From Crisis to Transformation
part 1: an holistic model of animal health & welfare
IntroductionAn holistic (formerly termed wholistic) approach to disease control consists essentially of considering whole situations, rather than isolated aspects of a situation. A "whole situation" means not just the three dimensions of space and the fourth dimension of time, but also the "whole" aspects of animals, pathogens, humans, environment and economics.
"Whole situation" also means the emotional, intellectual, political and spiritual dynamics of a situation as well as the physical dynamics.
Animal and human welfare factors are embraced as well as purely animal disease factors. The holistic model described here is therefore much wider in scope than the scientific models commonly applied to animal disease control.
One of the merits of an holistic approach is health and welfare are integrated. I believe that attempts to objectify and measure animal welfare are partly spurious. The opinion of trained and experienced people is probably as good a measure as we are likely to get. However, human evaluators must, where opinion is not clear-cut or easy, draw on objective data e.g. behavioural or hormone assay data. The point here is that spiritual and "moral value" aspects of welfare (and the almost lost art of stockperson empathy and intuition) cannot really be objectified. What is important is to rid the human evaluators (as far as feasible) of subjective reactions such as anthropomorphism, bias, desperation or greed.
the objectives of this essay are to...
It is not the purpose of this essay to say how things "should" have been handled in the UK FMD epidemic.
- introduce an holistic model for disease and welfare situations
- apply it to the United Kingdom FMD epidemic of 2001
- highlight healing opportunities for traumatised people
- reveal subtle dynamics in a disease epidemic
- identify constructive change in an out-of-control epidemic
The holistic approach is about navigating and responding to situations, as opposed to treating them as a problem to be solved (see "Health and Disease as a Natural Rhythm"). Insights about the epidemic are offered here in the spirit of creative ideas, NOT criticism and blame (see "FMD Consequences in UK" in Part 2)
The Art and Science of Veterinary Medicine
As a veterinary student, my pre-clinical training was based on the knowledge and philosophy of twentieth-century science. However, on reaching the clinical part of the course I came into contact with veterinary clinicians who spoke for the first time of the "Art and Science" of Veterinary Medicine. I immediately rejected the word Art. Surely the "Art" aspect of Veterinary Medicine was an anachronistic "mumbo-jumbo" of folklore - imprecise, unverified and highly subjective. "Experience" and "Gut-feeling" seemed to be poor and tenuous substitutes for controlled experiments and statistically valid data!
My views were to change when I entered veterinary practice and found that the real world of animal health and welfare was far more complex and "messy" that my student notes and textbooks acknowledged. Sometimes I encountered problems that veterinary science did not yet understand, or where the veterinary science seemed clear, but not very effective. These are the situations where I now consider that holistic veterinary medicine may have a place.
These are also the situations where "complementary" or "alternative" practices, such as acupuncture, homeopathy and osteopathy are being increasingly used.
I would like to make clear that my concept of "holistic veterinary medicine" is NOT synonymous with "alternative veterinary medicine". This model of "Holistic veterinary medicine" is about working with the "big picture" of a situation. Within this holistic approach any manner of knowledge and techniques, be they alternative, psychotherapeutic or scientific, can be applied.
Integrating Animal & Human Welfare
In my twentieth-century veterinary education, an animal was a physico-chemical mechanism which could be studied and understood by the principles of science. This established "mindset" has posed enormous problems for the growing science of "animal welfare" and for the ethical and political questions arising from blossoming spiritual aspirations in society. Behavioural science and stress physiology have been bravely, even exhaustively, deployed to try and reconcile "welfare" questions to the "physico-chemical", materialistic-universe, paradigm of science.
The plain truth is that twentieth-century science cannot really cope with "welfare considerations" such as the mass killing of healthy animals and traumatisation of their owners as part of an epidemic control programme. Welfare considerations include the science of metaphysics - the branch of philosophy that embraces societal values and personal spiritual beliefs.
How can the present and future value - in economic, morbidity and mortality terms - of disease control measures be logically weighed against costs which include emotional, political, psychological, social and spiritual elements? Even if the cost/benefit calculation was logically possible, the input data and variables involved are way beyond the capability of our computer modelling. For example, who knows how the economic, legal and political parameters might change over the next year or two?
The "bottom-line" is that multi-element, real-life animal health situations are beyond the capacity of veterinary science. What veterinarians often do in this situation is to go as far as they can with science, then take a decision-making leap into acquiescence, compromise, expediency or "gut-feeling". The holistic model outlined in this essay is an alternative way, a partly "touchy-feely way" in popular parlance, of determining veterinary action.
Energy - raw material of the Holistic Approach
The somewhat "touchy-feely" holistic approach allows us to integrate the rational and irrational elements of an animal health situation.
