CAND Orientation 2004 BCNA Conference Identifying the Root
CAND Orientation 2004 BCNA Conference Identifying the Root Cause of Disease Dr. Iva Lloyd, BSc. H, RPE, ND September 24 th 2010
Goal of Session Ø Provide a naturopathic framework that links all aspects – Assessment – Diagnosis – Treatment Ø Provide a logical framework for determining root cause of disease.
Ayurvedic Medicine Ø Ø Holistic and Vitalistic medical system Five Elements: ether, air, fire, water, earth Three doshas: vatta, pitta, kapha Three qualities (qunas): sattva, rajas, tamas Ø All aspects of life are explained based on elements, doshas and qualities Ø Assessment – Diagnosis – Treatment based on language of elements, doshas and qunas
Chinese Medicine Ø Holistic and Vitalistic medical system Ø Yin- Yang Theory Ø Five Elements – fire, wood, water, metal, and earth Ø All aspects of life are explained based on yin-yang theory and elements Ø Assessment – Diagnosis – Treatment based on language of Yin Yang and elements
Naturopathic Medicine Ø Holistic and Vitalistic medical system Ø Defined by six principles Ø Eclectic treatment approach Ø Challenge: lack of language and framework to link principles to the assessment – diagnosis – treatment process as a unit.
Assessment – Diagnosis Comparison Naturopathic Medicine Conventional Medicine • Holistic and vitalistic • Assessment: emphasis on patient’s story, holistic PE and labs • Diagnosis: categorical and explanatory. • Treatment: treat the individual and address the causal factors. • Reductionist and mechanistic • Assessment: emphasis on PE and labs. • Diagnosis: categorical. • Treatment: treat the disease and the symptoms.
Identifying Root Cause Ø Belief that there is a root cause Ø Educating patients on causal factors of disease and determinants of health. Ø What you view as “root cause” influences your assessment and diagnosis.
Approaches to Identifying Root Cause Ø Fast versus Slow Knowledge Ø Downstream versus Upstream Thinking Ø Treating Symptoms & Diseases versus the Cause
Fast Knowledge Ø Ø Ø Small picture – immediate, individual, anthropocentric Linear, reductionistic, silo thinking Content driven Reactive Paradigms shift slow progress Ø To fix the problem, treat the symptom Ø 1° fault: hubris, belief in human omnipotence Taken from Dr. Dennis O’Hara’s talk HF 2009
Slow Knowledge Ø Ø Ø Big picture – community, Earth-centered Spiral, ecosystem, integration, holistic Context driven Responsive Paradigms gradually evolve – slow change is part of the game Ø Avoid the problem, treat the cause Ø 1° fault: parochialism, resistance to change Taken from Dr. Dennis O’Hara’s talk HF 2009
Slow Knowledge Ø Fits to the ecological and cultural context Ø Acquired through cultural maturation and integration Ø Worked out through trial and error, observation, application Ø Evaluated and accepted or rejected according to our values Ø Requires time, patience and experience Taken from Dr. Dennis O’Hara’s talk HF 2009
Fast knowledge hinders sustainability (healthy systems) Ø Increased: speed of communication & volume of information Ø Not increased: rate of assimilation and integration of information and knowledge Ø Information silos favoured by fast knowledge hinder an understanding of whole-system effects Ø Short term benefits with costs deferred Ø Systems & personal comfort support this approach Ø Difficult to move away from it Taken from Dr. Dennis O’Hara’s talk HF 2009
Downstream vs Upstream Thinking • • Downstream Fast knowledge Technical fix Reactive Content Particularity Symptom Silo Upstream • Slow knowledge • Adaptive change • Responsive • Context • Global • Cause • Integrative
Downstream vs Upstream Thinking Ø Need both ways of thinking Ø Disproportionate focus on one to the virtual exclusion of the other is not sustainable Ø Identify causal factors of disease is more of downstream, slow knowledge process Taken from Dr. Dennis O’Hara’s talk HF 2009
Human Beings as Complex, Dynamic Systems of Energy Ø Ø Ø Waves of light energy Cellular communication The role of water Movement Complex Systems Ø Ø Ø Self-Organizing Open Systems Self-renewal Mutual Causality Self-transcendence
Waves of Light Energy Ø Everything in life (tangible and intangible) is simply an electrical field of energy. Ø “Human beings are not simply biochemical beings, but energetic and informational beings that interact and communicate on a constant basis both within themselves and with their external world. ” (Oschman 2003) Ø All aspects of a person (tangible and intangible) can be described based on its unique wave pattern. Ø The ability of waves to interact, to store and carry information is the means of cell-to-cell communication and occurs in response to internal and external signals. (Mc. Taggart 2002, Oschman 2003)
Cellular / Internal Communication Ø Initiated by endogenous and exogenous factors; between individuals and their environment, between individuals, within all aspects of an individual and between organs, tissues and cells. Ø Signals can be tangible or intangible – all have a unique wave pattern. Ø tangible: chemicals, molecules, substances Ø intangible: sound, colour, light, thoughts, magnetic energy, electronic conduction Ø Cellular communication is considered healthy when there is harmony and coherence.
