From existential psychotherapy to existential medicine.
Abstract: The aim of this article is to emphasise the relevance of existential analysis not just to psychotherapy but to both the philosophy and practice of medicine. Its message is that the very division of 'psychotherapy' from 'somatic' medicine runs counter to the philosophical foundations of existential analysis.

Key Words

Psychotherapy, somatic medicine, biomedicine, iatrogenesis, felt body, felt dis-ease, meaning of illness, Zollikon seminars
Article Type: Essay
Subject: Psychotherapy (Analysis)
Existentialism (Analysis)
Medicine
Author: Wilberg, Peter
Pub Date: 07/01/2011
Publication: Name: Existential Analysis Publisher: Society for Existential Analysis Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2011 Society for Existential Analysis ISSN: 1752-5616
Issue: Date: July, 2011 Source Volume: 22 Source Issue: 2
Product: Product Code: 8522200 Medicine NAICS Code: 54171 Research and Development in the Physical, Engineering, and Life Sciences
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 288874223
Full Text: 1. Guiding Thoughts

There is not much difference whether a human being is looked on as a 'case' or as a number to be tattooed on the arm. These are but two aspects of the faceless approach of an age without mercy.... This is the alchemy of the modern age, the transmogrification of subject into object, of man into thing against which the destructive urge may wreak its fury without restraint.

Mitscherlich, A. and Mielke, F. (1949)

This ... the organism's being, is its raison d'etre. All individual processes take their meaning from and are determined by this being. We describe this as the organism's essence.

... health is not an objective condition which can be understood by the methods of natural science alone. It is rather a condition related to the mental attitude by which the individual has to value what is essential for his life. 'Health' appears thus as a value; its value consists in the individual's capacity to actualise his nature to the degree, that for him at least, is essential. 'Being sick' appears as a loss or diminution of value, the value of self-realisation, of existence.

Kurt Goldstein (1934)

To be in a po sition to explain an illness genetically, we need first of all to explain what the illness in itself is.

... It is of the highest importance that there be thinking physicians, who are not of a mind to leave the field for the scientific technologists.

The essential realm in which biology moves can never be grounded in biology as a science.

Martin Heidegger (1987)

Before sickness came to be perceived primarily as an organic or behavioural abnormality, he who got sick could still find in the eyes of the doctor a reflection of his own anguish and some recognition of the uniqueness of his suffering. Now, what he meets is the gaze of a biological accountant engaged in input/output calculations. His sickness is taken from him and turned into the raw material for an institutional enterprise.

Ivan Illich (1976)

2. Introduction

None of the readers of this article will not have heard of 'Existential Philosophy' and its expression in 'Existential Psychotherapy'. Unfortunately however, the very term 'psychotherapy' reinforces a false theoretical, institutional and professional separation between the realm of the 'psychic'--of subjectivity--and that of 'somatic' illness, between subjectively expressed 'psychological' dis-ease and 'objective' biological illness. Since the era of those forgotten pioneers of psychoanalytic medicine such as Viktor von Weizsacker (1948), almost all schools of psychoanalysis and psychotherapy have effectively abnegated responsibility for exploring more deeply the psychological dimensions of all forms of human dis-ease--instead deferring to the authority of the medical profession and its 'science' when it comes to understanding the nature of somatic illness or 'disease'.

Even practitioners of so-called 'somatic' or 'body-oriented' psychotherapies such as 'bioenergetics' or 'biosynthesis' fear to 'stray' into the territory of somatic medicine--despite the fact that their principal pioneer--Freud's student Wilhelm Reich--offered an entirely different understanding of specific illnesses, specifically cancer, to those of orthodox biomedicine. And whilst acknowledgement of so-called 'psychosomatic' symptoms and of processes of 'somatisation' (people turning their problems into symptoms and illnesses) has been a recognised part of psychotherapeutic and psychoanalytic theory since Freud, what is still not recognised is the fundamentally social nature of 'somatisation'.

