Thursday, November 10, 2011

Improving the Quality of Health Care from Within

The starting as well as the central point of any healing is the faith that the patient has for the doctor. Implied in this is the patient's belief that the best treatment under the circumstances is being given to heal the disease he (or she) is suffering from. When the patient is content about this, he is prepared to wait for the disease to improve and to face whatever problems that may be encountered. The reassuring words from the physician strengthen his faith.

This faith that the patient has, can also involve faith in the institution or hospital where he is undergoing treatment. He believes that the place where he has come seeking relief would finally turn out to be good for him. Faith also matters in the case of a child or an invalid who believes that his parent or guardian is taking care of him. Faith is a deep seated feeling that leads to contentment and soothes the questioning mind.

Faith is essential for healing to take place regardless of the kind of treatment that is actually given. Without faith the mind is active and restless. This has repercussions on the immune system. The new field of psychoneuroimmunology [1-5] has validated the reality of mind-body-spirit medicine [6-9]. Where there is faith, the feeling is positive and this helps the body's built-in mechanisms of healing.

Therefore, a basic requirement for a successful health outcome would be to ensure that the care given at the healthcare setting strengthens the faith of the patient. The physician should live up to the faith reposed in him by arriving at the cause of the disease process just as the archer aims at the "bull's eye'. He needs to use his medical knowledge and clinical acumen to zero-in on the cause as soon as possible and start the appropriate treatment. The rest of the healing should be left to the body's built-in mechanisms; or in lay-man's term - to "nature'. It is unnecessary as well as virtually impossible to understand and "utilize' every mechanism underlying "nature'.

The central role of faith has implications on how medicine is taught to students. The young medico needs to learn the bio-medical aspects by acquiring a sound knowledge of the basic sciences. Even as he learns the basics of clinical examination, he needs to learn the art of dealing with the patient and his concerns. He needs to understand the central role of faith in healing and that his own medical knowledge and skill only help to supplement the body's built-in mechanisms of healing.

Post-graduate learning in medicine should concentrate on the student's ability to manage various disease conditions and lead to perfection of clinical acumen. Acquiring more and more theoretical knowledge of diseases without actual case management is of little use and would only serve to distract the budding physician from developing the habit of targeting the "bull's eye'. Sir William Osler's well-known emphasis on learning medicine by the bedside acquires added importance in the context of the new-found validity of mind-body-spirit medicine.

Presently modern medicine does not recognize the role of faith and the reality of mind-body-spirit medicine. Relying purely on the bio-medical aspects has led to a mechanical approach to diseases with loss of human touch. In addition there is uncertainty in the face of rapid medical advances, on how much of medicine is to be learnt and how best to evaluate the newly qualifying doctors.

The quality of health care would eventually depend on how well the roles of the health care professional, health care facilities, medical advances and medical education are synchronized to supplement and support the central nature of faith and the hidden reality of mind-body-spirit medicine. Otherwise the different aspects of health care would remain as disparate entities, one contradicting the other. For example, doctors may know the value of spending time with the patient and making a good clinical diagnosis, but may not be in a position to follow it in practice because of the necessity to make use of inappropriately built-up diagnostic facilities.

In these times of escalating health care costs and sorry state of national health services, quality health care for all is still attainable if the basics are got right.


References: (All references accessed on 2nd July, 2011)

1. Mausch K. The Psyche, the Immunological system and the problems of Health and Disease. Psychiatr Pol. 1995 Jul-Aug;29(4):435-41. http://www.ncbi.nlm.nih.gov/pubmed/7568516?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

2. Lutgendorf SK, Costanzo ES. Psychoneuroimmunology and health psychology: an integrative model. Brain Behav Immun. 2003 Aug; 17(4): 225-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12831823

3. Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity and mortality: new perspectives from psychoneuroimmunology. Annu Rev Psychol. 2002; 53:83-107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11752480

4. Kiecolt-Glaser JK, Glaser R. Psychoneuroimmunology and cancer: fact or fiction? European Journal of Cancer. 1999 Oct; 35(11):1603-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10673969

5. Robinson FP, Mathews HL, Witek-Janusek L. Stress reduction and HIV disease: a review of intervention studies using a psychoneuroimmunology framework. J Assoc Nurses AIDS Care. 2000 Mar-Apr; 11(2): 87-96 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10752051