The Role of Water Ø Cellular Communication uses water and water is the primary vehicle for the transmission of chemicals, hormones, and nutrients throughout the body. Ø Water is the medium responsible for sending and amplifying energetic wave patterns. (Mc. Taggart 2002, Oschman 2003) Ø In every cell there is one molecule of protein for every ten thousand molecules of water and it is water that holds the double helix together. Ø Water copies, memorizes, and carries energetic signals and messages.
Movement Ø If there is no movement, there is no life. Ø Difference between health and disease lies in the relative freedom, flexibility and coherence of the energetic wave pulsations throughout the body. Ø All pulsations of life energy occur in patterns of expansion and contraction, centrifugal and centripetal or involution and evolution. Ø Movement within the body affects the wave vibration of all aspects of the body.
Complex Systems Ø The properties of the whole are the essential properties, not the properties of the parts. Ø Microscopic approach is clouding macroscopic view of wholeness Ø Every part of a system is able to influence every other part. Ø Thinking about a movement creates the corresponding electrical impulses Ø Structural changes influence thoughts and emotions. Ø “Old” conventional model: reductionist – every part viewed separately and separate from their environment. Ø “New” complex systems model: holistic – every part interacts and is influenced by every other part, including the external environment and other people.
Self-Organizing
View of Health and Disease are a continuum. Health: the homeodynamic state. Ø Waves of a patient are in sync; state of order. Disease: the heterodynamic state Ø Transformation between health and disease. Ø All change in health is due to interacting waves which are out of sync.
Health and Disease: Guidelines Ø Health and disease are logical; they happen for a reason. Ø Most diseases have multi-factorial causes and individual factors that can be identified. Ø Underlying cause of disease is never another symptom. Ø Addressing aggravating factors lessens the intensity and severity of signs and symptoms and the progression of disease. Ø Only by addressing the causes of disease can health be restored. Ø Nature of symptoms provides guide to causal factors.
Individual Disease Process / Symptoms Lifestyle Social Environment External Physiology Filter Constitution / Senses Gestational / Developmental Inflammation. . Cancer Personal Essence Treatments Energetic pattern Level of Health / Disease Acute – Chronic – Life Threatening Palliative Factors That Influence Health
Factors That Influence Health Ø Disharmony within the Personal Essence Ø Lifestyle Factors Ø Gestational / Developmental Ø Social Ø External Factors Ø Environmental Factors Ø Physiology Ø Treatments
Factors That Influence Health Every factor exists on the Continuum of. . . Health -----------------------------Disease Enhancing Producing
Causal & Aggravating Factors Ø Number of factors increasing all the time. Ø Unlimited number of factors – but limited for each individual. Ø Each factor has its own energetic vibration which determines the energetic imprint on an individual.
