The Politics of Responsibility, Self Regulation & Optimal
Functioning
By Rob Kall, M.Ed.
211 N. Sycamore, Newtown, PA 18940,
215-504-1700 fax 215-860-5374 , HP@FUTUREHEALTH.ORG HTTP://FUTUREHEALTH.ORG
presented at the 6th Annual Winter Conference on Brain Function,
Modification & Training. Feb 8, 1998, Palm Springs CA,
The subjects of this meeting, bio and neurofeedback, self regulation,
consciousness, self awareness-- are revolutionary, and paradigm shifting. We operate
in a time when reductionist, pathology-elimination based, double blind proven medicine is
the ruling economic, philosophical, scientific and almost, the ruling religious model.
But the shift, though still subtle has begun, and we are at a turning point in the
phenomenological rhythm, or spiral of perception. Less than 200 years ago, health
care was based on systemic approaches. The new scientific and technological innovations--
X-ray, microscope, precision chemistry, anesthesia, surgery, targeted pharmacological
agents-- all helped to turn the vision of health care from treating the whole body
to treating specific lesions.
Even within the self regulation field, the history is one of moving from a more
generalized, systemic relaxation and arousal reduction model more localized and focused,
smaller system control strategies.
Consumers have begun to want more than symptom elimination. The reality is, modern
medicine has reached a plateau of sorts. It can help acute disease, but is still at a loss
for dealing with chronic problems--- and actually, many of the cures for acute diseases
have led to some of the chronic problems.
Certainly the use of drugs is one example. Drugs are ubiquitous, deeply ingrained elements
of Modern cultures, as are other medical “treatments.” And they do produce
incredible cures. But there is a down side. People expect a pill to solve any problem.
Then,
we have a massive increase in the categories of human conditions classed as pathological.
These
circumstances have led to a dependence upon medicine -- a dependence by patients to
have something done for/to them while they passively wait for help.
Edward Tenner, in his book, Why Things Bite Back; Technology and the Revenge of
Unintended Consequences, cites Ivan Illich’s Medical Nemesis, “ medical
bureaucracy creates ill-health by increasing stress, by multiplying disabling dependence,
by generating new, painful needs, by lowering the levels of tolerance for discomfort or
pain, be reducing the leeway that people are wont to concede to an individual when he
suffers, and by abolishing the right to self-care. And that was written in 1976, long
before managed care had the temerity to tell doctors that therapy other than
pharmaceutical was unacceptable for depression and other disorders. Tenner goes on
to ask, “Have the public and private insurance plans of the industrial world eroded
responsibility and rewarded sickness? “
Biofeedback, applied psychophysiology, self regulation-- call it what you will-- this self
control, self responsibility approach to health has many faces, which include nutrition,
exercise, lifestyle, work style, thought styles-- is really only given lip service
by the prevailing medical model. James Gordon, in book, Manifesto for a New Medicine,
writes,
"If anyone had come up with a new drug that doubled the life of women with metastatic
breast cancer, every oncologist in America would have had his or her prescription pad
ready; when David Spiegel demonstrated that support groups could make this kind of
difference, his work hardly made a wave on the surface of orthodox medical practice."
Gordon goes on to comment on standard of proof for drug research, “Nor has this
standard of proof been applied equally to all therapeutic interventions. Very few surgical
procedures-- which are not, as drugs are, subject to FDA approval-- have ever been through
large-scale clinical trials.”
He reports that one US congress Office of Technology Assessment study indicated that
approximately 85 percent of all therapies and procedures commonly used by physicians and
in hospitals had never received any kind of rigorous evaluation.
The problem runs deep. NIH research funding is based on pathology. You can’t go to
NIH with an approach which could help a wide range of diseases and seek support. First you
have to identify a disease. This is sick. And even if you do narrow down to a disease, NIH
has somewhere around 10 million dollars earmarked for this kind of approach to health--
out of a budget of over 12 billion (which Clinton is raising). That’s one thousandth
of the budget. They certainly spend more on accounting and secretarial than they do
on self-responsibility aspects of health care.
This reminds me of ancient life in the fertile crescent, or the Mayan culture, when
priests were in control of knowledge and the essentials of life, It was a paternalistic
time when individual’s souls and ability to live were controlled by the high priests,
only now we call them doctors.
