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Journal of Holistic Healthcare 2008-2009

  Issue 6.3 - Nov 2009
We need a new story about the human psyche, and this issue of JHH explores a radically different ecopsychological account of human nature. Ecopsychology views Nature as intelligent and human beings as integral with Nature...


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  Issue 6.2 - Aug 2009
Integrated self-care: developing individual and communal wellbeing Though the course of human life is uncertain, in our privileged society people can expect longer, safer lives than their recent forebears, but Big Pharma's Faustian bargain with the NHS is mirrored in soaring healthcare costs...


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  Issue 6.1 - May 2009
Text here to be checked as was the same as for 6.2

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  Issue 5.4 - December 2008
In this issue, one man's journey into the underbelly of hospital care and a heartfelt plea for deeper and more compassionate engagement and cooperation between doctors and patients. Does care trigger the homeopathic effect rather than water memory?...

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  Issue 5.3 - September 2008
Text coming soon

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  Issue 5.2 - May 2008
Healing spaces - BHMA conference issue The politics of sickness - Engaging in therapeutic dialogues - Creating spaces for a healthy community - Healing spaces in holistic healthcare...

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  Issue 5.1 - Feb 2008
Modern times - David Zigmond Northern Ireland: pathways to health - Boo Armstrong A paradigm of wellbeing - John Heron Finding the right word for personal care: ubuntu-botho - Tom Garrett Healing space: can it be done?...

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Journal of Holistic Healthcare
Issue 6.3 - Nov 2009
 

What we do to the earth, we do to ourselves
Isabel Clarke, Consultant clinical psychologist


My intention is to draw out a deep connection between our human wholeness and well-being, and the health of the earth that sustains us and all creatures with whom we share this planet. My starting points are that our self-sufficient individuality is partially illusory, and that the human mind has two fundamentally different dual ways of knowing. This cognitive model gives equal weight to self-conscious individualism, and to the reality of our interconnectedness. Recognition of these dual aspects provides a starting point for rebuilding our fractured relationship with the planet, and it has implications for psychotherapy, and for the future of us all.


Resilience, recovery and the self-help SSRI
Chris Johnstone , Addictions specialist

As we enter a new era of economic uncertainty and environmental concern, polls show many consider the condition of our world to be getting worse. Against this background of anxiety, depression has become the modern epidemic. Yet as well as bringing nightmares and despair, could our current crisis also call forth strengths and qualities associated with positive mental health? This article explores how crisis can become a turning point in personal and planetary healing, and introduces 'the self-help SSRI' as an intervention to strengthen our resilience and participation in the recovery of our world.


Yearning for our niche: the role of meaningfulness in eco-systemic health
Paul Maiteny, Ecological counsellor and transpersonal psychotherapist

As human beings, we mostly use our capacities to invent ever more ingenious ways of satisfying desires through what can be called a 'consuming orientation'. Our survival depends on moving beyond this orientation, toward a 'contextualising orientation'. But this seems difficult, even though we are acutely aware of the impending crisis. The challenge for 21st century humankind is to live as part of a bigger context, in which meaningfulness comes from seeking our true niche in the ecosystem. Finding the cultural impetus for sustained change will call for changing our currently entrenched habits of belief, which is not a trivial task.


Nature as subject: Exploring anthropocentrism
Mary-Jayne Rust Psychotherapist and ecopsychologist

In this paper I argue that our dominant culture both idealises and denigrates nature. Either way nature is treated as a collection of objects at our disposal, apparently separate from humans, rather than subjects to be related to. Arguably these attitudes are central to our current environmental crisis. I explore some of the projections that humans place onto the rest of nature and ask how these issues are relevant to therapy. Lastly I offer some thoughts about our role as therapists within the wider community as our global crisis quickens.


Rooted in health
William Bird, GP, strategic health advisor to Natural England

Access to green spaces promotes health and wellbeing, not only of individuals but of whole communities. Over time, public health policy has taken this into account, but with the increasing emphasis on medical solutions to society's many health problems, the healing power of nature has largely been forgotten. However, a growing body of research demonstrating the positive impact of green space on human health and wellbeing suggests that addressing 'green-deprivation' would help narrow the health gap between rich and poor. With this is mind, Natural England?s Natural Health Service initiative will bring the natural environment to people where they live and work, and bring people out to the natural environment.


