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Wellness
MANAGEMENT
Newsletter of the National Wellness Association
Membership Division of the National Wellness Institute, Inc.
Serving professionals working in all areas of wellness and health promotion.
Volume 15 Number 1 Spring, 1999
Reinventing Health Promotion: Moving
From Biomedical, Risk-Factor Control to
Holistic Health and Healing
Jonathan Robison, PhD, MS and Karen Carrier, MEd
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raditionally, health professionals attempt to motivate people to change certain
behaviors to prevent disease. Primary attention is given to controlling risk factors and the
motivation for change is fear of premature death. Unhealthy habits are identified and
individuals are encouraged to engage in behavior change programs that reward them for
substituting healthier behaviors. This approach to health promotion is an extension of the
“biomedical model” which has its roots in the worldview of the scientific revolution of
the 17th century. As with all traditional Western science, the biomedical model is based
on classical Newtonian physics, which portrays the universe as a great machine whose
inert components can be understood by reducing them to smaller and smaller separate
parts. According to this worldview, there is no purpose, life, or spirituality in matter and
only phenomenon that are measurable and quantifiable are valid and worthy of study.
Furthermore, the human body is seen as a sophisticated machine, disease is a mechanical
malfunction of the machine and the health professional is the repair-person who is called
upon to “fix” the machine. This mechanistic view of reality remains the cornerstone of
our current approaches to health and medicine, and also provides the foundation for all
human systems in contemporary society (politics, economics, education, legal, etc.).
Re-evaluating the Assumptions
Today, however, new developments in the sciences are challenging virtually all of the old
assumptions of the 17th century scientific revolution. An entirely new view of reality is
emerging from startling discoveries in the same scientific discipline that 300 years ago
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spawned the “mechanistic” worldview—physics! Along with this new worldview, a
completely new set of assumptions about why people get ill and how they heal is
developing. These assumptions are based on the findings from quantum physics as well
as from such widely divergent fields as psychoneuroimmunology, biology, anthropology,
and consciousness research. Together, these findings point us toward a more holistic,
ecological view of the universe. We now know that matter is not composed of tiny
separate building blocks, but is in reality a dynamic network of interconnected
particle/waves that have no existence if isolated by themselves. Quantum physics also
shows that these particle/waves cannot be precisely quantified and can only be defined by
their relationship to each other. In addition, findings in mind/body medicine or
psychoneuroimmunology show us that human beings are much more than just an
assortment of mechanical parts forming a sophisticated machine. In fact, a growing body
of research supports that unlike machines, humans have personalities, thoughts, feelings,
and emotions all of which can powerfully impact our immune system and affect our
resistance to illness and our ability to heal.
Implications for Programming
This research compels us to broaden our focus to consider a wide range of psychological,
social, and spiritual factors that appear to have as much if not more influence on our
health than the traditional biomedical risk factors for disease. These “supportive factors
for health” are listed alongside the traditional biomedical risk factors in Table 1 below.
Table 1
Health Promotion: Shifting the Focus
Biomedical Focus
Risk Factors for Disease
Holistic Focus
Supportive Factors for Health
Blood Pressure
Total Cholesterol
HDL Cholesterol
LDL Cholesterol
Total Cholesterol/HDL Ratio
Triglycerides
Smoking
Drinking
Cardiovascular Fitness
Abdominal Strength
Upper Body Strength
Flexibility
Back care
Weight
Fat Intake
Sodium Intake
Sugar Intake
Fiber Intake
Purpose in Life
Spiritual Connections
Social Support
Meaning in Work (paid/unpaid)
Ability to Experience Emotions
Ability to Express Emotions
Optimism and Hopefulness
Perceived Happiness
Perceived Health
Intellectual Stimulation
Restful Sleep
Time Alone
Pleasure and Play
Financial Resources
Laughter and Humor
Movement/Physical Resilience
Abundant/Varied Food Supply
Contact with Nature
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As we continue to move from a biomedical “Newtonian” view of health to a more
holistic “quantum” view, it is important for health professionals to rethink the philosophy
and design of traditional health promotion programs based on risk factor reduction. The
major tenets of the traditional health promotion model are contrasted with those of a more
holistic approach in Table 2 below.
Table 2
Comparison of Health Promotion Approaches
Traditional
Holistic
Disease: Main objective is to
identify and eliminate biomedical
risk factors for physical disease
Health: Main objective is to
address the interconnected web of
genetic, social, emotional,
spiritual, and physical factors that
contribute to health.
Emphasis
“Unhealthy” Behaviors: Poor
individual lifestyle choices are
considered the primary
determinants of sickness and
disease.
Meaning and Support: Meaning
in life, relationships, and work
and supportive human systems
are considered the primary
determinants of health.