Personal Essence Disharmony Ø Resides in inner core – permeates psychological – functional and structural aspects of a person. Ø Represents a person’s foundation, their blueprint, their core. Ø Beliefs and expectations. Ø Acts as a guide and a filter. Ø Influences / determines vitality. Ø Impacted by a person’s health and life. Ø Often unconscious and links to the collective unconsciousness. Ø Lack of harmony causes a sense of discontentment.
Lifestyle Factors Ø Ø Ø Ø Food and eating regimen Water Breathing Posture & alignment Sleep & rest Sunlight Exercise, movement Mental state, thoughts Ø Required for disease prevention and healing. Ø “Ideal” building blocks is unique for each individual - based on constitution, age and environment.
Gestational / Developmental Factors Ø Primarily before the age of eight Ø Ø Ø Genetics Prenatal exposure Intra-uterine influences Birth trauma Vaccinations
Social Factors Ø Family stress / dynamics Ø School or work stress / dynamics Ø Community dynamics Ø Relationships Ø Economy Ø Communication / social skills Ø Ability / freedom to express
Environmental Factors Ø Ø Ø Weather Exposure to sunlight, time spent in nature Nature’s rhythms Air Water Soil Pollution Chemicals Heavy metals Environmental toxins Pathogens Nature vs Concrete
External Factors Ø Accidents / Injuries Ø Life Events Ø Medical treatments / drugs Ø Dental work / procedures Ø Supplements, herbs Ø Cosmetic treatments Ø Cells phones, PDAs Ø Wireless networks Ø Chemicals in personal care / household products Ø Tattoos, body piercing, etc. Ø Clothing Ø Toys, paints, etc.
Treatments Ø Conventional – surgeries, procedures, drugs, etc Ø Dental – crowns, bridges, etc. Ø Other – cosmetic, other practitioners Ø Naturopathic – supplements, herbs, homeopathics, detoxification, IV Therapy, etc.
Physiology Factors Ø Limited to. . . Ø Functioning of the routes of elimination (urine, bowels, breath, sweat, voice, menses) Ø Suppression of bodily urges Ø Progression of disease (vitality can no longer support health)
Individual Disease Process / Symptoms Lifestyle Social Environment External Physiology Filter Constitution / Senses Gestational / Developmental Inflammation. . Cancer Personal Essence Treatments Energetic pattern Level of Health / Disease Acute – Chronic – Life Threatening Palliative Factors That Influence Health
Filter Ø Unique for everyone Ø Depends on one’s beliefs, expectations, attitudes Ø Constitution + life experiences = susceptibilities Ø Susceptibilities + will power = healing potential Ø Senses
Naturopathic Medicine – Individual
Individual Ø Personal Essence Ø Psychological Ø Functional Ø Structural
Aspects of Manifestation Ø Disharmony always appears on three levels – simultaneously. Ø Primary site: what level of the individual was initially “hit” or affected by the disharmony. Ø Psychological: anxious about an upcoming event Ø Functional: imbalance in nutrients Ø Structure: sports injury Ø Secondary site: corresponding shift in the other two aspects of the individual. Ø The longer the disharmony the greater the impact on all three levels.
Aspects of Manifestation
Individual Disease Process / Symptoms Lifestyle Social Environment External Physiology Filter Constitution / Senses Gestational / Developmental Inflammation. . Cancer Personal Essence Treatments Energetic pattern Level of Health / Disease Acute – Chronic – Life Threatening Palliative Factors That Influence Health
Symptom Patterns Ø Arise due to interacting wave patterns that aren’t in harmony, coherence. Ø Purpose is to convey a message. Ø Looking at symptoms from the perspective of patterns aids in understanding and assessing the relationship between human beings, their lifestyle and their environment. Ø The same pattern will be displayed in all aspects of an individual.
