When we relate with our body as soul carrier, we deal with its beauty, its poetry and its expressiveness. The same habit of treating the body as a machine where its muscles are like pulleys and its organs like engines carries his poetry to the underground, so we experience the body as an instrument and we only see his poetry in disease.
(Thomas Moore quoted by Schnake, 2008, 184).
Our health is related, in big part, to our way of life, to the conditions of our cultural and ecological environment, and to our interactions. It has to do with our life story, our present and our project into the future. It is connected to what we do, think, feel and value. And it is a dimension, like other aspects of our life that partially depends on us, on each other, and partially depends on others, on the sociocultural and ecological conditions, on specific situations in which we live in and how we interact with them.
According to the World Health Organization (WHO), we can understand by health "a state of complete physical, mental and social well-being and not merely the absence of disease or illness." Therefore, I consider pertinent to emphasize the aspect of welfare, with its different sides, as the direction to be searched over our existence for living healthy. This, to balance what seems to pull more attention and resources of individuals, organizations and governments, ie the cure of diseases.
In professional and everyday terms, in general, we are still making a distinction between body health -usually called physical- and mental health. WHO itself (2007) defines the latter as not "just the absence of mental disorders. It is defined as a state of being in which the individual is aware of his own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community."
The question is: which conditions are necessary to achieve the promotion of this physical, mental and social well-being which leads to the development of skills and competencies needed to productively and fruitfully interact with others, the environment and all the people and each one of them?
Answering this question means a complexity that is beyond the scope of this article. For this reason, we will focus on the microsocial level, focusing primarily on areas of action potentially available to people in their everyday life contexts. Of course, the dimension of this level does not eliminate the influence that meso and macrosocial conditions play on it. It must be recognized that they are there as a backdrop, influencing the possibilities and the personal limitations to create favorable conditions for the promotion of everyone’s health and those with whom we live closely.
The resources of our being-humans
"The body has been considered as something universal which lacks its own innate patterns of behavior" (Gendlin, 1986/2001: 158). However, as Gendlin himself points, "in all animal species very complex inherited behavioral patterns have been found. No human or animal body is only 'impulse'. The body includes behavior patterns. The 'residual body' of mere impulses is just a fiction" (159). If we take this perspective on human beings, we may propose at least as a hypothesis that there are corporal patterns in our body that guide us to life, welfare, health (Gendlin, 1996). And if we listen and heed from the experience of our interactions on what we bodily sensed, we can find ways to nurture and promote our well-being and decrease discomfort and disease.
There is, however, a category of problems we encounter in our culture when we identify a number of beliefs about ourselves, our bodies, our minds, health and disease, which often appear to reduce the scope of our action to promote wellbeing.
Some of those beliefs that may be obstacles to healthy living are:
- The human being is composed of body, mind and spirit or, in more colloquial terms, body and soul.
- The quintessential hallmark of humans is reason. The logical-rational knowledge is knowledge par excellence, the highest category, the one related to the scientific knowledge. All other forms of knowledge have to be by all means subject to it.
- The mind has "its seat" in the brain. This is the most important part of our body. Moreover, we can distinguish and almost separate the brain from the body itself. As Damasio notes (2003:190): "In the most popular and modern points of view, mind and brain go together on one hand and, on the other, the body (which is the total organism minus the brain)." 1
- Body health depends only on the conditions of hygiene and nutrition. The socio-cultural conditions and lifestyle, as well as mental and emotional states, do not have much to do with it.
Same lifestyles conditions, hygiene and nutrition influence in the same way in all the people.
- Mental health is fundamentally a problem of individuals rather than groups, society and culture, and it is primarily related to emotional or thinking processes.
- The diagnosis of diseases is important in order to give proper treatment. It's more important to know the diseases than sick persons.
- For the same disease, same treatment must be provided; characteristics of individuals and contexts in which they live are not so important.
- From the medical point of view, if there is no specific cause identified for a disease, then there is not a "real disease" or, as some often say, "calm down, it is your nerves, take a cup of tea" (Lara and Salgado, 2002).
- The identification of an anatomic lesion or a physiological or biochemical alteration is sufficient explanation for being sick. Neither relationships with other people nor the emotional aspects and lifestyle are so important.
- If I do something, eat or drink and I do not identify any close discomfort, it means it doesn’t hurt. Little corporal annoyances must be ignored.
We can further lengthen the list. Serve the previous list as an example of some of the common beliefs that may hinder healthy living. Now, what are some assumptions which can guide our actions to healthy living? Let’s consider:
- Human beings are a unit. We can talk about different dimensions: body, mind and spirit. But, by being a unit, we assume that what happens in any of them affects the whole, in the direction of well-being or discomfort.
