer from the audience gets hypnotized and does silly things on stage to entertain the crowd. As I read more, I realized that hypnosis was different than that and many people have used it to help stop smoking or to lose weight.

I was hesitant to take the leap until I found a local practitioner who also happened to be a fellow graduate of the Duke health coaching program I attended. This connection gave me the courage to reach out and make an appointment. Once again, it took a few appointments to completely kick the habit. However, in the past year or so since I first underwent hypnosis, I have only had a couple of minor relapses that were easily fixed with a one-time booster session. The cost of hypnosis is much more reasonable and since I sought the services to help address a health issue (anxiety), I have been able to use our Health Savings Account to cover the cost.

I will readily admit that I don’t know exactly how the energy work and the hypnosis helped me break this habit. When I questioned the shaman about how his therapy works, he really couldn’t explain it. His response was basically “if it fixed your problem, does it really matter how it works?” He’s got a point. From what I have read about hypnosis, it is a way to access a person’s subconscious mind to help implement the desired change. The hypnotist serves as a guide, using suggestions that can help you modify your behavior and achieve your goals. Regardless of how these approaches work, I am grateful that they have helped me when conventional healthcare couldn’t. I encourage you to consider exploring complementary approaches if you are not achieving the results you desire through more traditional means.

The Wheel of Health and Your Optimal Health Journey

wheel2-878x1024Today I’d like to share an overview of the Duke Integrative Medicine Wheel of Health (WOH). This wheel provides a framework for creating your personalized health plan – and a map of your optimal health journey. We will explore the various parts of the wheel in-depth in subsequent posts, but for now, let’s look at the big picture.

The WOH represents the whole picture of your health and wellbeing. It is a multidimensional, whole person approach that considers body, mind and spirit. As you can see, it does not focus on just physical health. It goes beyond managing disease and instead emphasizes optimizing health.

Dimensions of the Wheel

You

At the center of the wheel is YOU, because health coaching is a person-centered process. Your health journey is driven by your values, goals and desires. As a coach, I won’t tell you what to do or not to do – you get to decide based on your priorities and what works for you.

Mindful Awareness

Surrounding the center of the wheel is Mindful Awareness. The concept of mindfulness – paying attention on purpose, in the present moment, and non-judgmentally – is a powerful tool and resource for behavior change.  Being more present and aware of what is happening to you and in you can help you respond to changes in your life in a more proactive, engaged way.

Self-Care

The green ring in the wheel represents the seven areas of self-care. People often focus their efforts here when making changes to their health behaviors. Evaluating your current and desired states in each of these areas can help you create a healthier life. These include:

Movement, Exercise and Rest – This area addresses physical activity, whether it be formal exercise (for example, running 30 minutes a day) or general activities of daily living (such as cleaning the house or grocery shopping). Just as important, it also incorporates the need for adequate rest (good sleep is vital!) and relaxation or “down time”.

Nutrition – In a nutshell, eating a balanced, healthy diet that fuels and nourishes your body and mind. There is no specific diet that is recommended. There are some key healthy eating strategies that we’ll discuss in a future post, but it is also based on what works for your body.

Personal and Professional Development –  It is helpful to assess where you are with personal, career or life goals, particularly at times of transition or milestones. These may include work-life balance, financial goals, and personal growth that will support optimal wellbeing. Regular assessment of your goals can reinforce healthy behavior choices.

Physical Environment – Studies have suggested that your surroundings at work and home can impact your health, either positively or negatively. Exposure to light, noise or toxins in your home or work space can have a major impact on how you feel physically and emotionally. On the other hand, a supportive, nurturing physical environment can enhance your sense of peace and wellness.

Relationships and Communication – Research demonstrates that positive relationships built on open, respectful communication with family, friends and colleagues can have a beneficial impact on your health. Identify those relationships in your life that fuel you and those that drain you. In doing so, you can invest in your positive connections and minimize or re-evaluate those relationships that don’t serve you.

Spirituality – This area is about finding purpose and meaning in something larger than oneself. For some people, it may include a religious affiliation. For others, it may be a connection to nature or the arts. Although the definition of spirituality is very personal in nature, the role that it plays in your life can transform your health.

Mind-Body Connection – This area relates back to the inner ring of Mindful Awareness. It focuses on mind-body practices that can help you be more present. Techniques include things that activate the body’s relaxation and healing response, like breathing practices, meditation, yoga, or guided imagery.

Professional Care

It is important to seek routine preventive medical care such as an annual physical exam, recommended cancer screenings (e.g., mammogram, colonoscopy) and vaccinations. In addition, you can supplement your usual medical care with complementary approaches such as acupuncture, massage, hypnosis or energy work. A primary goal of Integrative Medicine is to remove the distinction between conventional and complementary approaches and create one integrated approach to health care. In this model, patients and their providers work together to determine the most effective, evidence-based personalized health plan to achieve life-long wellbeing.