Symptom Patterns Ø External / Internal Ø Excess / Deficiency Ø Yin Yang Ø Five Elements
Symptom Patterns: External / Internal Ø Internal: focus inward, on self Ø Very aware of signs and symptoms. Ø See the world from the perspective of self (impact it has on them). Ø Increase in personal responsibility. Ø External: focus outward, external factors Ø Concerned with health when it affects their ability to fulfill their responsibilities to others. Ø Often less awareness of signs and symptoms. Ø Decisions based on external commitments. Ø Easily affected by external factors. Ø Often first pattern revealed during a holistic intake. Ø Continuum
Symptom Patterns: External / Internal
Symptom Patterns: Excess / Deficiency Ø All symptoms can be quantitatively looked at on the continuum of excess to deficiency (even other patterns and qualities). Ø Too much or too little depends on a person’s constitution, environment, seasons and vitality. Ø Most people have factors that contribute to excess and deficiency (excess coffee and food, long hours at work; deficiency in sleep, exercise and sunlight. ) Ø Factors have a cumulative effect; like increases like, opposites decrease. Ø Areas of excess typically result in areas of deficiency in a corresponding part of the body. Ø Each individual can be classified as a whole on the continuum of excess to deficient.
Symptom Patterns: Excess • Energy becomes congested and blocked • Psychological: loud and full voice, intensity in thoughts or emotions. • Functional: intense, forceful movements, heavy breathing, pains worse pressure, swelling and inflammation, increase in weight or size. • Functional: Excess of hormones, enzymes, stomach acid and fluids. • Structural: stiffness, heaviness. • PE: thick coat on tongue, rapid pulse.
Symptom Patterns: Deficiency • Insufficiency of nutrients / energy or exhaustion due to extended state of excess. • Psychological: low and feeble voice. • Functional: white or pale complexion, fatigue, weakness and loss of strength, shallow breathing, pain relieved with pressure, excessive or spontaneous perspiration. • Functional: Insufficient of hormones or fluids. • Structure: breakdown of tissues, organs or muscles and structure. • PE: Tongue is pale and thin and the pulse is weak. • Most chronic conditions are due to an overriding deficiency state.
Symptom Patterns: Yin Yang Ø Used to explain the quantitative and qualitative aspects of nature, physiology, pathology and treatments. Ø Every organ symptom has a paired organ system. Ø Change in any one organ system affects all other organ systems. Ø Explains emotions and behaviours. Ø Explains the sidedness of symptoms. Ø Explains the progression of disease.
Symptom Patterns: Yin Yang
Symptom Patterns: Five Elements Ø Ayurvedic five elements: ether, air, fire, water and earth. Ø Everything in nature is composed of these five elements in varying proportions. Ø Each element has its own vibration and energetic pattern that mirrors the energetic patterns of color, sound, emotions, thoughts, organs, tissues, structure, etc. Ø All lifestyle, social, external and environmental factors can be assessed based on their elemental quality. Ø Every aspect of the body and every symptom can be explained based on the five elements.
Symptom Patterns: Five Elements Ø Earth: structure, bones, blood, adrenals, colon, kidneys, support, safety, security, boundaries, fear Ø Water: functional body, flesh, reproductive organs, lymphatic, intuition, nurturing, compulsions, attachments Ø Fire: emotional body, muscles, stomach, liver, pancreas, hormones, motivation, focus, frustration and irritability Ø Air: mental body, skin, lungs, nervous and circulatory system, many thoughts and ideas, erratic movement Ø Ether: space, purpose, joints, spinal cord, core of the body, vitality, peace, neutrality
Symptom Patterns: Five Elements
Symptom Patterns: Five Elements Ø Pain Ø Air: variable, migrating, throbbing and cutting. Better heat and worse cold. Area of pain is dry, scaly or cracked. Ø Fire: hot or burning, irritating, and frustating. Better cold and worse heat. Area is red and inflamed and there is often sweating. Ø Water: involves swelling and edema. Skin is oily and moist. Pain is better with heat and worse with cold, aggravated in damp weather. Ø Earth : sense of heaviness, dull ache, pain often localized and can involve congestion or erosion of tissues or structures. Better with movement and worse after resting.
