Psychology has a leading role to play here. The Lifestyle Medicine transition is firmly anchored in the Whole Foods, Plant-Based nutritional paradigm. It is an unprecedented paradigm shift and part of a cascading series of such shifts. The psychological resistance to change is at play every step of the way. The first mistake would be to continue the old-line medical thinking and focus on the physical change, the dietary change. The truth is that Whole Foods, Plant-Based nutrition and the accompanying lifestyle adjustments, like exercise, relaxation, and healthy relationships are the instrumentalities, but it all revolves around the decision to take responsibility for our health, which truly is a paradigm change and the locus of that change is the mind of the patient.
No different than with other existential dilemmas, there has to be that moment of changing the way you’ve always done things, once you notice that if you stay the same, the results are going to be the same every time. That decision moment is the key, the rest are the tools that are at your disposal to empower you to give form to that decision.
Neuro-Psychological dimensions
Douglas J. Lisle, Ph.D. is a clinical psychologist and principal author of the book The Pleasure Trap and he is one of the authorities in this field and indeed, his contribution is invaluable in helping people understand the neuropsychological issues of how bad food becomes addictive. Dr. Neal Barnard added fuel to this discussion with his book The Cheese Trap, which includes a discussion of the research that milk contains what amounts to a mild opiate, which is the physiological basis for the bond of the calf with its mother, so it wants more milk and quickly grows into a mature cow. When making cheese however, this substance is concentrated even more, which explains why people often find it hard to give up cheese. For many people it is the last thing to go.
In terms of succeeding with major change like this, there is more to it than understanding the mechanics , however helpful that might be. On the basis of this type of information, people are likely to end up fighting themselves, because they don’t understand why they have self-destructive tendencies that will set them up for failure. On will power alone, people are unlikely to succeed.
ACLM Positive Psychology
The American College for Lifestyle Medicine recently published a paper on Positive Psychology in Lifestyle Medicine and Health Care: Strategies for Implementation, sort of a modern day equivalent of the power of positive thinking, which again may be helpful to some degree, but it is not the whole answer and in fact may produce long detours, because it does not even touch the real problem and risks covering it up. which just makes for a worse crisis down the road. The road to hell is paved with good intentions, etc. This type of thinking has been very prevalent in New Age circles, but never gets out of the egoic realm and therefore cannot solve the problem because it focuses on behavior, just as in the work of Doug Lisle. As a result we are left with willpower and internal conflict and the result is more guilt which does not solve anything.
Holistic Medicine Isn’t
The work of Edgar Cayce and Mary Baker Eddy has been foundational to what most people call holistic medicine, which isn’t because it lacks a coherent metaphysical framework. The so-called mind-body-spirit paradigm that has been so omnipresent in New Age culture and in so-called holistic medicine misses the point entirely, and has given rise to a lot of wasted money, time and effort in the healing professions, for there is no equivalency here, there is a clear hierarchical organization, which was in some ways clearer in the work of Mary Baker Eddy than in Edgar Cayce’s work. MBE, much to her credit, gave up her denialism of the body and medicine at the end of her life, so in that sense she came closer, because she absolutely saw the primacy of the spirit, but by no longer denying our physical experience, she opened the door to the possibility of a sensible healthcare from a spiritual perspective that was free to incorporate all the available tools. In another way, Cayce taught by example the primacy of spirit, in the way he was able to tap into the mind and be guided to come up with amazing diagnoses and therapies that have often proven very effective and certainly got the attention of many in the medical profession and healing professions in general. His influence can be felt until today.
Where the New Age ended up is with this strange notion of Mind Body Spirit as an equivalency, seemingly three different aspects of our person, which somehow all needed to be addressed therapeutically. The inadequacy of this metaphysically sloppy notion becomes evident once we clearly realize that what we are is mind, having this bodily experience (as Einstein put it, we are non-local beings having a local experience) and start looking at the whole picture from that perspective, yet without denying our experience of being a body in a world, but simply with a split mind that comes with our dualistic consciousness and our experience as a body in a world.
The most practical resolution of this tripartite MBS equivalency came in the way A Course in Miracles treats this question when it makes very clear that healing is of the mind, however it clearly accepts that since we believe we are here and in a body, we very well may need to avail ourselves of healing agents at that level. Certainly we should not judge ourselves for needing that crutch, for doing that would indeed complicate the healing, for we are adding a layer of denial, namely we deny our own physical experience.
The acceptance of sickness as a decision of the mind, for a purpose for which it would use the body, is the basis of healing. 2 And this is so for healing in all forms. 3 A patient decides that this is so, and he recovers. 4 If he decides against recovery, he will not be healed. 5 Who is the physician? 6 Only the mind of the patient himself. 7 The outcome is what he decides that it is. 8 Special agents seem to be ministering to him, yet they but give form to his own choice. 9 He chooses them in order to bring tangible form to his desires. 10 And it is this they do, and nothing else. 11 They are not actually needed at all. 12 The patient could merely rise up without their aid and say, “I have no use for this.” 13 There is no form of sickness that would not be cured at once.
ACIM:M-5.II.2
Real Holistic/Integrative Health
The next step, and really the first step to the new paradigm that I have been talking about on this site has been verbalized with blistering clarity by philosopher Bernardo Kastrup in his article The Case for Integrative Medicine. Later, he published an expanded updated version of that article in his book Brief Peeks Beyond. Lifestyle Medicine smoothly fits within that paradigm and in fact is made even better with the perspective of the proper metaphysics which Kastrup expresses so clearly.
