Health is one of those vague concepts that is hard to pin down, until you no longer have it. For humans, health comes is several components that work together to create a total picture – a picture of health.
Physical health is defined as how well your body manages day to day tasks, such as eating, sleeping and exercise. You generally don’t notice that your bones are working fine, but you quickly notice when a bone is fractured. The subcategories that we look for in therapy are looking at blood work, diet, exercise, body mass, sleep and medication. When all of these factors are in balance, your physical health is good. If your iron levels are low, you might find yourself not sleeping well, lacking in motivation and becoming tired quickly. No amount of talking therapy is going to fix a low blood iron level or diabetes – this needs to be treated by a medical doctor.
The biological aspect of people’s health is where medical doctors excel. For some things a general practitioner will refer to a specialist.
It is not uncommon for me to suggest lines of investigation for a GP or a specialist.
Social and Cultural Health
Humans are social animals. Our beginning definition of self begins by defining ourselves as part of our group. If your group is abusive, you will either become abusive, or be abused. Abused people often become introverted, defensive, over pleasing, reactionary or aggressive.
If your group inspires you, you become more extroverted, more exploratory, and grow to fill that inspiration.
People who have come from abuse may find it hard to build trust in others, or change their habits from self sabotage to growth.
It is not uncommon that the people who have come to see me for therapy match the category of “surrounded by assholes”. That is, it often isn’t an intrinsic “mental health” issue of theirs, it is their reaction to bad people.
An important aspect of health is to feel wanted by others, to feel that we have a positive effect on the world and that our life matters. While some of that can be addressed at the social level, most of this is a statement of how you feel about your position and purpose in the world. What are you here for? Does your existence matter? How are you connected to people and the world?
Each person will find a variant of this that works for them.
Humans have a baseline of needs that need to be met, such as food, shelter and safety.
If your income does not match your expenses, then you will become very stressed and potentially homeless. It is hard to feel safe and secure if you are homeless.
Many people who come to see me have income problems, or are at risk of homelessness if they seek safety, which can seem less safe than staying in abuse. Our Australian government can impose costs to getting basic economic health. A great deal of our sense of identity is made up of our paid employment, which is frequently seen as our contribution to society.
Frequently chronic health conditions are accompanied by poverty. If you didn’t start in poverty, the odds are you will find yourself there. While we have an excellent health system here in Australia, that system only works well for you if your ill health is brief. Ongoing health will lead to unemployment, which often means you can no longer meet your cost of living.
Losing your job can be a method of damaging your identity health. Another is to have society condemn your inherent nature, such as sexual preference, gender identity, chronic health conditions, cultural identity, ethnicity, religious views and so on.
Society is ironically becoming far more tolerant of difference, such as our recent passing of “Same sex marriage”, while at the same time becoming more marginalising due to recent politics. If you are in a category that is being, or has been, marginalised, the very nature of you is being attacked.
Society has a bad way of trying to categorise everything, and idealising each of those categories as binary rather than recognising both spectrums of identity, and when people do not fit the spectrum.
The irony of creating these categories of health does not escape me.
We are our brains. While I may miss that bit of finger I lost, or the appendix that stopped working properly, I have not really changed – I am still me. When we lose a part of our brain, we change. There are a number of ways that our brain can be damaged, which can interfere with how our cognition works and how we feel we are, or how those who love us perceive us when we can’t see it ourselves.
Significant trauma, either brief or ongoing, can also radically change us. Many spouses commented that the person who came back from war is not the person they married; people who have a near death experience can radically change their outlook on life; and people who have been raised in abuse can experience the world quite differently to other people.
The way we think, the way we react, the things we perceive, the things we value and the way we behave is all the basis for our mental health. It is a complex interaction of unconscious perception, subconscious thought and conscious decision making that help us navigate the objective world we live in through a perception that we construct. There are many factors that can lead to a faulty construction of the world within our minds, that will then lead to poor interactions with the objective world.
I have separated health here into a number of categories to help highlight some of the less considered sources of ill health. It is important to note that they all affect our overall health and interact with each other. For example, poor social health can lead to poor identity health, which can lead to poor mental health, which can lead to poor physical health… and so on. Often the challenge is to work out what the priority aspect to triage is, and then find the underlying cause or causes once the person is roughly stable.
This is not an exhaustive list of causes. It is just a place to start the search. We know when people are healthy because things are working out well. When things stop working, or become difficult, this list helps to narrow down what may have occurred that has affected you, which begins the journey to addressing them.