For the fact remains that most people still express and 'present' their most currently acute or chronic 'psychological' problems to physicians rather than psychotherapists--biologically and culturally 'coding' them as somatic symptoms. Even psychotherapists who get ill will tend to turn to doctors and the medical profession rather than to their fellow psychotherapists. The false separation between 'psychological' and 'medical' problems is thus also reflected in a split between the professional and personal lives of psychotherapists themselves.

For all these reasons, I believe it is high time for psychotherapists of all schools to stop simply bowing to the authority of 'qualified' medical professionals when it comes to knowledge of the human body and bodily disease. For as long as they do so biomedicine, appealing to the evidence of its 'science' and technologies, will continue to claim a total monopoly on 'authoritative' knowledge of the human body--together with the 'diagnosis' and treatment of bodily illness.

Institutionalised medicine serves not only to protect its own interests but also to maintain and bolster the profits of the corporate health industry and its products. For make no mistake, today more than ever, Biomedicine is Big Money--and 'Big Pharma' remains, throughout all recessions--if not aided by them--the most profitable industrial sector of all.

Ultimately it reflects the nature of capitalist economies as such--which effectively define health purely as economic functionality and the capacity to submit to wage-slavery. Thus it is that what Szasz (2003) called the 'pharmacracy' seeks to medicalise and medicate all forms of dis-ease engendered by this slavery--effectively a form of 'health fascism'.

The monopoly of institutionalised medicine--and its counter productivity --was radically and cuttingly challenged by Ivan Illich. In his book entitled 'Medical Nemesis: The Expropriation of Health' he exposes the veritable epidemic of medically induced or 'iatrogenic' illness--a truth admitted by the Journal of the American Medical Association (April 15, 1998) when it declared that "the notorious and dangerous side effects of drugs have become the fourth main cause of death after infarction, cancer, and apoplexy."

In Illich's words:

The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for 'physician', and genesis, meaning 'origin'.

(Limits of Medicine, 1986)

Illich identified three types of iatrogenesis--clinical, social and cultural.

Iatrogenesis is clinical when pain, sickness and death result from medical care; it is social when health policies reinforce an industrial organization that generates ill-health; it is cultural and symbolic when medically sponsored behaviour and delusions restrict the vital autonomy of people by undermining their competence in growing up, caring for each other, and aging, or when medical intervention cripples personal responses to pain, disability, impairment, anguish and death.

(ibid.)

People who are angered, sickened, and impaired by their industrial labour ... can escape only into a life under medical supervision and are thereby seduced or disqualified from political struggle for a healthier world.

(ibid.)

Biological medicine has:

... the authority to declare one man's complaint a legitimate illness, to declare a second man sick though he himself does not complain, and to refuse a third social recognition of his pain, his disability, and even his death. It is medicine that stamps some pain as 'merely subjective', some impairment as malingering ...

(ibid.)

The monopoly of biomedicine is sustained despite the plethora of alternative or 'complementary' forms of medicine that continue to spring up as part of a global health industry--whether in the form of vitamin treatments, herbal or homeopathic medicine, 'integrative medicine' or 'energy medicine', Ayurvedic medicine or Traditional Chinese Medicine. For however suspect the 'scientific' credentials of the latter in the eyes of orthodox Western medicine, these complementary forms of medicine in fact offer no true alternative at all--sharing as they all do the same unquestioned root assumptions of what is called the 'biomedical' model. This is the assumption that illnesses have biological 'causes' rather than existential meanings. Together with this goes a view of the human being as a function of the human body and brain--what I call 'bio-ontology'--rather than its converse, an onto-biological understanding of the human body as embodiment of the human being.

The biomedical model leaves the patient in a hopeless situation--forced to choose between the false alternative of orthodox Western medicine, one or other form of non-Western or complementary medicine--or some admixture of the two. The problem is that none of the forms of medicine on offer in any way question or offer a true alternative to the basic 'cause and cure' model shared by them all.