Community transformation through Diggin'It
Pat Fleming Writer, researcher and educationalist

Deep in the city of Plymouth, people are getting their hands dirty and improving their health and wellbeing. Excluded schoolkids, refugees and people with specific health problems come together for practical work and courses that benefits not just themselves but also the wider community.

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Journal of Holistic Healthcare
Issue 6.2 - August 2009
 

Emotions and self-regulation for the heart
Elizabeth Wilde McCormick Psychotherapist, teacher, writer


This is drawn from my experience as a psychotherapist working with patients who have heart problems. They come to me through referrals made by GPs, cardiologists or physiotherapists or because they self-refer having read one of my books. The psychological interventions I use are varied and could be as brief as a single hour-and-a-half assessment with a three or six month follow up, short-term weekly interventions for eight to sixteen sessions or occasionally longer therapy stretching over several years.


Self-care and the need for interactive ICT
Tuvi Orbach CEO, Health-Smart Jane Vazquez Health Education 'Physiologist', Health-Smart

Long-term conditions threaten to bankrupt the NHS, as lifelong drug packages allow us to live longer but less healthy lives. If our overfed, stressed, under-exercised lifestyle is at the root of the problem, then millions of us will need help to make big changes. The health trainer role is full of potential, but they and people with or at risk of LTCs also need expert knowledge and support. Fortunately, advances in interactive ICT can now put a health coach in every pocket and every home.


Self-care and CAM: defining the differences, recognising the similarities
Karen Pilkington Senior Research Fellow, School of Life Sciences, University of Westminster

Self-care is promoted as an integral part of a 'patient-centred health service'. But how is self-care defined? And when is CAM considered self-care? Some of the basic tenets of self-care and of CAM are compared to highlight similarities. CAM appears to have a primary role in chronic, poorly defined and difficult to manage conditions. Patients with these conditions seek self-care options and frequently choose to use CAM. Choice is affected by cost and accessibility. Feasibility in practice and personal recommendation also play important roles in decision-making.


Helping street sex workers make healthy life choices
Josie Hill Fundraising and Publicity Co-ordinator, One25

One25 is the England winner of the 2008 Prince's Foundation for Integrated Health awards. It has a unique impact as the only organisation in Bristol that focuses on the specific needs of women trapped in street sex work. One25's extraordinary service brings food, therapies and medical services to women, and as a result many have left sex work behind, reclaimed their children from care and now lead normal lives. One25 gives these vulnerable women the support they need to escape and build towards a healthier future.


Using mind-body medicine for self-awareness and self-care in medical school
Scott Karpowicz Third year medical student, Mind?body Medicine Group participant Nancy Harazduk Director, Mind?body Medicine Program, Georgetown University School of Medicine Aviad Haramati Professor of Physiology and Medicine, Georgetown University School

An innovative educational program at Georgetown University School of Medicine teaches mind-body medicine skills to blend science and humanism to foster student and faculty self-awareness and self-care.


Helping patients to help themselves
Ruth Chambers GP & clinical champion for the Lifestyle Support Programme, NHS Stoke on Trent, Honorary Professor Staffordshire University

If people want to live for as long a time as their genes allow and be as healthy as possible then they have to take responsibility for their own health and wellbeing. There's only so much the NHS can do for people with long-term health conditions: nagging and motivating them to better their lifestyle; sharing the'power' of medication in jointly agreed management plans. An all-round integrated approach means consistent advice, person-friendly local lifestyle services, with high ratings for everything that will help - conventional treatments, alternative therapies and personal support.


Self-care, self-care, self-care...:have we been missing something?
Simon Y Mills Herbal practitioner

Complementary approaches may be ideally suited to supporting self-care rather than extending prescriptive medicine, and practitioners may rediscover their role as mentors. The Department of Health may be ahead of the professions in understanding the importance of this.


NHS LifeCheck: Self-care online Empowering the socially-disadvantaged to manage personal lifestyle change
Dr Sunjai Gupta Deputy Director, Head of Public Health Strategy and Social Marketing Branch Health Improvement and Protection Directorate, Department of Health, England Maria Reeves NHS LifeCheck,

What measures should be taken to motivate socially disadvantaged individuals to embark on a programme of health-related behaviour change? How can a simple lifestyle quiz promote self-care and reduce health inequalities? Could a website increase an individual's capacity for change? How does NHS LifeCheck fit into a health professional's toolkit and impact on PSA targets without increasing their workload?