- "The body (strictly speaking) and the brain form an integrated organism, and reciprocally and completely interact with each other through chemical and neural pathways... Body, brain and mind are manifestations of a single organism." (Damasio, 2003: 194-195). The divisions we made are only for research and teaching purposes.
- There are different forms of valid knowledge. The logical-rational knowledge is not the best or the most appropriate in all circumstances (Michel, 2006; Villoro, 1984).
- According to Gendlin (1978/1983), there is a special kind of body knowledge, reliable, with which we can guide our life. He notes: "there is a kind of body awareness that deeply influences our lives and can be used as a tool to help us achieving personal goals" (57).
- Our body (from the neck down) is as important as our brain. In fact, both better work integrated than apart. From the perspective of Damasio (1994/1996: 260), "regardless of what we are doing or thinking, it is clear the quasi-inevitability of body processing. Chances are that mind is not conceivable without some degree of embodiment".
- Lifestyle, the meaning of life for each one of us and how we position ourselves in it as well as what we think, do and feel, significantly influence in healthy living.
- Physical and mental health is primarily a biopsychosocial matter which implies society, families and individuals.
- Same living conditions, hygiene and nutrition influence in a particular way in each person and family.
- There are no diseases but healthy or sick persons, with processes which are similar to those of others, but also particular. We must find and build the personal path to healthy living in the relationship with others and with the environment. The same applies to regain health.
- Many of the so-called corporal diseases are closely related to living conditions, to our way of living, to what we do, feel, value and think. Same thing happens with the healing process; hence the effectiveness of medical procedures in every person also depends on these factors (Berteuris, 2007, Jaffe, 1980; Lara and Salgado, 2002; Schnake, 2008).
- Our body-organism (Moreno, 2007, 2009) provides reliable signals of our state of comfort or discomfort. When we recognize and follow what Gendlin (1986/2001) called a felt sense, we can find concrete ways to live healthy. In his words: "that feeling is a new step. It allows you to discover a more appropriate way to act because the feeling is related to more things than it can be normally interrelated" (163).
Then, we have different hypotheses to guide our healthy living. Recalling that health is not just absence of pain but presence of welfare, I will now discuss some situations in life in which we may require intentional actions to promote or recover such welfare.
Learning to live healthily
I think the most important thing is to promote health. And this involves searching and creating ways of living that contribute to our welfare -for everyone and all. In this direction, one choice is to take into account our corporal wisdom; to keep in mind that "with our body, we know much more than we can say at any given time, and from our body we can also find ways of interaction which are appropriate in the following times, in the situation in which we find ourselves.” (Moreno, 2009: 18). Through that, we assume that "the living body is a continuous interaction with its environment. It contains, therefore, environmental information" (Gendlin, 2003: 104) and in that process of interaction we can find appropriate actions for us-in-the-situations, and such actions will lead us in the direction of welfare.
The bottom line with this proposal is: how are we going to guide our living through this body wisdom especially if, sometimes, it seems to go in a different direction to such marked by certain cultural patterns? We find an example of this in feeding. One of the first key decisions in relation to it may be, for a mother, to decide if she feeds her newborn baby when he is hungry or at a scheduled time indicated by someone else. From there, it is not only the time but what she feeds and how she takes into account the baby's own reactions to that food. As we grow, we may be selecting foods according to the effect they have on us, if we know to listen to ourselves; or else to choose "the menu" according to advertisements and trends of the moment, or simply to eat what is at hand, not forgetting the situation of millions of people who barely have anything to eat.
Another area of decision is the one about the amount of food we eat. Have we learned to recognize when we are already satisfied or do we eat under external slogans? We can say the same thing about the psychosocial environment that occurs in relation to the food in different families. In some of them, eating is associated with moments of coexistence and pleasant conversation. In others, it may be more related to an atmosphere of tension and anxiety, either by food shortages or the problems of the family members. The result is that all these conditions and others are playing within a complexity that is not always properly processed. This can lead us to act in detrimental ways for our well-being.
Of course, I recognize that there are social and cultural factors that complicate situations and decisions, and that several of them seem to be beyond the possibility of change of individuals and families. Without forgetting this, the focus is now on the field of action that can be guided and transformed by the decisions and actions of individuals and groups.
