***Saying What We're Doing

Labels and titles set the tone and direction for our actions. What we call ourselves both identifies and directs our actions. The ways therapists/caregivers identify what they are doing sets expectations for themselves and for the careseekers who come to them for help.nnComplementary/ Alternative/ IntegrativenAlternative medicine is the term most commonly used for therapies that have been outside the spectrum of conventional medical care. These include therapist-administered treatments such as acupuncture and massage, as well as the self-healing techniques of relaxation, meditation and imagery (the latter three have been combined as psychoneuroimmunology). When expertise is required in learning the methods or in choosing remedies, as in aromatherapy, flower essences and homeopathy, the approaches and healer/ healee relationship can be fairly similar to those found in conventional care. The self-healing approaches are often practiced under the guidance of trained practitioners. nnHolistic/ WholisticnHolistic has been in use for several decades, used generally to indicate a focus in treatment that extends beyond physical problems as addressed by conventional medicine. In some instances holistic includes what I term wholistic, but in most instances it refers to the addition of some aspects of CAM therapies to medical care. Often this sort of holism includes bits and pieces of therapies, such as needling particular acupuncture points for pain relief, or providing massage for relaxation and post-injury rehabilitation.nnHolistic may overlap with psychosomatic, including psychological aspects of illness, as reflected in emotional responses to the physical problems, in mental aberrations that occur as the result of disorders of the body (e.g. psychosis that may result for hormonal abnormalities), and psychological influences on the body. Minimal mention is made of the psychological contributors to disease and psychosomatic medicine has been grossly neglected in medical training at most medical schools. nnnWholistic refers to whole person care, including body, emotions, mind, relationships and spirit. Where CAM therapies are modalities for wholistic care, wholistic healing acknowledges the broader philosophies of these approaches. For instance, acupuncture includes a complete system of biological energy diagnosis and treatment. This is fundamentally different from Western medicine, addressing the biological energies of the body as avenues for diagnosis and treatment. Western medicine tends to discount and discredit acupuncture (and the theoretical and philosophical cosmologies of other CAM modalities), ignoring that many of these have served the larger portion of our world?s populace, and continue to do so. nnMany varieties of bioenergy therapies are available within the wholistic healing spectrum nnIntegrative carenIntegrative care - in its highest form - seeks to blend the best of conventional and CAM modalities, respecting the approaches of each modality. However, this term, too, may be used to cover token selected CAM interventions that are lifted out of their original contexts into Western settings.nnCongruence of caregivers with their teachingsnWithin all of the variations on the theme of caregiver, we often tend to focus on the content of their ministrations. The family doctor prescribes medicines, the surgeon cuts and sews, the herbalist prescribes plants, and so on. We should not overlook the importance of caregivers as healing agents, in and of themselves. Within wholistic frameworks, caregivers are an essential part of the healing.nnCaregivers are far more effective when they model what they are teaching than when they are simply purveyors of information. A quiet voice, a heart connection, and suggestions based on personal experience enhance the impact of any therapeutic intervention. In the deepest sense, this is when the therapist is keeping his or her word.nnBiofeedback is an excellent example of the importance of therapist congruence with the therapy. Biofeedback introduces instruments or other methods for becoming aware of bodily processes that are usually outside of conscious awareness. For instance, a very sensitive thermometer or electrodes that measure electrical skin resistance may be taped to your hand. Your challenge is to discover ways to raise the temperature of your hand or to alter the electrical resistance of your skin, using the feedback provided by that thermometer or resistance meter. There are no precise instructions that can be given in how to do this. Each person must explore what works best for them. Biofeedback therapists who have mastered these techniques themselves are more effective in teaching them to be healees.nnAbbreviationsnCaution may be in order when we use abbreviations in saying what we are doing.nnInternet users often use abbreviations in their quest for ever more time-efficient communications.nnBTW - By the waynRUOK - Are you OK?nOIC - Oh, I seenKWIM - Know what I meannSigning off with nBCNU - Be seeing you or nBFN - Bye for nownnMedical charts are full of such abbreviations, as doctors maximize their use of pen on patients' charts in the interests of saving time. For instance:nnCOPD - Chronic obstructive pulmonary diseasenCVA - Cerebrovascular accident (technicalese for having a stroke)nEEG - ElectroencephalogramnEKG or ECG - ElectrocardiogramnnWe have to be careful with potentials for misunderstanding with some of these, such as SOB - Shortness of Breath.nnAs hospitals move into more wholistic care, some of these become a liability. The Planetree hospital group is humanizing hospital care in a big way. Some Planetree facilities are in custom-built structures that may include healing architectural features, such as an atrium extending from ground to top floors, facilities for relatives to cook home-style meals, and places for family to bed down near their relatives who are being treated in the hospital. Music may be played in the ground floor, audible through much of the hospital. Respants are invited to read their own medical charts and enter their own notes in the charts. When a doctor reads, "Dr. Smith was in a bad mood yesterday. He only peeked in and said, "Hello" but didn't give me a chance to ask about my lab tests!" there is likely to be more doctor-respant communication.nnDoctors have learned to not use certain abbreviations where respants might review their charts.nnASVD - arteriosclerotic vascular disease (may raise anxieties that the lab tests showed venereal disease)nBS - bowel soundsnPET - poor exercise tolerancenPIG - pertussis immune globulinnPIGI - pregnancy induced glucose intolerancenPROM - premature rupture of (amniotic) membranesnROT - remedial occupational therapynSOB - short of breath nWe do well to watch our words!nn