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Journal of Holistic Healthcare
Issue 6.1 - May 2009
 

The campaign against CAM - a reason to be proud
Harald Walach Research Professor in Psychology, University of Northampton


Does the campaign against CAM indicate that powerful factions feel threatened? A complacent CAM world has been slow to collect supporting data, but the waning of big pharma's once unassailable economic and clinical dominance may be a significant motivator for some who oppose integration. With biotech innovation slowing down, and adverse event scandals and research irregularities, users are distrusting flagship revenue-producing medications. As healthcare policy reshapes mainstream medicine we will need to understand the forces ranged against integrated medicine.


High costs, large disease burden
Jonathan Lord, MD. CEO Navigenics, former CEO Humana EU


One of today's greatest health challenges is the rising burden of disease and the associated costs. There are good arguments - financial and health-based - for using more CAM to help people be healthier.


Challenges in interpreting and applying the evidence for CAM and IM
Catherine Zollman GP and Hugh MacPherson Senior Research Fellow, University of York

This paper explores the reasons why evidence based medicine has only a limited role in informing real world practice. We set out why this appears to be an issue particularly for complementary, alternative and integrated medical practice. We also address the need for a research agenda that focuses on developing evidence that is relevant to the field. This will include research beyond placebo-controlled trials and that will incorporate characteristics of a patient-centred medicine.


Vested interests and the greater good
William House GP, researcher, commissioner, BHMA trustee

The title of this article expresses an essential tension we have to live with. How we negotiate this tension will determine whether we thrive, or even survive, as a species. Currently we are not doing well. So much is obvious from the inequalities between rich and poor, and the degradation of the environment.


More harm than good?
George Lewith Professor of Health Research, University Of Southampton School of Medicine

All medical interventions involve balancing benefit and risk. CAM has a poor evidence base associated with very little research spending, as does much chronic benign illness managed conventionally. Adverse reactions to conventional interventions are common, dangerous and expensive. CAM appears to be relatively safe and possibly equally effective although more research is needed. The evidence for the effectiveness and safety for some interventions has been selectively misrepresented by those who oppose CAM. They have suggested inappropriate research methods and exaggerated the risks, thus unhelpfully polarising opinions and denying patients an integrated approach to their condition.


Integration, long term disease and creating a sustainable NHS
David Peters Professor of Integrated Healthcare, School of Integrated Health, University of Westminster; Chair, British Holistic Medical Association

Healthcare faces three interconnected crises of cost, cure and care. Costs are soaring as a pandemic of chronic disease outstrips the development of cures, and caring is losing ground as medicine industrialises and its commitment to timeless principles wanes. Our medical system can pull out of this high-tech nosedive and become more sustainable if it develops a new model of health, recovers timeless shared values, and explores the potential of integrated medicine.


Approaches to healthcare: connectedness and spirituality
Dr Denise Peerbhoy Director, The Commonsense Partnership Limited

This paper explores the importance of the relationship between healthcare practitioners and clients in a particular healthcare setting. The research reviewed user narratives to explore the experience and health impact of contact with this service. The results revealed evidence of a 'response shift', ie changes in people's self-perception of their quality of life. A significant feature of the healthcare provided was the therapeutic value of the practitioner-client interaction itself.


On becoming a 'recovery ally' for people with depression
Damien Ridge Reader in Integrated Health, University of Westminster

Depression is unique in the way it attacks the mind and undermines the 'voice' and patient abilities to tell a life-giving story. So how then do patients actually go about organising their recovery from depression? What is the role of memory and narrative? And how can professionals best encourage revitalising narratives?


Nursing in partnership with patients means embracing integrated healthcare
Donna Kinnair DBE Director of Nursing, The Foundation for Integrated Health

Improving the quality of care for patients will require nurses to understand how patients integrate complementary therapies into their self-care. If nurses are to work in partnership effectively they will have to learn to facilitate integration effectively, and that will mean understanding more about these ideas and practices.


An integrated approach to gynaecology
Michael Dooley Consultant Gynaecologist, The Poundbury Clinic

Gynaecology and women's health is ideally suited for an integrated approach. Women must be offered a choice with a team approach. It is essential to have good communication between different practitioners. The problems with developing evidence base is raised and a systematic approach to the integrated management of patients using the acronym DR AID is discussed. The problems of infertility, menopause and premenstrual syndrome are also addressed.