Certainly there have been notable thinkers such as Thomas Szasz, who have questioned the relevance and applicability of the 'medical model' to so-called 'mental illness'. What is questioned here however is only the application of this model within the realm of psychiatry and psychotherapy. Few have gone so far as to question the value and effectiveness of the biomedical model to medicine as such. Thus, as Illich remarks:

Yet to ignore the subjective dimension of the body--the 'lived body' or 'subjective body'--is to ignore what brings patients to doctors in the first place--not an 'objectively' measurable pain for example, but a subjective experience of pain, one which may have no identifiable cause, and may persist for a lifetime even if an 'objective' cause is found and treated. More fundamentally, how do we know we have a body in the first place except through a subjective awareness of it? And since subjective awareness is the most fundamental precondition for our experience of bodyhood, how can it--in principle--be reduced to a mere property or function of that body--or to that private, self-encapsulated 'psyche' mysteriously residing within the brain?

In contrast to Biomedicine, Existential Medicine questions--as Martin Heidegger did in the Zollikon seminars--the very concepts of psyche and soma, concepts which serve also to reinforce the socially institutionalised separation of 'psychotherapy' from 'somatic' medicine.

Yet whilst the groundwork for a thorough-going Existential Medicine has long since been laid by Martin Heidegger and Medard Boss (1979), this groundwork has yet to be transformed into a means of radically challenging--both in principle and in practice--the unquestioned assumptions of biomedical 'science'. The concept of causation still governs this science--even and not least in all talk of 'psychosomatic causation'. In contrast, the foundations of Existential Medicine lie in an essentially non-causal understandings of illness, and in a non-causal science of phenomena as such--in 'phenomenology' or 'phenomenological science'.

3. Phenomenological and Hermeneutic Dimensions of Existential Medicine

A foundational principle of what I term 'field-phenomenological science' is that no phenomenon arising from or present within a given contextual field of emergence can be said to be 'caused' by any another phenomena present or arising within the same field. To even attempt such a form of causal explanation would be like attempting to find the 'cause' of something we dream of in some other phenomenon experienced in the same dream--thus ignoring the common source of both phenomena in the overall contextual field of our dreaming consciousness and indeed of our waking consciousness as well.

Existential Medicine is both phenomenological and hermeneutic in character--seeking the meaning rather than the 'cause' of symptoms. Hermeneutics is the art of interpretation. The word derives from Greek god Hermes--he who was also the messenger of the gods and who led dying souls to the 'underworld'. Symptoms too are 'messengers' and terminal illnesses can too serve as a way of dying--of leading our souls to the afterlife.

A 'hermeneutic' approach to the human body understands it as a living biological language--one whose fleshly 'text' is many-layered only to be understood in its existential context. Hermeneutics too, is a type of knowledge and science that has no place for the notion of causality. For no text--and no symptom--can ever give full expression to its larger context of emergence, let alone be said to be 'caused' by that context. And whilst meaning finds expression in words, as it also finds expression in dreams and in bodily symptoms--this does not imply that a particular meaning 'causes' a particular mode of expression or embodiment, for meaning is above all characterised by a multiplicity of different possible modes of expression.

Existential Medicine not only challenges the scientific foundations of orthodox medicine but also transgresses the taboo it imposes--the taboo on anyone who is not a qualified medical professional daring to suggest different understandings of illness to a patient. 'Doctor knows best' remains the motto--implying that physicians know the patient's body better than the patient themselves. Yet the 'body' that doctors 'know' is not the lived or felt body--the body as felt from within by the patient themselves (German Leib) but the 'clinical body'. This is the body as it is 'objectively' perceived and examined from without (German Korper) and understood solely through the language and body of clinical terminology that make up medical 'science'. In contrast, as a subjective body, the felt or lived body is not the possible object of any form of biomedical examination, testing or treatment.