What in fact is happening here is a cascade of Russian dolls of paradigm change:
- Arguably the plant-based nutritional paradigm of T. Colin Campbell comes first, for it brings together the scientific proof of the paradigm that was already suspected by many clinicians over many years, but lacked a coherent paradigm. Campbell’s work in The China Study and Whole represents an entirely new nutritional paradigm, where previously there were merely a set of loosely organized normative assumptions that came together by virtue of the sequence of the discovery of different nutrients. Campbell’s emphasis on a holistic approach as opposed to the reductionist approach, is highly relevant, because medicine has become stuck in a reductionist paradigm of its own.
- Now comes Lifestyle Medicine, which is entirely based on widening the diagnostic aperture of medicine to include nutrition (#WFPB).
In the process, it must become clear that what we call medicine in our materialist society is a practice that gained credibility, not to mention near monopoly status, is in fact a specialty that addresses mostly infectious diseases and some surgery skills. That disease model, the germ theory of disease, has lent itself to a reductionist approach and lots of apparent successes, that all revolve around the notion of a diagnosis of the symptomology of a disease state caused by a single identifiable organism, after which it was seemingly just a matter of selecting the right ammunition to combat the organism, hand in hand with the necessary palliative care.
But this type of medicine proved useless for the treatment of the systemic, chronic and degenerative illnesses from which the majority of people die today. To the delight of big pharma, the best they can come up with is: “You’ll have to take this medicine for the rest of your life,” until they learn Lifestyle Medicine, and find out that 85% of healthcare spending can be replaced with grocery shopping, which is much cheaper. Specifically, it is a matter of teaching people #WFPB nutrition. So the first step of the medical paradigm shift is the inclusion of plant-based nutrition, and what Dean Ornish calls the unified theory of disease, namely the fact that 7 of the 10 leading causes of death are all caused by our diet of animal protein, refined foods, including oil, sugar and salt, and can be prevented or reversed for a fraction of the cost by teaching people #WFPB minus SOS (a Whole Foods, Plant-Based diet minus added sugar, oil and salt. - Lastly, it then must occur to us that what matters is the decision of the patient to be well and change their lifestyle. In other words the change is in the mind, and the diet is only the instrument of that change. The materialist/physicalist model mistakes the dietary change for the change itself, and therefore does not know anything better but to appeal to willpower (Lisle) or to shout down our self-destructive tendencies (ACLM Positive Pscyhology). This is where a spiritual and psychological process comes in. Some people will be motivated by the empowerment provided by lifestyle changes that are more powerful than drugs. The material change however is the shift from the patience victim stance (which fits so perfectly with the germ theory of disease) to one of taking primary responsibility for our health (which has its perfect corollary in the systemic nature of of our current diseases of affluence).
- The next stage in the cascade is that primary care physicians will become predominantly Lifestyle Medicine practitioners, and will need to learn to become in fact the healing partner to their patients, simply the subject matter expert, or the navigator in a relationship where the patient is driving the bus.
- Infectious diseases will be relegated to their niche. In simple cases a Primary Care Physician may be able to help, but more likely the specialty of Infectious diseases will be strengthened, with the proviso that the changes of Lifestyle Medicine put much more emphasis on a strong immune system, so that also there, doctors will have to be much more conscious of assisting the person in healing in an appropriate manner, for the more is handled by the patient’s immune system, the stronger they will be, so the therapeutic stance will change.
- Once it is clear that it’s the mind of the patient where the action is (see a.o. Cindy Lora-Renard’s A Course in Health and Well-being), then it will also become clearer that all other reasonable healing modalities should be entertained on an equal level with the now monopolistic medicine, which is simply not qualified once it. Some important work is being done in Holland in this area, see a.o. this site on health mastery. Where health and healing becomes the mission, all reasonable modalities are reasonable until they are not. The challenge will be to keep a check on frauds, but for now the biggest fraud is the healthcare system we have, which is spending 85% of healthcare dollars on treatments for things we now know and understand it cannot treat, simply because doctors are not trained in nutrition, and are blindly providing treatments that cannot cure the diseases in question, everything from cardiovascular disease (CVD), Diabetes (mostly T2D, but to a degree T1D as well), MS, RA, some cancers, IBD, Crohn’s disease, Alzheimers, Lupus, and the list goes on.
Conclusion: The Next Healthcare System
I have begun to write here about possible healthcare systems of the future, here, and here. The essence from an economics point of view is that we now have a system that rewards treatment of diseases, to the point where more treatment equals more money, and it has resulted in ridiculous over-treatment. Volumes have been written about this, but, feel free to explore my Bibliography of Pharmageddon on this point.
The healthcare system of the future will have to honor the responsibility of the patient and reflect also the economic meaning of personal choices while providing what insurance was meant to do in the first place, which is protect against true disasters. My favorite idea is still a mutual society of healthcare consumers, who pay for the maintenance out of their own pocket, but are insured for special care, but have their PCP and backup staff at their disposal in making critical health decisions and prevent over-treatment and over-charging.
Today’s model of exploitative disease treatment is entirely based on the wrong incentives and impossible to control. Even very extensive support for Lifestyle Medicine might cost less than $10K for a budding heart patient who shows up with ED, but untreated, would result in lifetime billings of as much as $5 million for escalating heart disease staring with Viagra, which does nothing for the disease, except for suppressing the symptoms and ending with multiple bypass surgeries. Psychology is a key factor, and the resistance to serious paradigm changes is at play throughout this process. These transitions are all paradigm changes, the Whole Foods, Plant-Based diet is a paradigm change within nutrition, Incorporating plant-based nutrition in healthcare in the form of Lifestyle Medicine is another paradigm change. Any other form of healthcare reform is treading water.