The challenge of obesity
Chris Drinkwater Emeritus Professor of Primary Care Development, Northumbria University

Knowledge and information about the management of obesity remains firmly located within a disease-based medical model. This model is inherently paternalistic and tends to undermine both collective and individual responsibility for our behaviours.We need to shift to a model that is about fully engaging the public as co-producers of health. Challenging the prevailing orthodoxy of the medical/pharmaceutical industrial complex will not be easy, but sustainable long-term solutions will only be achieved if we are serious about devolving responsibility, power and funds to local communities.

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Journal of Holistic Healthcare
Issue 5.4 - December 2008
 

Shadows in Wonderland - a hospital odyssey Staff
Colin Ludlow


When television producer Colin Ludlow was admitted to hospital for an operation, he expected to be home in 10 days. In the event, he ended up staying for five months, nearly died on several occasions, contracted MRSA, and was still recovering from his experiences more than three years later. In Shadows in Wonderland he tells his story, and takes a fascinating philosophical journey through chronic illness as he explores its wider significance. Here we reproduce the chapter Staff.


Just what the doctor ordered?
Donald Watson Author, ex-cancer patient and patient representative

How happy are patients with medical consultations? What do they like about the way their doctors interact with them? Have their priorities changed in recent decades? How has the success of modern medicine affected both the way doctors behave towards patients and what patients want from doctors? What do patients perceive as still lacking, and how can doctor and patient work together to form a more effective partnership and achieve better healthcare? And where does integrated healthcare fit into all this?


Radical ordinariness: the women's service in Purley
Foxley Lane Women's Service staff

The Women's Service in Purley, London, is radically different from the stereotype of mental hospitals as frightening impersonal places. A large 1930s house is home for up to eight women at a time who are going through a mental health crisis. Inside, there are bundles of NHS leaflets on the windowsills and the odd reminder of smoking regulations, but otherwise it's an ordinary house offering a unique service.


Medicine and the healing vocation
Revd Dr Jeremy Swayne

The paper discusses the need to reconcile the achievements of modern medicine with the limitations its methods impose on our understanding of and response to illness; particularly the dichotomy between medicine as a means of controlling disease processes and manipulating body functions, and healing as a process of enabling self-regulation, re-integration, insight and new growth. I suggest that dependence upon the power of medicine to control is at the expense of equally important, sometimes more important, subtle, whole-making functions of healthcare.

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Journal of Holistic Healthcare
Issue 5.3 - September 2008
 

Breathing can damage your health
Michael Lingard BSc. DO. BIBH


This is a brief look at the most neglected function of breathing, something that is so unconscious and automatic in our lives that we rarely stop to consider its effects on our health or its protean impact on every disease. 'The breath of life' can be incredibly damaging to our health, especially when chronic hyperventilation is unrecognised, undiagnosed and untreated.


Midlothian Sure Start
Karen Hooton RSCN, MIFPA, MSIR


Midlothian Sure Start won the 2007 Prince's Foundation for Integrated Health awards. It provides services for vulnerable families with very young children. As well as dealing with the challenge of parenting a naturally demanding age group, many parents are dealing with their own difficulties, which range from poverty, to isolation, to drug addiction. Many have found the treatments of a complementary therapist invaluable.


The sacred addiction: exploring the spiritual and psychological components of Alcoholics Anonymous
Kevin Hinchliffe Hypno-psychotherapist


The philosophical basis of Alcoholics Anonymous is outlined and the role that spirituality plays is compared to that of psychology. Spirituality is presented in the context of a transpersonal rather than religious experience. In response to concerns about the current lack of spiritual understanding in therapy I introduce the reader to sources of modern transpersonal thinking and the challenges for future development.


Stress management within the undergraduate medical education curriculum
John Perry Principal Teaching Fellow in Healthcare Communication, University of Southampton Nick Purkis Clinical Skills Facilitator, University of Southampton

In this paper, we present evidence relating to the existence of high levels of stress within medical students, and then consider a range of possible solutions with reference to various curriculum definitions and models. Throughout the paper, the definition of stress we have in mind is that provided by the Health and Safety Executive: 'Stress is the adverse reaction people have to excessive pressure or other types of demand placed upon them' (www.hse.gov.uk/stress). This is distinguished from healthy levels of pressure, which are experienced as motivating rather than debilitating.


Dear Department of Health...
Lesley Wye Research Fellow, Academic Unit of Primary Care, University of Bristol

Four years ago I look part in a Department of Health 'experiment' and moved into academia to study for a CAM PhD. Could a holistic complementary practitioner survive, or better still thrive, in an academic medical environment? Although I and my fellow 'guinea pigs' have gained from the experience, the impetus for the initiative needs to be maintained or it could be lost amidst lack of funds and attacks on CAM.