Through the theoretical framework and social practice of the biomedical model, any directly sensed significance or meaning latent in a patient's felt dis-ease and its symptoms is immediately 'enframed' by the already signified senses posited in advance by medical-diagnostic terminology with its notion of illnesses as autonomous disease 'entities' or 'things in themselves'. As a social practice, biomedicine reduces the physician's professional role to one of identifying some purely biological or genetic cause for these symptoms--reducing them to the expression of some hypothetical disease entity to which the patient has inexplicably become victim.

Language is taken over by doctors: the sick person is deprived of meaningful words for his anguish, which is thus further increased by linguistic mysticification. Illich (1976)

Biomedical 'science' is a science that does not even recognise that its own true foundation is not 'hard facts' but linguistic metaphors--in particular the military metaphors of immunology and immune 'defences'. Hence we have an entire medical industry and profession which sees itself militaristically engaged in a 'war' against disease and death--a war in which patients are the major victims of the 'collateral damage' it inflicts.

Both medically (iatrogenically) induced death and the medicalisation of death and dying deny the basic existential right asserted by Illich--to die without diagnosis. They also stand in direct opposition to Heidegger's understanding that acknowledgement of mortality and 'being toward death' is the very foundation of authentic living. Thus, though Illich himself was diagnosed with cancer, he refused all but palliative care--and referred to his obvious facial tumour simply as 'my mortality'. The biomedical model would have us believe that Illich himself died 'of' or 'from' cancer. Yet the very idea of 'terminal' illnesses assumes that people die from diseases, rather than through them. If there is such a thing as 'premature' death then it is largely a consequence of people not choosing to reject medical treatments of a sort which radically reduce their quality of life and with it, their will to live.

Medicine had its roots in philosophy and not in 'science' as it is understood today. This has good reason--for profound questions to do with the nature of life and death, health and illness simply cannot be enframed within a biomedical model or made the subject of controlled scientific tests. Yet as Fredrik Svenaeus (2000) points out, historically:

Thus living as we do in a culture in which science has, as Heidegger recognised, effectively replaced philosophy as a path to knowledge and truth, the need for a new philosophical approach to medicine--for what he called 'thinking physicians'--is now greater than ever.

4. Basic Questions

Existential Medicine is a philosophical revolution in our basic understanding of what constitutes 'health' and 'illness'--one which reveals and challenges countless core assumptions of current medical science in a way which even existential psychotherapy still fails to do--despite the decisive new understanding of the body offered by its founders. It needs to be emphasised however, that by its very nature, Existential Medicine cannot be reduced to yet another form of medical 'treatment' or 'cure'. Instead it is essentially what I call 'medicine beyond medicine' or 'metamedicine'. That is because it so radically undermines and challenges 'the medical model' in all its forms--whether in the guise of 'biological' and 'genetic' medicine, 'traditional' or 'complementary' medicine, 'psychosomatic medicine' and even so-called 'spiritual healing'.

For again, the central question addressed by all these diverse forms of medicine is not the meaning of a patient's illness but rather what 'causes' it and how best to 'treat' or 'cure' it. In contrast, the far more fundamental question first posed by Heidegger, and taken up by Boss, Goldstein, Illich, Szasz, Mindell, Svenaeus and others, are questions such as: 'What is health?' and 'What is illness?' Within these questions however, lie yet further fundamental questions of a sort totally excluded from the realm of current medical 'research'. Examples of such fundamental questions are:

Is illness an aberration from 'natural' health or is it a natural part of life and human existence--as natural as birth and death?

Is illness some 'thing' that we 'get' or 'have' or is it a natural life process comparable to the processes of being born, maturing and dying?

Can the human body be separated from the human being or is it a living embodiment of our individuality as human beings?