In order to integrate and inter-relate the varied components of an animal health situation we need a common currency. The holistic jargon for this common currency is "energy". The holistic concept of energy has much in common with the views of physics - that the universe is basically made up of varied forms of energy, and that solid matter and dynamic forms of energy are interchangeable (E=mc2). Human emotions, mental activity and ethico-spiritual aspirations are also considered by holistic practitioners to be forms of energy.
Is it not rather bizarre to relate quantifiable, tangible energies, such as money and livestock mortality rates to intangible energies like anger, fear, political debate and spiritual values?
Not at all!
The "bottom line" for human life is our subjective experience. Animal disease matters because of the impact it has on people, be it financial or emotional or spiritual. This is why the holistic "measuring device" for what it calls "energy" is simply a human being. In the end, the prioritisation and reconcilation of diverse elements in an animal health or welfare situation, depends on their human impact.
So, should we just do "what feels right" in any health or welfare situation? And how do we cope with the fact that different people feel differently?
At this point, holistic medicine needs to draw strongly on the discipline, self-criticism and rigour of twentieth-century science! We must as far as possible objectify human perception. Objective perception is the common task of good science and good holistic practice. All that differs is that science mainly looks outside ourselves for precision and truth, whereas holistic medicine mainly looks inside ourselves for precision and truth.
Holistic training is about learning to contact our deepest intuition and wisdom. To do this we must clear away, as far as possible, the dysfunctional thinking and feeling that originates from restrictive training (conditioning), bad habits and unresolved (unhealed) emotional traumas. This is the internal debris that clouds our perception and obstructs our wisdom in a given situation. This is the aspect of good holistic practice where we can usefully draw on the technologies of counselling, personal development, professional skills and psychotherapy.
An Holistic Practice Protocol
A simple holistic approach to an animal health situation can be:
to the full range of elements and dynamics in the situation
of the emotional, mental, physical and spiritual reactions in the observer, using meditative or reflective techniques
- CLEARING and SELF-HEALING:
of fixed ideas, self-defeating beliefs, dysfunctional perceptions etc, using techniques from counselling, cognitive therapy psychotherapy.
restructuring perceptions of the situation and thereby gaining insight and inspiration
Dr. Edward de Bono's strategic thinking tools can help here
with people in the situation to ascertain self-defeating beliefs, clear dysfunctional perceptions, develop healthy shared perceptions and build creative options for action
DETERMINE RESPONSIBILITY ALLOCATIONS:
decide the boundaries of personal, organisational, political etc. responsibility
TAKE PERSONAL ACTION:
considering personal responsibilites, risks, opportunities, strengths, values, and weaknesses
This sample protocol illustrates how holistic practice aims at transformation of the practitioner as well as the problem. The downstream benefits of holistic veterinary practice include healing and personal growth for the practitioner.
Health and Disease as a Natural Rhythm
The twentieth-century veterinary practice model tended to regard disease as something which need not happen and which we should therefore control. In short, the conventional veterinary attitude to disease is to approach it as a "problem to be solved".
In contrast, a truly holistic approach sees disease as a normal part of the natural (i.e. seen ubiquitously in the world of nature) intrinsic rhythms of life on earth.
Health and disease are seen to ebb and flow (in individuals and in populations) in an endless rhythm. How can disease possibly be normal? Archeological and historical evidence indicates that disease has recurrently occurred in humans and in farm animals ever since they first evolved. In the recorded history of medicine we know that medical advances and environmental changes can eradicate specific diseases in populations, but this effect is repeatedly negated by the continual emergence of new diseases or by the re-entry of eradicated pathogens.
This holistic concept that disease is "normal" has the immediate benefit of removing a lot of the blaming, defensiveness and guilt that arises from that conventional judgement "This should not have happened!"
If disease is viewed as "normal" - does that let us "off the hook" of taking responsibility for preventing disease?
Does it "let us off the hook" of responsibility for dealing promptly and effectively with disease outbreaks?
Actually - No!
The very concept of dis-ease means that affected animals and people suffer discomfort in some form, and therefore we will naturally choose to respond to it in a way that reduces our distress. Being human, we will sometimes feel angry about the economic, physical, emotional or spiritual effects of disease on ourselves or the animals, people and things that we hold dear.
The holistic model outlined in this essay recognises that we may move into attitudes of blame or guilt, but invites us to recognise that these are just beliefs and feeling reactions as opposed to manifestations of "reality". In this way a holistic view of disease outbreaks opens the way for us to move through our unskilled human reactions of blame and guilt to a more skilful "mindset" wherein we can focus on:
- learning what we can to avoid repetition of this disease experience
- repairing (healing) damage incurred by this disease experience
We don't have to learn from our disease experience, but if we do, this can can be entertaining, satisfying and healing (e.g. in reducing residual feelings of vulnerability). If the learning is effective it will also reduce the chance of a recurrence of this particular disease experience.