Symptom Patterns: Five Elements Ø Constipation Ø Air: governs movement through the GI tract. Small, rabbit-pellet like stools, gas and abdominal distention. Often association with worry and anxiety or overstimulation of nervous system. Ø Fire: governs digestive function. weak digestive fire, fever or excess internal heat, ‘fire’ emotions. Ø Water: governs body fluids. due to decrease in body fluids or body fluids that are too viscous. Imbalance in food based on constitution or states of excess and deficiency of certain nutrients. Ø Earth : governs structure of bowel wall. Obstruction, polyps, masses.
Patterns are Conveyed Through: Ø Ø Ø Ø Meaning of words Limiting beliefs Verbal linking Energy of words Speech patterns Non-verbal behaviour Changes in affect Somatic metaphors Ø Symptoms and Diseases Ø Naturopathic Physical Exam Ø Laboratory Reports
Energy of Words Ø Internal versus External Ø “I’m not able to do the job” vs “The boss expects too much. ” Ø Yin / Yang Ø Elements Ø Earth: sense of self, safety, security, structure, support, boundaries, protected, sense of fear or uncertainty. Ø Water: relationships, nurturing, process, flow, sense of dependency. Ø Fire: anger, irritability, lack of motivation, frustration, lack of direction and clarity. Ø Air: a lot of thoughts and ideas, impatient, diversity, quick, impatience, spontaneity, sense of being “all over the place”. Ø Ether: vitality in voice, overall energy.
Energy of Words Ø Speaking is an emmunctory pathway. Ø Listening for patterns conveyed in words, symbolism of words and change in affect. Ø Language Ø Spoken words Ø Conscious thought Ø Unconscious thought Ø Expression versus suppression.
Somatic Metaphors Ø Mirroring of language and disease. Ø When a physical disease appears to be “saying” the same thing, expressing the same meaning, as the patient’s subjective ‘story’ conveyed in verbal language. Ø Ø Ø No control Stuck Feel suffocated Irritating Not able to let go No support
Somatic Metaphors Ø Unitary model of personhood and disease. Ø Body is a feedback mechanism – mirrors language. Ø Every part of the body has a literal and an energetic meaning. Ø Legs / hips: direction, moving forward Ø Arms / hands: choice, grasping, letting go, hanging on Ø Eyes: vision, outlook on life
Naturopathic Physical Exam Ø Ø Ø Physical Structure Gait Assessment of joints Breathing Tongue Assessment Pulse Diagnosis Face and Special Senses Teeth Eyes Skin Fingers and Toes
Qualities Ø Ø Ø Sidedness: Yin Yang pattern Peripheral: External pattern Core or medial: Internal pattern Heaviness: excess of water or earth Light: excess of air, deficiency of earth Slow: excess of water or earth, deficiency in fire or air Cold: excess in air or water, deficiency of fire or earth Hot: excess fire or earth, deficiency air or water Oily: excess water Dry: excess air, fire or earth, deficient water Rough: excess air
Gait Assessment Ø Earth: walk is slow, steady and heavy. Indicates a person who stands firmly on the ground and who expresses stability and firmness. Ø Water: walk is flowing and continuous, like a gentle stroll. Ø Fire: walk is fast, intense, and with a clear direction. Ø Air: walk is quick with frequent changes in direction. Ø Ether: seen as the ease and ability of walking overall. Ø Yin-Yang: difference between right and left sides of the body or the top and bottom of the body.
Face and Special Senses
Joints
Skin Ø Skin is the boundary separating Self from the external world; thus it participates both in the subjective and objective reality. (Thass-Thienemann, 1968) Ø Symbolic meaning to skin and placement of skin diseases. Ø Earth: dry and tough; excess - increase in thickness; deficiency – thinness and loss of structure Ø Water: smooth, oily; excess – plumb and oily; deficiency dryness Ø Fire: excess – red and hot, prone to rashes; deficiency - pallor Ø Air: appear in variable areas, dull, dark, lack in luster; excess – dry, cold, rough and chapped skin with cracks.
Fingers and Toes
Fingers and Toes
www. NDHealth. Facts. ca Ø Website for patients and practitioners that explores the determinants of health and the causal factors of disease in detail. Ø Research and referenced. Ø Articles and input from NDs is welcome. Ø No advertisements.
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