Do 'somatic' states, symptoms and diseases merely 'affect' our consciousness or 'psychological' state or is every somatic state itself and essentially a state of consciousness--an embodied state of being or 'self-state'--just as every 'psychological' or 'mental' state is at the same time a 'somatic' state, experienced not just 'in the mind' but as a mode of bodily self-experiencing and of bodying our self-experience? Is a particular illness something reducible to a set of biological 'causes'--or does the emergence of a particular illness at particular time in the life of an individual always have a definite meaning in the larger existential context of their life-world (Lebenswelt) as a w hole--including not only their environment and relational world (Umwelt and Mitwelt) but also their 'work world' (Arbeitswelt)? Last but not least, does healing come about through medicating an illness and 'treating its causes' or through meditating its meaning? The two-column table that follows (Figure 1) sets out in brief a series of fundamental contrasts between the unquestioned assumptions of Biomedicine and the foundations of Existential Medicine:

5. On the Healing Value of Illness

In the medical 'war' against disease and the attempt to 'heal' illness by whatever means, conventional or unconventional, the potentially healing value of illness is entirely ignored. Existential Medicine is founded on an understanding that illness, ill-health, or 'disease' can in itself be beneficial and 'healthy' in many different ways:

* Giving somatic expression to a felt 'dis-ease'--the way in which a person feels ill-at-ease with themselves, other people or their life world as a whole.

* Forcing a person to take 'time out' from mere normal 'functioning' by developing some diagnosable bodily disorder or 'dysfunction'.

* Helping people to feel, focus on and confront painful problems even if only through the way in which physical pain can focus the mind.

* Bringing a person to a necessary 'crisis' in the root sense of the word--a decisive 'turning point' in their lives.

* Allowing a person to fully express and reveal intense emotional pain by feeling and expressing it as a reaction to intense physical pain--moaning and groaning.

* Incapacitating a person in a w ay that allows them to accept already-existing limits to their capacities--limits they might otherwise have sought (or been put under pressure) to deny and overcome.

* Letting a person become dependent on others in a socially acceptable way, thereby allowing them to express dependency needs in themselves which they might otherwise have fought or rejected.

* Enabling a person to indirectly ask for and receive emotional care through care of our bodies and through being taken care of as 'patients'.

* Helping a person to give more time and be more patient with themselves and others by becoming 'a patient'.

* Providing a temporary respite from life problems through a temporary identity as 'patient' or victim of a particular illness.

* Providing the human organism with a temporary but coherent organising principle for a person's life--built around their symptoms or around timetables of rest and treatment.

* Overcoming isolation and offering a medium of human contact through relationships with physicians or through the social environment of a hospital ward.

* Putting a person into an altered state of consciousness--one in which they are able to feel themselves or look at their lives and problems in a different way.

* Stopping a person from living in their heads and minds and making them feel their bodies again--thereby giving them a fuller, more embodied sense of self.

* Bringing about changes in a person's 'body identity'--allowing them to give birth to a different bodily sense of self.

* Giving embodied metaphorical expression to a person's felt disease. For example heart conditions as an embodiment of 'loss of heart' or 'heartlessness', 'cold-heartedness' or 'faint-heartedness' etc.

This last point brings us to the heart of the contrast between Biological Medicine and Existential Medicine. Existential Medicine understands somatic symptoms and illnesses as 'body dreams' (or nightmares) with both a general and a highly personal symbolic meaning. The most basic of the core assumptions of 'scientific' medicine--namely that illness has no meaning--is comparable to the attitude of materialist science towards dreams and nightmares before Freud. Dreams, like illnesses, were denied any symbolic meaning or beneficial value. Whereas Freud sought scientific methods of interpreting the meaning of dream symbols and events, modern medicine makes no attempt whatsoever to develop methods for the interpretation of somatic symptoms or disorders as body symbols or 'embodied dreams'.

Finally, we must not forget the importance of illness as a quite natural way out of this life--as a way of dying. The war that biological medicine wages on disease is part of a general war against the basic existential realities of aging and death--a war that is one of the most unnatural and unhealthy aspects of modern culture and its science.

The individual's felt dis-ease and their felt body is not merely the way they subjectively feel their physical body and its condition. On the contrary, the physical body is but the outer, physical expression of the individual's psychical body--their subjective or felt body. The essence of the subjective, felt body or lived body (Zeib) is the individual's bodily sense of self. That is why all illness begins with a vague sense of 'not feeling ourselves'--and yet can lead us in turn to 'feeling another self'--and to bodying that self in new and more fulfilling ways of 'being-in-the-world'.

