Week 2: Ponderings of My Journey

My student's pondering

Our second weekend of classes had me pondering many questions. We began on Friday with a video.  The video was not the main focus, the focus  was about the audience of the video and the depth our conversation turned to.  The discussion of health and the health models that existed and the approaches that existed.

I struggled with the discussion of the models of health.  I am a massage therapist.  My training focuses on the biomedical model.  If something is broken, use our knowledge of the machine and fix it.  The mechanics are straightforward, yet treatment doesn't always work. The biomedical model is so focused on a pathogenic approach that you are unable to see the whole picture.  We had orthopeadic models of treatment and care and mental health models of treatment and care. The reality is that the individualism between mind and body, and the treatment of physical and mental/emotional/spiritual all need to be integrated together.

Another model we explored was the social/environmental model.  My training and work has given me the opportunity to work with women that are very well positioned both within social construct and in financial security.  I have also worked with women in the most challenged areas of Vancouver.  There is such requirement for social support.  Housing, food, community of support were all discussed for optimal health.

I found the approaches really reframed the way I viewed health care.  Was I viewing issues in the health care system as pathogenic or salutogenic. Salutogenic model of care was a term coined by Aaron Antonovsky.  He was a sociologist that focused on a health model to support health.  He felt that the disease model created a dualism of health vs disease, when in reality we are on a continuum.  You can read some of his work here. Our current health care system has been under fire for years.  It has many challenges the more primary of being a reactive system.  The pathogenic model is based upon treating the symptoms of a deeper more diffuse problem.  How do we turn the framework around?

This week I also was in the group that presented material to the class.  We focused on three primary topics.  One was about income inequality, employment and health.  Income inequality was very interesting.  We did an activity to inquire the perceptions of our classmates.  Most groups made a bell curve with the highest percentage of the population in the middle class wages.  The reality is that many more of our population is at the lowest end of earning and at the upper end of earning.  We watched this video that will challenge your perceptions of who really is earning the money. We had some terrific discussions about workplace health.  With the loss of workplace security and more part-time jobs we can relate it to personal health suffering.  How can you take time and energy for healthy activities when you are focused on getting food on the table, roof over your head, or savings for the future when you don't know if your job will be there in a month, a year or a decade?

I suppose that is what higher learning is suppose to do.  Challenge my foundations of knowledge, expand my intellectual comfort zones and see from a variety of perspectives.  There is a term for this process.  It is called appreciative inquiry and I have begun my inquiries.

My questions that I have been pondering:
1. How can I shift my practice to be salutogenic vs my trained pathogenic model?
2. How can our society survive with the circle of poor income leading to poor health?