Caregivers and careseekers
We have many terms for those who offer treatments and those who seek them. Each has its own tradition and shapes the relationships of the caregivers and careseekers in subtle but pervasive ways.
The first term I suggest for consideration is respant, asking you to consider all the other terms in contrast with this one.
Bernie Siegel (1986; 2002), a remarkable surgeon, developed support groups for people he was treating who had cancer. He says that the most important thing he learned was to be quiet and listen, letting the group members sort out their problems within the group sharing process. He finds that people have a deep wisdom within themselves that understands their problems and knows ways to deal with them. The doctor’s job is not to prescribe the solution, but rather to ask questions that will challenge people to discover their own solutions to their problems.
Siegel coined the term, “respant” – standing for responsible participant – to replace the term, patient. Respants are encouraged to ask their doctors lots of questions, so that they themselves can make informed decisions about dealing with their problems. Respants look for ways that they can improve their own conditions, including:
- Lifestyle changes – exercise, healthy foods in reasonable quantities, avoiding toxic substances
- Healthy diets – balanced for nutrition, varied for essential elements, free of toxins
- Supplements – vitamins, minerals, herbs
- Self-healing techniques – relaxation, meditation, imagery, prayer, communing with nature
- Seeking out caregivers who respect the rights of respants to decide for themselves, after appropriate consultations
- Seeking treatments that are consonant with their beliefs and wishes
- Refusing recommendations that are not clear or acceptable
Not every patient is ready to be a respant. Some prefer to accept the educated advice of an expert. This is fine, as there are plenty of experts who are happier with patients who accept their advice without question.
Doctors are perceived to have the knowledge and expertise to diagnose and treat problems. This places most of the responsibility for dealing with problems on the physician. The doctor questions the patient, seeking symptom patterns and supporting diagnostic factors in physical examination and laboratory data that fit recognized disease patterns, for which the doctor supplies a diagnostic name. Treatments are administered directly (as in surgery or physiotherapy) or prescribed (as in diets or medication). The advantage to this system is that within the conventional medical model that views most medical problems as dysfunctions of the physical body, this works reasonably well. Modern medicine is excellent in diagnosing and treating infections, physical trauma, structural abnormalities, and hormonal imbalances that fit well within this model.
The disadvantage is that the prescriptive model is often less successful with chronic problems. For instance, arthritis, chronic pains, neurological disorders, chronic fatigue syndrome and other chronic disorders may not respond to medical treatments. Doctors continue to prescribe one medicine after another, hoping to find one that will provide symptomatic relief. Patients may have adverse reactions to the medications, for which they are given further medications. They often become weary or despairing with the lack of progress.
The label, doctor, has come to have the associations to it that are given to a priest. It carries an aura of knowledge, wisdom, and power to heal. On the positive side, this mantle of authority vastly enhances the placebo, or self-healing potential in all medical interventions. Patients come with the expectation that they will be given a cure, and this produces self-healing that will respond in about a third of cases to any treatment whatsoever.
Sadly, on the negative side, power corrupts. There are many within the medical profession who have assumed that their methods of healing are the only true methods, all others being the work of infidels. This attitude, plus economics and politics have led doctors to lobby successfully over the past century for exclusive legislative license to declare who should treat and how treatments should be given.
A major segment of the public, not fooled by this arrogance, has voted with its feet and health care dollars in a big way for therapies that have been outside the knowledge and competence of the medical profession. Awareness of the billions of dollars spent out of pocket for complementary/alternative medicine (CAM) has encouraged medicine to begin to integrate these approaches into medical care, and is encouraging legislation that allows the public freer access to these treatments.
Therapists provide treatments much as doctors do. They are the experts, dispensing advice, psychotherapy, herbs, homeopathic remedies, flower essences, providing acupuncture, craniosacral therapy, massage, or other interventions.
Coaching is instruction for executives in human relations, to develop smoother team efforts in the workplace. This term has facilitated the acceptance of what is essentially counseling, which is not well accepted because it carries the implication that the executive that needs treatment. By using coaching, there is no implied criticism or suggestion that there may be something wrong with the executive.
In many of the CAM modalities that promote self-healing, the caregiver is more a teacher than a therapist. Respants are instructed in lifestyle changes, meditations, relaxations, imagery exercises, and other self-healing approaches that they practice on their own.
I have come to perceive myself primarily as a teacher or guide in most of my interactions with my psychiatric psychotherapy clients. In addition to instructing them in their options with various medications, I often introduce self-healing approaches – particularly acupressure techniques that are rapidly and potently effective in dealing with stress reactions, pains, and allergies.
Healer and Healee
There are people we call healers who have gifts of intuitive awareness and abilities to facilitate wholistic changes in body, emotions, mind, relationships and spirit. In Western society, many healers and their patients have modeled aspects of their interactions on the conventional medical system. Healers are perceived as intervening to identify problems and provide the necessary treatments. This mode of interpreting healing is reinforced by the media, who like to headline unusual cures that occasionally result from healings. Some healers promote this perception of healing, thriving on a sense of power, providing their healing as a medical doctor would perform surgery, with every bit as much ego inflation.
Recipients of healing are often called healees. In following the medical model, healees are often passive, expecting healers to provide whatever is necessary for dealing with their problems.
There is a trend toward encouraging healees to take more responsibility for self-healing – among progressive healers. These caregivers model their interactions after those of CAM practitioners who empower people they treat to activate their self-healing abilities, encouraging them to be respants. (Conversely, many CAM practitioners are integrating spiritual healing with their CAM modalities. It is not uncommon to find massage or bodymind therapies combined with Reiki or Therapeutic Touch.) Within this definition of healing, treatment is viewed by many as a boost to healee energies rather than as a cure for their problems provided by the healer. Others view this respantifying process as helping people to connect with their innate healing wisdom, with their higher selves, with spiritual guidance, or directly with the Infinite Source.
While this is a growing trend, the term healer carries entrenched nuances of passivity that can hinder the shift towards healees taking charge of their lives and dealing with their problems themselves. Healers have not found an alternative to this word that feels comfortable. Consider the following alternatives.
Patients expect doctors to diagnose their problems and prescribe treatments to fix them. The very term, patient, suggests someone who patiently waits for someone else to intervene on his or her behalf.
Doctor: “What’s your problem?”
Patient: “You’re the doctor. You should tell me what’s wrong!”
Many CAM practitioners refer to the people they treat as clients. This shapes the conceptualization of their relationship, acknowledging that people have choices in selecting therapists and that therapists are in advisory and teaching roles.
Siegel, Bernie. Love, Medicine and Miracles: Lessons Learned about Self-Healing from a Surgeon’s Experience with Exceptional Patients NY: Harper & Row 1986.
Siegel, Bernie. Respants: Information, Inspiration and Expiration, International J. of Healing and Caring – On line, www.ijhc.org 2002, 2(1), 1-5.
*An expanded version of this article appears in Benor, DJ, In a Word, International J of Healing and Caring – On Line, http://www.ijhc.org January, 2001, 1-8.
(Continued in next column)