May 2012

June 3, 2012

BlogMay 24, 2012


“The trend towards integrative medicine is clear, but the approach is only now gaining traction in nursing.” (Klatt, 2010) 


This quote is terribly important for integrative healthcare because clearly demonstrates how responsive the medical field is when it comes to public demands in healthcare changes. AND how slowly nursing education and practice responds to these demands.  Tongue in cheek! The medical profession only became responsive when it was clear the consumer was paying out of pocket for complementary and alternative care. However, the academic program to educate physicians in most medical schools now includes courses on integrative medicine.  Schools of nursing universally state they are holistic in teaching care of whole patient/person; but holism and integrative healthcare are NOT the same thing. Holism/holistic care does in fact consider the entire body/mind/spirit of the individual but Integrative Medicine or Integrative Healthcare includes treatments which are complementary/alternative and melds them into the allopathic/ traditional Western medicine model of patient care.


Interestingly, the actual foundation of both requires an in-depth understanding of cognitive neuroscience and the mechanisms by which change is brought about by brain chemistry influencing responses in both body and brain. If we look at the originations of this current model for care we have to go back to the original research in stress responses by Hans Selye in his 1936 article “A Syndrome Produced by Diverse Nocuous Agents,”  and the use of hypnosis for managing pain and healing by Milton Erickson, M.D. developed in the sixties.


The foundations for this view of treatment for the patient as a being “stuck” in a stress response which is an interior response to external stressors and the process of mind influencing the healing process began with psychotherapy. The process of understanding is much like watching a hamster running on a wheel/treadmill. The action is cyclic and unremitting unless the hamster is removed from the environment. Nevertheless, once the behaviors are learned…the brain is changed…this is what learning is…and the changes are difficult to transform.


It still requires psychotherapeutic skills for the management of patient care in illness and in a move toward wellness in preventive care. Those of us caring for patients both mentally and physically understand the entrenchment of behaviors which are self-destructive and clearly against the patient’s knowledge of what will bring about their own health or return to health. In order to changes minds, we have to literally change neural pathways, transforming the brain to a healthier process and thereby transform the body.


A recent study of women with cardiac risk factors showed they “knew” the information about cardiac disease, they knew what changes they needed to make but they still were not making healthy choices. The authors concluded the information dissemination was working but we needed to do a better job of educating for making change. I disagree…there is a step before primary prevention which must happen if action is to be taken. The brain itself has to change! And from those changes another ways of being, thinking, choosing, and living happens.


We will be considering and working on these methods in subsequent blogs.

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