Holistic Definitions of Health and Disease
Conventional medicine has wrestled throughout its history with the questions: "What is health?" and "What is disease?"
The non-specific ebb and flow relationship between health and disease will be emphasised in this essay by adopting an holistic definition of health as being "a state of comfortable and efficient functioning ("energy flow") or "ease". This is a wider definition than those used in conventional medicine and has the value of integrating welfare and health. Although lacking the attempted precision of conventional definitions of health, Holistic health or "ease" has the benefit of being very flexible. Holistic health can be assessed not just for an individual or population, but also to a veterinary service, to a mixed population of animals and people (e.g. a farm) and even to an entire nation.
How can health possibly be assessed on such grand scales and in such diverse aggregations of life-forms?
The holistic model described here uses the "deepest wisdom and intuition" of trained and experienced human beings to sense and evaluate a wide range of data. This process can include evaluation of epidemiological and other conventional veterinary scientific data, but must go beyond these. The range of information available will often be impossibly wide and overwhelming to gather, let alone evaluate. Therefore the data and issues for action have to be prioritised and selected on the basis of their perceived power - often termed "energy" by holistic healers and therapists. Sensing the power of situational components requires first that the subjective reactions of human observers are brought into awareness and cleared (see "Holistic Practice Protocol" section).
From the holistic viewpoint, health and disease are not separate - they are mixed phenomena, as illustrated in this essay's "YinYang" symbol of intertwined blue and red areas.
There will be times when an animal or person appears outwardly healthy (the red area, representing vitality, ease, functionality) and dis-ease (represented by the small blue area inside the red area) is not obvious.
At other times, an animal or person appears outwardly sick (the blue area, representing dis-ease, dis-function, a depression of vitality) and healthy functioning (represented by the small red area inside the blue area) is not outstanding.
"Dis-ease", from a holistic viewpoint, is the situation where potential vitality (energy flow), functioning or comfort is disturbed. Therefore energy flow is less efficient and this may lead pathological changes and/or a conscious sensation of discomfort or pain.
One final point...
The holistic definitions of health and disease are better described as "concepts" rather than "definitions". To define them precisely is to destroy their vital assets of flexibility and transportability. They are not offered here as an alternative or better usage than the conventional understandings of health and disease - they are just a different tool for working with and understanding complex real-life situations. Being a different tool, they have the potential to produce different results and might extend our range of options for responding to a health or disease situation.
"Holistic" versus conventional "Reductionist" approach
The European Union (EU)'s response to Foot and Mouth Disease (FMD) has in recent years been a reductionist evidence-based medicine, approach i.e. that this is a disease caused by a virus (FMDV) and that animal health and human welfare are best promoted by investing our resources in exterminating the virus and creating barriers to further entry of the virus.
Questions have been raised about the effectiveness of the traditional EU approach to animal disease epidemics in the context of the agricultural, social and political circumstances of the 21st Century.v
Is this goal-focussed, reductionist approach still our only option as a veterinary disease control model in the face of an epidemic which is out of control?
In recent years we have seen an upsurge of interest in "holistic" approaches to human health and welfare. Can the great livestock "plague" of FMD be approached from a holistic viewpoint? Are there situations where an holistic response to FMD could serve animal health and human welfare better, or as a supplement to, the "stamping out" policy?
Can an holistic response be a viable "alternative" or useful "complement" to a reductionist response based on "Germ-Pathogen theory"?
"Control a Disease Problem" or "Respond to a Dis-ease Situation"?
The reductionist approach to health problems tends to be used in a directed, linear way for purposes of "control". The holistic approach, in contrast, is about "responding" or "flowing" sensitively with the situation in a flexible way, with the purpose of finding the way forward - either in circular fashion back to the original state of health, or forward transformatively to a new state of health. An holistic path forward is open to transformation of both the subject (human expectations, beliefs, system of husbandry, legislation etc.) and the object (e.g. pathogen).
With a "control" agenda for Foot and Mouth Disease (FMD), once we find "the cause" - FMD virus - we proceed to develop and apply ways of controlling the cause. An approach designed to improve quality of life for ourselves and our animals.
Controlling disease agents is both a very plausible and a very attractive proposition - no wonder reductionist medicine is so popular! A problem arises, however, when our attempts at disease control fail, or do more harm than good. At this point, what was initially an animal dis-ease becomes increasingly also a human dis-ease. In economic, social or emotional terms, there might come a point where controlling the disease costs more than the disease itself.
