The Four Forms of Care
When it comes to our health and healthcare, there are so many options, opinions, studies, and viewpoints out there. I don’t know about you, but it overwhelms me. Even having undergone a science-focused bachelor’s degree followed by five years of medical school, eleven years of practice as a naturopathic doctor, and the education of a lifetime of chronic illness, it’s hard to sort through the noise for the wisdom.
I have had the privilege of learning from some amazing doctors, herbalists, and bodyworkers. What I have come to understand is that no matter which medical system, medicine, product, device, app, or service you choose to investigate, they are all trying to do one of the following things. As you will see, all of these treatment targets have their place and can be found within any comprehensive treatment plan and used with any medicine.
Suppression:
Suppressive medicines save lives. Don’t be fooled into thinking they have no place in your life.
A suppressive medicine will stop a response your body is having to a stressor. This may be preventing an asthma attack with an albuterol inhaler, controlling pain levels, turning down an over-aggressive immune response, or lowering blood pressure. Any anti… category of medication is a suppressive one. This includes herbs and drugs.
Our dominant medical system here in the US is built around the art of suppression and we call this allopathic medicine. The overall goal is to keep you in a balanced state with no over- or under-reactions that vary from established normal function. This is where all those lab tests come in handy and why when you receive treatment you are retested to see how closely your numbers meet these established goals.
While suppression is what we are used to as standard medicine, more and more of us find that it isn’t enough, and that sometimes the side effects are more than we are willing to endure. We also see medications beginning to lose their effectiveness as our bodies find ways to adjust and work around them.
While suppression has its place, it cannot be the only approach. Because suppressive care is the mainstream form of care where I live, I don’t practice this form of care unless it is needed immediately to prevent harm and my patient is unable to access this care from their PCP promptly.
Amelioration:
Amelioration is soothing. It is a sibling of suppression, but a gentler sibling. Instead of trying to stop a process, we try to ease the symptoms.
This can take many forms and include activities like stretching or breathwork, services such as massage, herbal medicines to relax spasming muscles or reduce gas after a big meal, and sleep aids or flower essences to soothe our minds.
Amelioration makes us feel better for a short time; it comes with its own side effects when overused; and it also tends to become less effective over time. It also does nothing to address the cause of the symptoms. This is fine if all that is needed for healing is time, but if ignoring the problem by covering the symptoms allows the problem to get bigger, we are doing more harm than good.
I like to work with ameliorative therapies as a way to give us time while we work on the next category of care.
Restoration:
Restoration takes time and effort. It is the most difficult form of care, but it is the form of care with the longest-lasting and farthest-reaching results. Restoration means helping the body heal and regain function.
Please note, that this isn’t always possible: with some conditions where tissue destruction has occurred or a specific function is compromised due to a person’s genetics, some level of suppression, amelioration, or both will always be needed. I know this lesson well as someone who has lived with psoriasis and psoriatic arthritis since I was a child. I too have been made to feel less than and at fault for my disease.
Having a medical condition isn’t a character flaw, it is biology. Don’t let anyone tell you that you have somehow failed if you need ongoing care and their “cure” doesn’t work for you.
Restoration can be complete or incomplete, but either way, it is rewarding.
Restoration involves two different goals:
Identifying and removing stressors:
Symptoms are our bodies' way of showing us that something is off and we don’t have the resources needed to proceed as usual. For some of us, a slight upset in our schedule will trigger symptoms and they are easy to identify. For others, it takes a lot to get to the point where things that didn’t bother us in the past are now causing us misery.
Our first step is trying to identify all of our stressors and figure out how to reduce the load as much as possible. This is easier said than done and often involves adjusting expectations, setting boundaries, and re-negotiating our roles in our lives. Counseling, coaching, constitutional homeopathy, and ameliorating treatments are very helpful during this step.
Restore depleted systems:
Where in your body are you experiencing your symptoms? This shows us what systems in your body are most stressed. This is where we target your treatments. Restorative treatments involve nutrition, rest, strengthening, realignment, and understanding our needs and limits. My favorite treatments for this include food, herbs, craniosacral therapy, movement, and helping you establish a self-care routine that is designed to prevent burnout.
Maintenance/Prevention:
This phase of healthcare is actually the most important and often overlooked. This is what comes after the Before and After pictures. It’s what happens after you meet your goals and are no longer working as closely with your healthcare team.
The restoration phase is physically the most demanding, but maintenance/prevention is probably the most mentally demanding. This is where we “grow up” and take responsibility for our health fully into our own hands, and honestly, it’s where we most often “fall off the wagon”.
Understand that this phase is difficult for everyone and treat yourself with compassion. Then, get to work. Return to the self-care strategies that worked for you in the past, then if, after two weeks, you find that what worked before isn’t working, get help. Good healthcare providers who “know it all” get help from others when what they are doing isn’t working, why shouldn’t you do the same?