6. Seaward BL. Alternative medicine complements standard. Various forms focus on holistic concepts. Health Prog.1994 Sep; 75(7): 52-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10136081&query_hl=13
7. Seaward BL. Stress and human spirituality 2000: at the cross roads of physics and metaphysics. Appl Psychophysiol Biofeedback. 2000 Dec; 25(4): 241-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11218925

8. Brian McMullen. Spiritual Intelligence. Student BMJ 2003 March; 11:60-61 http://archive.student.bmj.com/search/pdf/03/03/sbmj60.pdf

9. Recognizing the Mind/Body/Spirit Connection in Medical Care. Samuel E. Karff, DHL. Virtual Mentor. Oct 2009, Vol 11, No 10: 788-792 http://virtualmentor.ama-assn.org/2009/10/msoc1-0910.html  

Thursday, September 1, 2011

Bliss Feedback Therapy

In my previous articles, I have dwelt on the terms - "consciousness', "apparent self', "inner self' and the process of "meditation'. The feeling of bliss, which is formless, is perceived and sustained by the individual through the "built-in biofeedback'.

During the process of meditation, when the individual consciously tries to reach the bliss of the "inner self', he uses a framework to perceive the formless bliss. A sensory perception, usually visual or auditory, that is associated with inner bliss is made use of by the mind. This "associate' of bliss depends on the method of meditation.
A pitfall in meditation is to start believing this "associate' of bliss as real, pushing the bliss itself to the background. Individuals may be practicing a particular method of meditation in a mechanical way forgetting the bliss. True meditation would always focus on the bliss, which is the essence.

Philosophically speaking, all religions help individuals to reach their blissful "inner self'. They use auditory or visual frameworks to help the individual to perceive the bliss within oneself. If this primary purpose of religion is understood, then the apparent "rituals' of religion become more meaningful.

Once established in bliss, the framework is no longer needed. However since we are frequently distanced from bliss, we need to be reestablished in bliss by constantly remembering the framework that is associated with bliss. With guidance and by practice, reaching and remaining in a state of bliss becomes easier.

Enjoying a state of bliss implies that the mind, body and the spirit are in an optimal state of health. The quality of sleep is good and this ensures a whole lot of health benefits. Any disease that might have set in heals faster when the individual practices meditation. Meditation may thus be called as "bliss feedback therapy'.

Understanding Meditation

I have explained the concept of "self' or the "perceived reality' of an individual, which is the state of his consciousness at the time of awakening from sleep, in my previous article. This "self' persists and influences the quality of that particular day through "our built-in biofeedback'. I emphasized on the presence or absence of the quality of bliss.

Blissfulness is the core quality that would determine the expression of other faculties of the mind. When a person is blissful, his mind is calm and his intellect and judgment is optimal. Blissfulness is the natural quality of the "self' as is evident in children. Being blissful allows all other human faculties to blossom.

As grownups many of us would feel far removed from bliss. This is because we allow the mind and its senses to dwell upon so many things in our day-to-day lives. Thus the "self' or the "perceived reality', even if it is blissful soon after a good night's sleep, soon forgets this core reality of bliss.

The problem is to recover from this "superimposed reality' that is lacking in bliss and reach back again to the "self' that is blissful. Our mind should release itself from the problems of the day and start dwelling on the inner "self' that is hidden from consciousness.

Many would be able to do this involuntarily by just relaxing and going to sleep. On reaching the deep sleep state, freed from thoughts and input from the senses the individual experiences pure bliss.

But in today's world more and more people find it difficult to get released from the thoughts of the day. To overcome this problem, several techniques of relaxation and meditation are available. The individual may choose the particular technique that appeals to him most.

A simplified understanding of meditation is - it is basically the process of consciously transcending the "apparent self' to reach the "inner self', which is blissful.

Our Built-in Biofeedback

In my article titled - "Everything is a Play of Consciousness", I have made the point that the state of our consciousness at the moment of our awakening from sleep, determines the quality of life for the rest of the day. If we feel blissful at the moment of awakening, then it is perpetuated for the rest of the day. If bliss is lacking then the whole day feels indifferent or even miserable.