In the United Kingdom FMD crisis, a linguistic portent of the crisis to come appeared in the words of key decision makers and opinion leaders when they used expressions like "..we must eradicate this disease at all costs". This mind-set "set us up" for the FMD crisis that emerged, where costs of £20 billion (currency conversion), over 3 million animals killed, several farmer suicides, extensive environmental pollution, children and adults emotionally traumatised and a nation in anguish and division, appear to have considerably outweighed the benefits of the single-minded, reductionist approach: eradication.
The holistic approach to FMD appears, superficially, to be unattractive (vague or "wishy-washy"), compared with the sharp, narrowly result-focussed approach of eradicating the virus as quickly and directly as possible. The power of a holistic approach is that it draws input information from a wider view, thereby harnessing more resources and mitigating the "collateral damage" of a reductionist (focussed attack on the virus) approach.
I envisage at least four disease experience situations....
- control feasible and working effectively - holistic model not needed
- control poorly effective - combine with holistic approach
- control not working - change to holistic approach
- control not feasible - holistic approach used from outset
In a narrow view, a holistic model will not always be as successful as a "blinkered" control policy. The enormous power of holistic veterinary medicine only really becomes apparent when we consider the broad sweep of potential outcomes and costs in a disease situation (see below).
The Holistic Model - Basics
The holistic view of health is based on the premise of an energy-based universe in which the various forms of static (material) energy, such as money, food, virus particles, animal tissues, disease lesions, human agendas, intentions and perceptions, and the various patterns of moving (dynamic) energy such as animal activities, human activities, food production and air movements are all inter-connected. The energy forms that make up our universe are also all "mutable" in that, as modern physics teaches us, energy is indestructible and can only move from one place to another, or transform from one form to another (even from "energy" to "matter" and back again).
"Life", be it animal or human, is, from a holistic viewpoint, a folding and unfolding (oscillating) process of energy movements (patterns). The holistic view of health is fundamentally that health ("ease") is the condition of life where energy patterns flow and interconnect in an efficient way according to the laws (genetically and karmically predetermined) of nature. Dis-ease is the condition where energy flow is blocked or diverted away from the naturally efficient patterns, and is therefore not moving in an efficient way. The difference between health ( ease ) and disease can therefore be seen as a difference between the situation where energy moves in an efficient, evolutionarily pre-ordained way, consistent with the present ecology (harmonious balance) of the universe, and the situation (in dis-ease) where energy moves in an inefficient way that disturbs (conflicts with) the evolved ecology of the universe.
It is the "blocks" to energy flow and the "diversions" of energy away from efficient dynamic processes that create what we call "pathological processes", "disease symptoms" or "stress". In holistic medicine these clinical and welfare disturbances are not seen as "errors", "flaws" or "problems" to be controlled and eradicated, but as "signposts" to the underlying folding and unfolding process which we experience as "life". Thus, a fundamental difference between reductionist and holistic approaches to health is that the reductionist approaches (which dominate animal and human health activities in Western Europe) act to exclude dis-ease experiences, whereas holistic approaches seek to accept, integrate ("learn and grow" from) and move forward through dis-ease experiences back towards health.
The Holistic Model - Summary
The Holistic Model could be described as the approach to disease situations that we all dream of, but never dare use! It is about letting-go of our bias, dogma and limited knowledge in favour of being "in the moment", receptive, flowing, and open to whatever possibilities are in the situation.
It is liberating - liberating us, paradoxically, from the constraints of models and systems. It is about being ourselves and connecting with the universe - the universe within us and the universe outside us. This can be refreshingly different from (but does NOT reject the value of) the convention-bound, fact-bound, straitjacket of twentieth-century science and veterinary "recipes".
However, there is a significant "down-side" or cost to holistic practice...
Firstly, it is more risky - risky in terms of doing things a new way and in not having the cosy support of accepted practice and conventions.
Secondly, it is not a licence to indulge our human frailty, our personal beliefs, personal weaknesses, unhealed traumatic experiences or our critically-unexamined experiences. Quality holistic practice requires at least as much training as a narrowly evidence-based, scientific medicine approach. In addition, a higher degree of critical self-examination, plus a higher degree of honesty and openness to others, and to the situation in general.
Symbolic image of this essay
The holistic paradigm of this essay is symbolised by this traditional "YinYang" holistic circle of interlocking commas. This embodies the concepts of wholeness, balance and inter-flow of energy which underly the holistic model presented here.
Around the "YinYang" circle of balanced energies, are arranged hexagrams of the I Ching - an ancient Chinese book of divination which dates back four thousand years. The I Ching has often been dismissed as a system of "fortune telling" but in fact it is a symbolic way of generating new viewpoints and new options in a current situation that is causing concern.
The composite image of these two ancient symbols of wisdom neatly summarises the paradigm on which this essay is based. A paradigm of assessing the "big picture" of interacting dynamics in a troublesome disease situation and from this generating new options for future action and healing.
Go to: Title & Music Overview & Index Part 2 Notes & Resources