References

Boss, M. (1994). Existential Foundations of Medicine & Psychology. Trans. Conway, S. and Cleaves. New Jersey: A. Jason Aronson.

Goldstein, K. (2000). The Organism--with foreword by Oliver Sacks. New York: Zone Books.

Heidegger, M./Boss, M. (ed) (2001). Martin Heidegger--Zollikon Seminars. Trans. Mayr, F. and Askey, R. Evanston IL: Northwestern University Press.

Illich, I. (2010). Medical Nemesis: The Expropriation of Health. London: Marion Boyars.

Lewontin, R.C. (1993). Biology as Ideology--The Doctrine of DNA. New York: Harper.

Mindell, A. (1989). Working with the Dreaming Body. London: Arkana.

Mitscherlich, A. and Mielke, F. (2007). Doctors of Infamy--The Story of Nazi Medical Crimes. Whitefish MT: Kessinger Publishing Co.

Shapiro, K.J. (1985). Bodily Reflective Modes. Durham NC: Duke University Press.

Svenaeus, F. (2000). The Hermeneutics of Medicine and t he Phenomenology of Health--Steps Towards a Philosophy of Medical Practice. Dordrecht: Kluwer Academic Publishers.

Szasz, T. (2003). Pharmacracy--Medicine and Politics in America. Syracuse NY: Syracuse University Press.

Weizsacker, V. von. (1948). Warum wird man krank? Frankfurt: Suhrkamp.

Wilberg, P. (2008). Heidegger, Medicine and 'Scientific Method'. Whitstable: New Gnosis Publications.

Wilberg, P. (2011). From Psychosomatics to Soma-Semiotics; Felt Sense and the Sensed Body in Medicine and Psychotherapy. Whitstable: New Gnosis Publications.

For further articles see: www.existentialmedicine.org (for counsellors and therapists) and www.lifedoctoring.org.uk (for patients).

Peter Wilberg M.A. is an author and therapist who applies existential analysis to patients suffering from chronic or serious 'somatic' illness. See also his book Heidegger, Medicine and 'Scientific Method' and his sites: www.existentialmedicine.org and www.lifedoctoring.org.uk

Contact information: 175 Cromwell Rd. Whitstable, Kent CT51NF, United Kingdom. peter_wilberg@tiscali.co.uk
A number of authors have ... tried to debunk the status of mental
   deviance as a ' disease'. Paradoxically, they have rendered it more
   and not less difficult to raise the same kind of question about
   disease in general.

   (ibid.)

   And through the practice of biomedicine:

   The patient is reduced to an object--his body--being repaired; he
   is no longer a subject being helped to heal. If he is allowed to
   participate in the repair process, he acts as the lowest apprentice
   in a hierarch of repairmen.

   (ibid.)


Medicine and philosophy enjoyed a rather close partnership until
   the emergence of modern medicine around 1800. What happened around
   that point can be envisioned as a radical philosophectomy in
   medicine. Philosophy is cut off as a useless and even dangerous
   speculative approach to questions of health ...


Figure 1

Assumptions of Medical Science      Foundations of Existential Medicine

Health is 'good'. Illness is        Illness is part of a healthy
'bad '.                             life, just as dealing with life-
                                    problems is.

Health and illness are              Illness is a natural part of a
opposites.                          healthy life.

The human body can be separated     The human body is a living
from the life of the individual     embodiment of the individual
human being.                        human being

The patient's life problem is       The patient's illness is the
their illness and its symptoms.     symptom of a life problem.

Illnesses are things that we        Illnesses are natural life and
'get ' or 'have'.                   learning processes.

Illnesses have 'causes' but no      Illnesses have meanings--giving
meanings--aside from interfering    expression to basic existential
with our health and thus            life questions and situations.
requiring treatment or healing.