In this vein, I can say that a crucial issue related with our welfare is food. Our whole being is affected by what we eat, how and how much we eat and also by the psychosocial environment where we eat. That is why improper eating is something related not only to the food we eat and the time we do it. It also has to do with feelings, emotions and meanings associated with eating, and they have both a personal and sociocultural dimensions. Each person’s story with its contexts plays its part. The complexity involved in changing and improving eating habits can be addressed with the experiential listening mode (Friedman, 2005), it means to listen to ourselves from the bodily lived (Moreno, 2009).
Currently, another most recognized factor in relation to health and welfare is stress (Mathes, 2003; Schnake, 2008). It seems that the current living conditions generate high levels of stress in many people and it is associated, among other things, with a variety of ailments such as insomnia, nightmares, mood changes, difficulty in concentrating, hyperactivity, major difficulties in interpersonal relationships, chronic fatigue, decreased interest in life, memory, fear of dying, feelings of isolation, sadness or loneliness, along with problems in the immune system, and psychosomatic ailments such as headaches, neck and back pain, asthma and digestive disorders, among others (Levine, 1997).
Feeling stressful is something related to the way a person lives a situation. That is, it involves the person / situation interaction, where the ways that such person lives and positions in that circumstance (with fear, weakness, disability, threat, vulnerability, etc.) stand out, given the conscious and unconscious meanings that situation has for the individual. We can then identify that in everyday life we find various situations ranging from some little stressful ones to others that become even traumatic due to the effects they generate.
One way to take care of our welfare is by responding quickly to the small signs that something in our life is not well and by not giving simplistic explanations and ignoring them until they rise and indicate that the problem is greater. Another important aspect of this care is to understand discomforts as signs and not as the problem itself. When I turn to painkillers whenever I have a headache and to sedatives or antidepressants whenever I cannot sleep well, I stop listening carefully to the messages that I’m giving to myself through the discomfort. However, remember that we have at least two options: 1) to see the headache and insomnia as nuisances to be removed –by any means-; or 2) to listen to ourselves in order to understand what they say about my way of living that requires attention and in order to generate needed actions and changes (Berteuris, 2007, Jaffe, 1980; Schnake, 2008).
No doubt there are other important factors to promote our welfare. I identified, among them, hygiene, environmental stewardship, collaboration with others, valuing ourselves (oneself and others) as human beings, giving meaning to our work, clarifying our values and priorities in life beyond the mass media proposals, treating others with respect, appreciating the beauty in our lives (without ignoring shortcomings and suffering), recognizing the possibilities we have to be agents of our own life and giving it some direction and sense (Moreno, 2007). Additionally, I remind that the perspective of this article is located in the area of freedom of action of individuals and groups. I do not directly deal with either the level of institutions and agencies, or social, economic and political structures.
Chronic and emotional ailments
While I locate the main emphasis on the promotion of wellness and health, we must assist ourselves when we are sick. Being sick has an effect upon our living, on how we feel, on how we think, on what we do and on how we interact with our environment. The current living conditions often face us against several issues on which we need to decide and act when we are sick. If the disease is chronic, this may be more complicated.
A first issue to be addressed when we are sick has to do with the type of treatment we will follow. While we certainly start from available options, we often have to make choices and take decisions. For example, will we follow an allopathic or homeopathic treatment, from traditional medicine or other? Where and with whom shall we go?... From here, we can act automatically, doing what we are supposed to do or what we are said to do, or we can consider with our body-organism the options and let us guide by the answers coming from it. Then there are the adjustments we need to do in our way of life, which are not always easy. And besides, there are the decisions to be taken given the diversity of opinions from family members, friends and health personnel we consult.
It is also important to consider the aspects of diagnosis and prognosis. They involve several different beliefs and assumptions about the sickness, depending on who makes them. Many of us know healing processes that have gone against medical odds. So, we ask ourselves what to believe, who to believe, what attitudes to take in order to face what we do and what happens to us. We need to monitor how we are doing in relation with our health and disease, and to identify what seems to help and what doesn’t. They are not easy tasks. We also face here the complexity of situations. We may collect information, talk with several people of our confidence, listen to different opinions and points of view from health professionals, see how we feel, take into account the present symptoms and signs, review the results of various analyzes, and then, what do we do with all this? Gendlin (1986/2001) notes that people in psychotherapy "discover, from the body felt sense, more complex perceptions and nuances than they ever found outside. Steps towards healing and personal growth are more intricate than the old patterns of animals and society "(163). We find, then, in the process of focusing a rich way in constructive opportunities for addressing and solving the complexity of these situations.
