In conventional medicine, the body is the starting point for addressing most of people’s ills. Many in this tradition believe that we are the physical products of our genetic inheritance, shaped by the physical environment, and slated – when the physical body releases its hold on life – to end our existence and return to dust. There is no purpose to life other than reproducing the species, plus that which an individual chooses to make of her or his existence.
These assumptions have significant implications for caregivers and careseekers. Within this belief system, good health ranges from the absence of dysfunction to optimal function. Deviations from health are considered malfunctions of the body or illnesses, for which cures should be sought in order to return the body to health.
Within the prevalent Western mechanistic worldview, we simply address the physical body dysfunctions, applying various physical interventions to deal with these, according to our mechanistic diagnoses. In a large percent of cases we are successful with medications, hormones, surgery, and in recent years with genetic manipulations.
While stress is acknowledged as a contributor to many of these problems, we tend to relegate stress factors to a secondary tier of assessments and treatments. Most doctors give pills first and ask questions about stress only if the pills are not working satisfactorily. Economic factors of time and monetary resources favor these simplistic approaches. It takes a doctor only a few minutes to make a fairly good educated guess about medications that could relieve symptoms. It takes much longer to delve into the details of people’s lives in order to figure out what stressors might be contributing to or causing symptoms and illnesses.
The physical body is believed to be the source of all of life’s phenomena. Our genes determine the structure and functions of the body. From conception through death, physical factors may influence the body, including genetic endowments and predispositions, infections, metabolic and hormonal imbalances, toxins (chemical or radiations), allergic reactions, traumatic (physical) injuries, cancers, and degenerative processes.
The mind is believed to be the product of the physical brain, which is proven by the fact that physical, electrical or chemical stimulation, or damage to parts of the brain causes specific cognitive, behavioral and emotional reactions and dysfunctions. Emotions are the products of bioelectrical, chemical and hormonal activity in parts of the brain. This is proven by altered emotions that result from changes in these factors in the brain. We can stimulate specific areas within the brain and elicit anger, laughter, and joy. In fact, the intensity of joy from brain electrical stimulation may exceed that of sexual orgasm.
Psychological factors influence health through choices of individuals or social groups to alter the environments that impinge upon the physical body. A healthy or unhealthy lifestyle, programs for sanitation and immunizations, and education for safe sex can enhance and prolong life; using alcohol or street drugs, overeating, and limiting governmental expenditures for health care can be detrimental to health.
Psychological interventions are helpful when they lead to healthier lifestyle choices. Their benefits derive from stress reduction and from introduction of a broader range of healthy options.
Body-focused medicine may carry distinct risks and consequences. If we focus only on the body, then physical life is all we know and can reliably count on having, and we must preserve and prolong it at all costs. This belief contributes to the poor ways in which Western medicine often deals with chronic illness, death, bereavement, and spiritual issues.
Doctors receive their education and training in hospitals where acute problems are treated. Doctors are expected to make the correct diagnosis and apply effective treatments. In many cases they are successful, discharging patients from the hospital with marked improvements. This sets up unreal expectations in the student doctors about the practice of medicine. They are poorly prepared to deal with chronic illnesses that do not respond immediately to their interventions.
Death is perceived by many doctors as their personal failure to either make the right diagnosis or apply the correct treatment. About 30 percent of our medical budget is spent in treating people in the last 30 days of their lives. This is often to no avail other than to keep a heart beating those few extra days, frequently with a very poor quality of life during this period – not to mention the discomforts and pains of the terminal illness and its treatments. Many doctors are reluctant to let people die without receiving every last symptomatic treatment possible, because death is perceived as the doctor’s failure to conquer disease.
Bereavement is difficult to deal with in any case, but for those doctors who are feeling responsible for people having died, it is often more than they know how to handle.
Spiritual issues are relegated for the most part by modern medicine to the clergy. Historically, this evolved from the mutual fears of science and clergy. The Church was anxious that scientific inquiry would erode its teachings of faith as a motivation for belief in matters of religion. Science was concerned that it might suffer attacks similar to those against Galileo, who was prosecuted for advancing scientific theories that contradicted Church beliefs and doctrines. This conflict continues today in the legal battles over teaching Darwinism and Biblical theories of creationism in public schools.
Figure 1 shows how the body is viewed as being primary in conventional medicine, and all else derives from it.
*An expanded version of this article appears in Benor, DJ, The Body, International J of Healing and Caring – on line, http://www.ijhc.org September, 2002, 1-18.