A somatic symptom is a              A symptom is a somatic symbol of
diagnostic 'sign' of a bodily       a felt existential or emotional
disease entity.                     disease.

Diagnosis identifies independent    There are no such thing as
disease entities in the body and    disease entities separable from
thus guides treatment.              the body and life of the
                                    individual as whole.

Illnesses can be life-              People die through illnesses and
threatening and thus a cau se of    not 'from' or 'of 'them--and do
premature death. People die from    so only w hen they are ready to
them if they are untreated or       die. No one dies 'before their
incurable.                          time'.

The aim of medicine is to 'cure'    The illness itself is the
or rid ourselves of an illness.     potential 'cure'--helping to
                                    heal or 'make whole' our self.

Illness is an attack by 'foreign    Illness is a form of pregnancy--
bodies' or 'non-self organisms      the bodily expression of unborn
such as viruses or mutated          aspects of our self as a whole--
cells.                              our 'soul'.

Medicine is war against disease-    Medicine is midwifery--helping
helping our bodies to 'fight'       us to give birth to a new sense
disease.                            of self.

Healing means bringing about        Healing means letting our bodies
changes in our bodies.              change us--our bodily sense of
                                    self.

Mind and body, psyche and soma,     Every mental-emotional or
brain and body may objectively      psychological state is a
 'affect ' one another though       subjectively felt bodily or
physiological processes.            somatic state--and vice versa.

Illness is the result of an         Illness is the result of changes
objective biological process        occurring in our subjective or
occurring in the physical body.     felt body--which is also our
                                    bodily identity, our 'body
                                    self'.

Feeling ill results from            Getting ill' results from
'getting ill' with some             feeling ill--from a subjectively
objective physical 'disease'.       felt dis-ease.

The way we feel our bodies--our     The 'physical' body is an
inwardly felt body--is a            external expression of our
subjective expression of the        subjective body--our inwardly
physical body.                      felt body.

The aim of the physician is to      The aim of the physician is to
help the patient to recover or      help the patient to change--to
'feel themselves' again--to         feel a different self to the one
feel the same way they did          they felt before getting ill.
before getting ill.

The purpose of the physician-       It is the relationship itself
patient relationship is to heal     that is the chief healing
the patient by diagnosing and       factor, helping -or not helping--
treating their symptoms.            the patient to heal.

The health of the individual is     Individual health is an
an entirely private matter and a    expression of the health of
function of their bodies.           human relations in society.
                                    Sickness are sicknesses of
                                    relation.

Symptoms are caused by a            Both symptoms and their causes
physical disease or disorder in     are the expression of a felt
the human body or brain.            disease of the individual human
                                    being.

Symptoms have bodily causes.        Symptoms are bodily symbols.

The human body is a functioning     The human body is a living
biological machine.                 biological language.

We 'have' a body--a body which      We do not 'have' a body. We body-
we can feel in different ways.      embodying the way we feel.

Health is our capacity to           Health is our capacity to fully
maintain a fully functioning        embody and fulfil our values and
body and mind, no matter how        potentials as individual human
sick the society in which we        beings.
live.

Every patient's illness is just     Every patient's illness is a
an individual 'case' of a g         unique expression of their
eneric disease.                     individuality.

Medical science is based on         Modern medicine is based on
'proven facts', such as the way     metaphors--such as the military
the immune system functions.        metaphor of immune 'defences'.

Most medical research is            Most medical research is funded
'neutral' and 'objective'.          by the pharmaceutical industry.

Most medications are                Most medications are only
scientifically trialled and         marginally more effective than
tested to show their                placebos, whilst often producing
effectiveness and safety.           severe or even life-threatening
                                    side effects.

Modern medical treatments of        Modern medical treatments are
illness save countless lives and    one of the 4 principal and
are therefore indispensable.        leading causes of death, as well
                                    as producing countless
                                    illnesses.

Well-being' is a subjective         Bodily health is the embodiment
expression of bodily 'health'.      of a s ubjective sense of well-
                                    being.
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