Holistic vs. Wholistic (From 4/4/14)

I was talking to a friend last weekend about some different health problems she had been having. “I just don’t know what to do,” she said. “My doctor wants me to take these medications, and he says that if I don’t get better soon that we may have to do surgery. I just wish he would take a more holistic approach. Medication and surgery are bad for you, and I just don’t want to go down that road.” My friend and I talked for a while about her condition, and some different options she had available, but our conversation got me thinking, what does holistic actually mean? And what are the potential reasons for, or implication of using holistic treatments?

Dictionary.com defines holistic as:
1.  Incorporating the concept of holism in theory or practice
2.  Identifying with principles of holism in a system of therapeutics, especially on considered outside of the mainstream of scientific medicine…and often involving nutritional measures

Holism is defined as:
1.  The theory that whole entities, as fundamental components of reality, have an existence other than as the mere sum of their parts.
2.  Also, holiatry, care of the entire patient in all aspects of well being, including physical, psychological, and social.

The Wikipedia page on holistic medicine states:
“Holistic health (or holistic medicine) is a diverse field of alternative medicine in which the ‘whole person’ is focused on, not just the malady itself.”

I think that there is some definition confusion about what holistic actually means. In the first definition, we see that holistic means that a practitioner should treat the whole person, not just one part or symptom. However, the second definition seems to state that this is done outside mainstream medicine. This would seem to imply that physicians, nurses, physical therapists, occupational therapists, dentists, psychiatrists, and many other health professionals are not holistic.

This could not be farther from the truth. As physical therapists we are trained to treat the WHOLE person. This why many times, you may go to therapy for an injured or painful knee, but do an abundance of exercises for hip strength. Remember? “The foot bone’s connected to the, leg bone, the leg bone’s connected to the, hip bone…” Many physicians treat patients in this fashion as well. When an internal medicine doctor prescribes a medication, they carefully consider what the addition of the new chemical into the body will do to the balance of natural hormones and chemicals already present, thus preserving the normal function of the whole body, while affecting a pathological system. Dentists often recommend people simply brush and floss their teeth, rather than undergoing the extensive drilling, injecting and synthetically replacing their chompers. And if you have read a magazine, watched TV, or talked to another person in the last 10 years then you know that nearly all mainstream health professionals recommend exercise as the number one way to holistically treat and prevent many major maladies.

So then what is this other thing that we have been talking about as holistic? If mainstream medicine isn’t it, then what is? I think the definitions above seem to point toward alternative medicine.

The Wikipedia page on alternative medicine states:
“Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method.”

So if alternative medicine is not based on science, then what is it based on? And if there are sound theories then why hasn’t it, or rather why can’t it be validated by scientific study. A simple search in PubMed will reveal varying levels of effectiveness for many alternative medicine techniques, that may add up to no more than placebo effect.

Additionally, if we look at the holistic properties of many alternative medicine practices, they don’t quite meet the criteria. Many treatment methods will look at a single symptom (i.e. transient weakness in a single body part, skin pigmentation changes in one area, headaches or nausea, etc.) and then offer a single treatment for that single symptom. This is not looking at the whole person, as some of these symptoms could be explained away easily (weakness actually a difference between dominant and non-dominant hands, skin pigmentation change due to sun exposure, headaches due to neck muscle tightness or loss of thoracic mobility, nausea due to pregnancy, etc.). Additionally, we cannot speculate as to the safety or effectiveness of the treatments offered.

Many people assume that alternative medicine treatments are safer because they are “natural” and do not contain chemicals. This logic is flawed because there are many natural things that can harm you. Examples would include cobra venom, certain types of plants and berries, or minerals such as arsenic. If you still doubt, just remember, tobacco grows in the ground and naturally comes from the earth even when not grown by farmers, and is very harmful.

There are some concessions that must be made however. There are some natural treatments which have been shown to be more effective than their medication counterparts. The best example of this that comes to mind is ginger. In multiple randomized, double-blind, controlled trials ginger has been shown to be more effective at treating nausea than many medication designed to do the same. This example merely underscores the need for better scientific testing and rigor when evaluating alternative medicine. With better study, more viable treatment options become available.

I think that new terms and definitions may be useful moving forward.

Holistic: Any alternative medicine which is outside of traditional medicine, and is not based on evidence evaluated by the scientific method.

Wholistic: Any method of treatment which treats an individual in all aspects of well-being, and cares for the whole person, rather than a single part or symptom. Additionally, treatments rely on science and methodological rigor to validate efficacy.

By using these new definitions we can identify wholistic professionals throughout mainstream medicine. While medication and surgery are not always necessary, we should not fear these treatments, as they have an important place in medicine. Rather if you are looking for a less invasive, wholistic option, seek out a physical therapist. They will certainly help you heal wholistically.

Patrick

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