Moreover, when it comes to diseases in which some emotional components and lived experiences and meanings are clearly ingredients of both the process of disease and the healing process and restoring wellness, they must be explicitly addressed. If we do this properly, it is more likely to heal even against some professional prognosis (Berturis, 2007). In one case referred by Berteuris, the patient named Mary attended the bodily felt in relation to his back ailment, with a diagnosed spondylolisthesis and, as reported by her doctor, "the felt sense was changing and taking shape. It was opening, giving its message to the patient. And in this work that Maria chose to do with her images (which arrived from the felt sense) she strides and improves "(42).
I have personally attended a 32 year old woman with three months of insomnia. As she narrates she slept a maximum of two hours broken daily, in spite of taking medication. Her corporal, emotional and relational conditions were very affected. She felt and was exhausted. When she talked with me, she was desperate due to the ineffectiveness of the various actions she had performed. The first thing we did was what we call in focusing clearing a space (Gendlin, 1978/1983, Moreno, 2009); it means to identify and to kindly put pending matters, issues and concerns aside in order to, from a carefree space, be able to attend more clearly the felt senses that arise in the process. Once the space is cleared, we begin the process with an inquiry / invitation: How do I feel now about my not sleeping? ... We wait the first felt sense to arrive. Then, she sought for the accurate symbolization for her. It took a while for her to find it. When she finally did it, it acted on the formation of a new felt sense. In the course of the conversation and the process, lived images of different situations appeared as well as feelings and meanings associated with them. In this interaction between felt-senses and accurate symbolizations, in the context of a trustful, accompanying and respectful relationship, she was changing her corporal feeling in relation to various situations and meanings of her life. In the end, she felt different and her whole body seemed relaxed, calm and in peace. That night she slept about six hours, as she commented to me later on, and in her words, "I rested as I had not rested long ago." I suggested her continuing to pay attention to her felt senses; she had learned before how to facilitate this process. In the course of a week, she slept eight hours a day, rested, and regained her energy and her joie de vivre. Three months later, her condition remained "very well"; this means she slept eight hours and rested.
It is important to note that when we are sick, it is convenient to have a diagnosis from a health professional that helps us knowing what happens. And in many cases, it may be necessary to perform several different actions to promote health recovery. This may involve even the participation of health personnel with different approaches -in terms of the kind of medicine they practice.
To describe and to note that an alternative approach as focusing can help in the promotion and restoration of health does not imply denial or no use of other options. What I emphasize here is the ability to maintain the condition of agent within existential and contextual constraints in order to take charge, through actions and attitudes, of our life and our well-being even if it sometimes means to leave to others some decisions or activities that concern to us (Moreno, 2007). Nor should we forget that the sociocultural and ecological conditions in which everyone lives play an important role in the processes of wellness and illness, both in physical and mental health (Jaffe, 1980; Lara and Salgado, 2002). And that these conditions can also be approached from the perspective of the focusing process (Gendlin, 1978/1983, 1986/2001).
Concluding without finishing
The issue is open to keep on developing it in its complexity. What I have stated here is that Focusing as philosophy about human beings, as a theory of constructive personal change, as a process of change itself and as technical procedure to promote personal transformations that involve our interactions in our living, has some input that we may find valuable to promote our wellbeing in different spheres of life and to assist us when we are sick, either to regain health or to better face the hopelessness of a chronic disease or the closeness of the final moment of our life.
Something that I've learned to value of this proposal is its compatibility and easiness to integrate into a constructive dialogue with various proposals that address other dimensions of our living.
I end with two quotes from different fields that seem to point in the same direction: we are beings-in-interaction. Welfare and discomfort are being promoted in those interactions. "When we see, we hear, we touch, we taste or we smell in the interaction with the environment, the brain and the body properly participate" (Damasio, 1994/196: 250). We are total organisms, not a set of parts or organs. And I agree with Gendlin (1986/2001) from another perspective by stating that "to separate individual and social powers is to excessively simplify. Both individual and society, are always involved but their relationship can be studied better if several kind of steps and processes are differentiated" (166). For this time, the focus has been put by people’s side. However, we do not forget the sociocultural dimension with all the complexity that it implies.
Salvador Moreno is a psychologist and psychotherapist. Coordinator of Masters in Psychotherapy at ITESO, Guadalajara. Focusing Coordinator, Mexico Institute of New York. Body Focus Certified Instructor (Focusing). Author of numerous articles on educational issues in psychotherapy and human development. Psychotherapist and Coordinator on Focusing-related workshops.
Emails: smorenol@iteso.mx - smorenol@prodigy.net.mx
References
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