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Journal of Holistic Healthcare
Issue 5.2 - May 2008
 

Engaging in therapeutic dialogues. Can holistic practice lead the way towards a 'fully engaged' healthcare system
Bob Sang


This paper links learning from my work in patient and public involvement in health (PPIH) to my experience as a long-term user of medical services, including holistic medical practice. My purpose is to find a means of bridging the apparent gap between the stochastic field of holistic medicine and the mainstream opportunities to improve the health and wellbeing of citizens and populations. In offering a series of frameworks that challenge conventional thinking about 'patients', the paper proposes that effective holistic practice has a key role to play in the achievement of a sustainable healthcare economy. The challenge to practitioners, then, is whether or not to engage: both as influential contributors to healthcare reform and as partners with active citizens ? informed patients and their families. An alliance of considerable, as yet untested, potential.


Lifting Your Spirits: A self-help approach to coping with illness
Jan Alcoe


This is an extract from my guide (a booklet and two audio CDs) to coping with serious illness, published by the Janki Foundation in April 2008. It offers practical tools for self-help during times of illness. The contents are based on my own experiences and insights and those of others who have coped with serious illness and treatments, with contributions from a range of healthcare practitioners.


Doctors' health matters - learning to care for yourself
Craig Brown GP


It would be reasonable to think that doctors, who spend their working life looking after others, would be skilled at caring for themselves. The opposite is true. We know doctors' work is stressful, yet they do not handle it well. It can result in burnout and illness. This is compounded by a culture of denial of ill-health and lack of support. The article outlines the need for self-care, and describes the workshop, Caring for Yourself, taken from from the Values in Healthcare - A Spiritual Approach training pack. It outlines the evolution of a style of facilitation developed for the training.


Passing people by (why being a mindful practitioner matters)
Chris Johns Professor of Nursing, University of Bedfordshire


Being mindful is the root of all skilful action. As such it seems vital that such a quality of being a practitioner is cultivated. One way is through reflection. At the core of reflection is story. Through Peggy?s story I explore the reflective process and the significance of mindfulness towards easing suffering by 'not passing people by'. I then reveal the reflective process through six movements of dialogue culminating in narrative and dialogue with an audience.

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Journal of Holistic Healthcare
Issue 5.1 - February 2008
 

Modern times (True) Parables from the frontline of the NHS
David Zigmond General Practitioner, Bermondsey; Liaison Psychiatrist, Hammersmith Hospital, London

The non-physical wellbeing of individuals is ill-served by the industrialisation of healthcare. This brings both cost implications and difficult choices. Emotinoal damage or distress is frequent but not identified in official statistics. Fragile therapeutic opportunities are lost. From the basis of current NHS events, these and related themes are illustrated. The narrative and dialogues are authentic. Only peripheral descriptive detail is changed to guard anonymity. Although the personal nature of the recording may be uncommon, the dilemmas they describe are not.


Northern Ireland - pathways to health
Boo Armstrong

A ground-breaking pilot scheme in Northern Ireland is taking seriously the possibility that complementary therapies can improve health and save money. How was the service set up? What problems did it face? And what is the outcome?


A paradigm of wellbeing
John Heron Co-director, South Pacific Centre for Human Inquiry

This paper presents wellbeing as the product of four factors - responsibility, agency, process, and dimension of being - each with three forms; as encompassing treatment, prevention and enhancement; also conventional and complementary medicine. Issues are raised about compliance and co-operation, the potential of internal agency, demarcation in using catalytic and confronting processes, the independence-interdependence of different levels of being, the scope of the model, holistic practice, training and therapy, cure and enhancement and implications for medical education.


Finding the right word for personal care: ubuntu-botho
Tom Garrett GP educationalist

Whole person care begins with medical teaching - students need to be treated as persons, to discover their own personhood, in order to work humanely. Different cultures can give us insight into this.


Healing space - can it be done? An architect's personal view
Mike Hymas Director LCE Architects

In advance of the BHMA's Healing Spaces in Holistic Healthcare awards, this sets out the prospects for holistically built healing environments. What are the constraints, why are they resisted? What is the role of the architect and why should they care?


Being a medical student - a holistic approach
Phoebe Votolato 4th year medical student, Brighton and Sussex Medical School

Following the publication in the August issue of the winner of the BHMA student essay competition, in this issue a 4th year medical student gives her view on holistic self-care.

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