Motivation
Fear: Reason for change is
primarily to prevent disease and
premature death.
Happiness: Reason for change is
primarily to enhance a sense of
purpose and enjoyment of life.
Primary Assumption
People are Bad: Left to their
own devices people will naturally
gravitate toward “unhealthy”
behaviors.
People are Good: People have a
natural desire and ability to seek
out healthy behaviors.
Professional Role
Expert: Primary job is to police
behaviors and prescribe changes
to save people from themselves.
Ally: Primary job is to facilitate
people’s reconnection with their
own internal wisdom about their
body and their life.
Change Process
Controlling Behavior: Behavior
change techniques are used to
suppress or eliminate targeted
behaviors.
Creating Consciousness: People
are assisted in understanding and
healing life issues that underlie
illness and behavioral struggles.
Focus
Our challenge is to reinvent health promotion by accessing the new information emerging
from the field of holistic health. This will involve re-examining all aspects of traditional
programming. Fitness centers, health fairs, brown-bag sessions, and many other standard
areas of wellness programming need to be revised to reflect more holistic concepts. And
new programs that acknowledge the interconnectedness of relationship, work, and
community issues in relation to health also need to be developed. Furthermore, we must
make sure that the images, language, and artwork used in marketing pieces and
educational programs also reflect the new holistic information and themes. (Table 3
below presents some ideas for modifying traditional programs.)
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Table 3
Traditional Program Modification Ideas
Traditional
Holistic Modification
Fitness Facility
Life Center: Soften the emphasis on physical
health, cardiovascular conditioning and strength
training. Create a resource/support center that helps
people explore a broad range of life issues
(relationships, financial wellness, rest and play,
aging, mind/body healing, spirituality, etc.).
Exercise Classes
Movement Offerings: Create experiences for
exploration of the mind/body/spirit connection
through movement. Move away from connecting
movement with reshaping the body, losing weight,
and compensating for overeating.
Weight Control/Nutrition
Body Image/Eating Behavior: Help people regain
a normal relation-ship with food by addressing
chronic dieting, body dissatisfaction, and cultural
weight prejudice.
Stress Management
Life Simplification/Enhancement: Move away
from emphasis on con-trolling symptoms of stress.
Help people to address the origins of stress and
understand the relationship between life struggles
and the development of illness and pain.
Competitions/Incentives
Eliminate These Whenever Possible: If this is not
possible, sponsor individual promotions rather than
group competitions, reward behaviors and not
outcomes, and provide incentives that encourage
individuals to explore a broad range of behaviors
and accomplishments.
Reinventing the Profession
We have the opportunity to support people’s health and human needs in a more
compassionate and effective way. Instead of focusing on controlling isolated
symptomatic illnesses or behaviors (such as hypertension, high cholesterol, smoking,
overeating, or under-exercising) we can help people explore the interconnectedness of
these health issues within the larger context of their lives. Our clients and program
participants then have a powerful opportunity to heal their “symptoms” while also
developing a deeper understanding of the underlying life struggles that these symptoms
represent. As with any paradigm shift, moving into a more holistic era of health pro
motion can cause anxiety for individuals who are comfortable with the status quo.
Certainly the idea of talking to people about health problems in relation to social
oppression, isolation, childhood trauma, job satisfaction, and purpose in life can create
apprehension among those of us trained only in biomedical approaches. But perhaps the
greatest challenge will be the way holistic health promotion encourages us to make
ourselves vulnerable, equal allies to our clients by exploring and healing our own lives at
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a level never demanded in the traditional biomedical model. No matter what our fears or
resistance, reaching out to the new holistic mind/body/spirit information and finding
ways to support each other professionally during this difficult transition will help make
this a powerful and rewarding transformation for everyone involved.
RESOURCES
Capra, F. The Turning Point: Science, Society, and the Rising Culture. Bantam, Toronto, 1983.
Kohn, A. Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A’s, Praise and Other
Bribes. Houghton Mifflin, Boston, 1993.
Myss, Caroline. Why People Don’t Heal and How They Can. Harmony Books, New York, 1997.
Pert, Candace. Molecules of Emotion: Why You Feel the Way You Feel. Scribner, New York, 1997.
Keck, L.R. Sacred Eyes. Synergy Associates, Boulder, Colorado, 1995.
Eisler, R. The Chalice and the Blade: Our History, Our Future. Harper, San Fransisco, 1987, 1995.
Gaesser, G. Big Fat Lies: The Truth About Your Weight and Your Health. Fawcett Columbine, New
York, 1996.
Jon Robison PhD, MS
[email protected]
517-347-6016
website: www.jonrobison.net
Karen Carrier MEd
[email protected]
713-849-9868
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