This phenomenon is due to an in-built mechanism where the mind keeps coming back to the "perceived reality' for that day, which is the state of our consciousness at the time of awakening. This forms the "core consciousness' or the "self' of that individual for that day, with all activities of the mind having this core as the basis.

The mind judges events of the day with this core as the reference point. If the core is blissful then the mind also sees the world as basically blissful. When confronted by problems the feedback from the core anchors the mind to the "blissful reality' and the mind overcomes problems by creating solutions.

This biofeedback from the "core consciousness' maintains the quality of our consciousness, whether blissful or not. The mechanism of our built-in biofeedback explains why positive thinking works. See good, be good and do good may appear to be a moral advice to lead a happy blissful life, but it has a biological basis.
 

Everything is a Play of Consciousness


Take for instance a typical day in the life of an individual. When the person wakes up in the morning the world comes into existence as far as he/she is concerned. If he feels bliss within himself after a nice deep sleep, he tends to feel happiness in the world around him. He is unaffected by problems around him, but tries to solve them if possible. His entire day feels positive and productive.

On the other hand if the same person wakes up after a poor sleep, he lacks bliss in his heart and his "mood' is not so good. He tends to get affected by problems around him. He may even compound the existing problems rather than helping to solve them. He may wish that the day ends soon.

What matters here is how the person feels at the moment of his awakening. The state of his conscious mind when he starts perceiving the world, determines the quality of the rest of the day for him. That "consciousness', whether it is blissful or lacks bliss, is the basis upon which his day is built. All other things are secondary.

Once this foundation - the principle of consciousness - is understood then we have a way to influence the state of our own consciousness and the quality of our day. All we have to do is to ensure that we have a nice sound sleep by avoiding things that can disturb our feeling of happiness during the previous day.

Once we have a good sleep the next day dawns well and it is easier to maintain the feeling of happiness on subsequent days, provided we do not fall prey to negative emotions that can disturb us. One way of perpetuating happiness is to keep contemplating on the bliss that persists for sometime after a good night's sleep during the course of the day.

When we understand that everything in a day's life is a play of consciousness then we can ourselves play with our consciousness. Control of consciousness leads to better control of mind. Better control of the mind means better control of what is done with the body and better health of the individual.

Wednesday, August 31, 2011

The Unlimited Potential of Mind-Body-Spirit Medicine

There is increasing scientific evidence (especially in the developing field of psychoneuroimmunology) for a rational basis for the concept of Mind-Body-Spirit medicine. It is also termed as Era 3 medicine, Era 1 being Body and Era 2 being Mind-Body medicine.

However, Mind-Body-Spirit medicine is best viewed as a philosophy where the mind, the body and the spirit are viewed as an integrated whole. Mind-Body-Spirit integrity is actually an age-old concept being fundamental to Ayurveda and other similar systems that come under the category of Alternative medicine.

Those of us who have been educated in the modern scientific way, trained in Physics Chemistry and Biology, find it difficult to accept the intuitive way of understanding the concept of spirit. We find the logical way of understanding matters, sensible. We tend to discard anything that is not supported by logic. In fact our intuitive mind has regressed.

Accepting the philosophy of Mind-Body-Spirit medicine requires a developed intuitive mind that is balanced by the logical mind. Intuitive mind is simply the ability to feel within oneself the nature of a problem or thing. Though every one of us has this in-born faculty and make use of it, we are trained by science to use our logical mind to understand matters.

The learning and teaching of conventional biomedical approach to health and disease consists of understanding the structure and function conveyed through words. Deeper understanding implies assimilating more information. It mainly depends upon the efficacy of the logical aspect of mind.

Understanding and applying the philosophy of mind-body-spirit medicine depends mainly on the intuitive aspect of mind. Assimilation of more and more information is not a priority. Instead, understanding the soul of the patient through the faculty of empathy is a primary requirement. In fact, assimilating more information beyond a limit may be deleterious to the physician's faculty of empathy.

The physician understands the patient as a person and then utilizes the information about the disease process to the extent needed and prescribes his treatment. Mind-body-spirit medicine allows the unknown to be tackled by the body's built-in mechanisms.Thus the therapeutic potential of mind-body-spirit medicine is unlimited, while the purely biomedical approach confines itself to limits set by the logical mind.