Even the most enthusiastic defender of Western medicine and therapy would have to admit that their effectiveness is questionable. The list of illnesses that cannot be cured is frighteningly long, from Parkinson’s and Multiple Sclerosis to Alzheimer’s and Motor Neurone Disease. And little can be done even to rid people of the petty miseries, like acne and male pattern baldness. In the 1970s, President Nixon famously declared war on cancer and yet, after 40 years of research and literally billions spent, it remains a mass killer. As for mental illness, almost every family has a tales of a life blighted by depression, anxiety, and addiction. Could it be that Western doctors and psychotherapists need to adopt a more holistic approach? Does Western medicine and psychiatry have something to learn from the East?
The Modern View
In the 17th century, a scientific revolution began in England, Holland, and France. Thanks to men like Francis Bacon and Rene Descartes, a new way of understanding the world was born, one that emphasized reason, skepticism and objectivity. One of the consequences of this revolution has been the so-called ‘mechanistic’ picture of reality. There is now a tendency to view things as machine-like: composed of collections of parts, just like a clock or a car. A sharp line also exists between mind and body, with the body included among the other ‘machines.’
To clarify this mechanistic view, it might be helpful to contrast it with other views. Throughout most of pre-history, human beings lived in nomadic, tribal groups. And one of the most important figures in these groups was the shaman, someone who acted as doctor, sage, poet, and religious leader. Indeed, it is only recently that religion and medicine have gone their separate ways. The shaman was usually someone of great sensitivity and intuition, able to enter into altered states of consciousness and make contact with the spirit world. In general, shamans regarded illness as a result of disharmony. The individual was not a machine and the shaman did not try to fix the bit that had broken down. Instead, he sought to restore harmony between the sick individual and the tribe, spirit world, and cosmos. Pre-modern people understood disease as part of a wider social and cultural context.
Another interesting example is the Chinese approach. Chinese medicine begins with the concept of ‘chi,’ meaning something like energy or flow. When the chi is out of balance, illness follows. And this disruption can be caused by a variety of things, from seasonal changes and family arguments to poor diet and lack of sleep. Interestingly, Western medicine is beginning to come around to this idea of balance. Nutritionists, for example, stress the need to balance acid and alkaline levels. And any physician will tell you that disharmony within the home leads to stress which can in turn trigger physical disease.
The Holistic and the Reductive
There are essentially two different ways of approaching psychological and physical health: the holistic and the reductive. Western psychology and medicine remain broadly reductive, while Eastern systems are generally holistic. Of course, the holistic approach isn’t necessarily more effective. When comparing different cultures, there is always the danger of exaggerating the strengths of one at the expense of the other.
A couple of hypothetical examples will help to clarify these different approaches. First, imagine a 52-year-old lady named Sarah. She visits her doctor complaining of severe depression. Some days, she says, she cannot see the point of going on. Her doctor diagnoses a ‘chemical imbalance’ and prescribes her some SSRI anti-depressants. “Don’t worry,” he reassures Sarah, “you are just low on the feel-good chemical serotonin – these tablets will boost the amount in your brain and make you feel better.” But the doctor asks nothing about other areas of Sarah’s life. He doesn’t ask her about her diet, for example. Does she eat a regular, healthy diet, packed with fresh fruits and vegetables? How about her belief system? Does she have a spiritual faith, or has she recently lost one? Is she lonely?
Next, imagine a 47-year-old man named John. In John’s case, he visits his psychiatrist and complains that he hates going to work and has developed a profound urge to just climb back into bed, pull the duvet over himself and shut out the world. The psychiatrist asks him about his childhood. He then suggests that John has an unconscious yearning to return to the safety of the womb, away from the harsh realities of the world. The soft, enveloping duvet is his substitute. He then goes on to explain that John is unfortunate to live in a society in which spiritual values mean so little. At a deeper level still, he wishes to retreat from the nihilistic emptiness of Western culture.
In the first case, a reductive approach was adopted. But Sarah really needed someone to talk to. She was raised a Christian but had lost her faith and was undergoing a spiritual crisis. Her physician reduced this to a mere “chemical imbalance.” Sarah needed a more thoughtful, broad-minded doctor. She needed a holistic approach to her depression, but he treated her like a malfunctioning machine. In the second case, however, the psychiatrist got carried away. John, it turned out, was slightly hypoglycemic and just needed to stop eating sugary breakfast cereal! Here, a so-called ‘reductive’ approach would have worked much better.
Integration and Wholeness
For over 300 years, Western societies have treated the human body as a machine composed of individual parts and the mind as a separate entity. When the machine malfunctions, it is approached as a mechanic would approach a car. Doctors and surgeons look for the bit that has gone wrong and try to fix it.
But physical and mental health are closely linked. It is now known, for example, that loneliness, isolation and stress can all cause physical illness. And poor diet unquestionably contributes to depression. Too many people who visit their doctor with depression are sent away with a box of tablets, as if something has simply gone wrong with their brain and can be fixed by a mass-produced pill. In many cases, they just need to cut fizzy drinks and junk food, or to end a dysfunctional relationship.
In the 1970s, the oncologist Carl Simonton even hypothesized that there was more to cancer than the uncontrollable proliferation of cells. Simonton was one of the pioneers of Psycho-Oncology, an exciting new field that seeks to understand the social, psychological, cultural and even spiritual factors involved in the disease. Of course, it should be stressed that cancer is a physical illness in the sense that it is a result of cell proliferation. And it would be both arrogant and irresponsible of someone to suggest that the conventional approach is worthless. Nevertheless, while Simonton fully accepted that things like smoking and genetics play their part, he also found that cancer sufferers sometimes get ill as a kind of symbolic cry for help. This was especially true when an event threatened some role or relationship crucial to their identity and sense of self-worth. Another study, conducted by Lawrence le Shan, found a pattern re-appearing over and over again in the lives of cancer patients: isolation, loneliness and neglect in childhood, loss of some highly prized relationship in their late teens or early twenties, internalization of this pain and despair, and then a lifetime of such emotional repression.
It should be emphasized once again that the reductive, or mechanistic, approach has its place. It isn’t wrong – just limited. Human beings are not like machines. To be a fully healthy, fully integrated human being, you need to recognize that mind and body are not separate but interlinked. Neither does disease occur in isolation. Mental and physical illnesses both begin and progress within a particular cultural and social context.