We live in a society in which one of the largest, if not the largest industries is the
trillion plus dollar health care empire. It is “multicameral” in nature, with
government divisions-- FDA , NIH and state licensing boards, Insurers, and corporate
divisions-- the huge pharmaceutical houses, hospital chains, hospital suppliers, and of
course, the Priests of power-- the doctors, nurses, technologists, bio-researchers,
attorneys, and bureaucrats who all have a stake in maintaining the status quo. When
Clinton tried to take on this empire several years ago, even with the mobilization of the
resources of the presidency of the US, he was soundly trounced by an obviously more
powerful foe.
So..... how can we, a small, under-funded .group of idealists, visionaries
and dreamers ever hope to get the giant to change? I like to think we are the
hot-blooded little mammals who survived the cataclysms which caused the extinctions of the
dinosaurs-- in this case-- the reductionist medical industrial empire.
But
we don’t have to wait until catastrophe strikes. Actually, Tenner describes how we
have shifted from an era of discovery of cures for acute illness to an era in which we are
challenged to deal with chronic illness. And we know that this is where reductionist
medicine is far less effective, where one might even say it fails. It is where a health
responsibility model must be employed. The problem is that the reductionist medical model
sabotages responsibility, as Illich and Tenner state.
America was founded with the clear vision that self-responsibility,
independence, self-reliance were all strong positive vales and personal traits of a person
with character. They’re as American as apple pie. But as I have pointed out, they are
being eroded. It will now require a national commitment to rescuing these endangered
values. We need to take our case to the American people and seek legislation to require
health insurers to include the right to self-responsibility based approaches to health and
illness. At first, I was going to propose that we need to drum up legislative support for
NIH to spend 100 times more money (about a billion a year or ten percent of the budget) on
developing responsibility-based health approach.
But after further thought, I believe we should be asking for an equal budget for
responsibility and optimal fucntioning (the logical consequence for taking responsibility
for achieving your potential) oriented science, research,, technology and service
development. investing in the character of the American people, in bringing out our
people’s best will produce a return on investment in many ways-- new jobs, better
performance at work, lessened crime, better school work, new industries. We can even
develop a counterpart to the technology incubators for character, responsibility,
compassion and optimal functioning service start-ups.
I believe that this kind of agenda could reverberate in the heartstrings of Americans from
all walks of life at a bipartisan level of support. Framing the threat of the erosion of
basic American values with the promise of answers to chronic illness, we offer something
powerful, with a real chance of getting legislative and financial support. We need to,
deserve to and should be proud of our work. We are doing the right thing and as
Julie Gold, the writer of the song, played on the air more than a million times, who still
struggles to get her work accepted said,
"Realize you have the potential and power to touch and affect millions of people.
Remember above all, if you believe you are right, then you are and your critics are
wrong."
Now, if you find yourself nodding your head in agreement, here are a few steps you can
take. First, make a clear decision and commitment within yourself, that you are a part of
this movement, that you are proud of the vision you hold and the path you are on. You
don’t need to apologize to anyone. You can decide to take action. What action
can you take.
-You can educate the professionals around you. Don’t worry about the anals who
religiously demand double
blind studies, the negatives, the fundamentalists. Expect that 25%-30% of the people on
this planet are afraid of change
or have vested interests in keeping things the way they are. The rest of the people either
don’t care or will be
happy to hear your message. And since, as we know, only about five or ten percent of
the population really
makes anything happen, you just need to connect with those people.
-Allow yourself to make a good living but also do service-- pro-bono work with people who
can’t afford the fees
you must charge because insurance doesn’t reimburse. The good you do will come
back to you manyfold.
-Get involved with AAPB’s advocacy plans-- legislative, PR, insurance.
-get involved in building a model, a vision, a plan for a new approach.
- Get your clients to become aware of the issues. Teach them to think about health
responsibility and to see
what insurance and managed care is doing. They are the choir. They are ready
to hear it. This is how we
get a grassroots support network going.
-Let’s put together a document-- a statement which expresses the goals
and positions we agree upon.
-contact your legislators.
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