THE PERSPECTIVE OF HOLISTIC HEALTH AND WELL-BEING
Mary C. Howell
Contemporary medicine can be criticized for its emphasis on physiological disease caused by known, identifiable agents. It is argued that people are more than just their physical processes, and good health is more than just freedom from illness and injury. Further, many experts in health believe that most human maladies and afflictions have multiple causes and multiple consequences in the life of an individual.
In the Kennedy Aging Project we were charged to teach "health professionals." We were fortunate to be able to work with faculty members who were knowledgeable about aspects of well-being that are important to health but are not always considered in assessments of health. These aspects included leisure, law (the individual's relationship with society and public policy), and spirituality, in addition to more conventional areas of health professionalism like nursing, medicine, and social work.
In order to move away from a narrow view of health as a negative state, the absence of illness and injury, we needed to challenge conventional habits of thinking about health and well-being. One conventional habit, a simplistic outgrowth of the science of medicine, is to think in dichotomies. We think: this is either a physical disease or it is a psychosomatic disease. We think: this patient either needs attention from a doctor or from a spiritual counselor. We think: we must find a diagnostic "litmus test" for Alzheimer's disease so we can know whether that particular form of dementia is present or not. Clean, clear, dichotomous answers are actually rare in the art of medicine; more commonly we have to deal with multiple causation, probabilities, and ambiguity.
We health professionals have also let ourselves be drawn into more and more narrow fields of specialization. First there was specialization in mental retardation, then specialization in geriatric mental