Chapter 11 Treatment Strategies

The intention of naturopathic medicine is to treat the initiating and aggravating factors that are preventing the innate healing ability of the body. It is then to use the most gentle treatments possible to re-establish health and achieve the patient’s goals. The naturopathic doctor chooses treatments that restore the natural harmony, rhythm, and coherence to the body. From a conventional medical point of view, treatment is based on the achievement of objective criteria; from a naturopathic medical perspective, treatment is based on achieving the patient’s which may be subjective, versus objective goals. From a naturopathic perspective, healing is like cultivating a garden; from a conventional medical perspective it is like fixing a machine.

A practitioner’s approach to healing is based on their philosophies and beliefs. Healing, like assessment, is a mindset. The perspective on health, the knowledge of energy patterns and complex systems, the expectations and belief about the purpose of life all influences the healing options and treatment strategy that are chosen, both for a practitioner and a patient. For example, one practitioner might use nutrition and lifestyle counseling, another herbs, another might use acupuncture, another talk therapy, and another hands-on healing. Every practitioner, if they properly assess and treat the causative factors and the pattern of disharmony and if they have a good rapport with a patient, would be able to achieve the same result. The actual healing method does not matter as much as the intention.

A naturopathic treatment plan might involve the use of herbs, supplements, or other treatments, but the focus of treatment involves a shift away from ‘what do I take’ to ‘what do I change.’ The role of a practitioner is to facilitate change. They do not ‘heal’ a patient. It is what the patient does that determines the degree that the body will heal and their ability to maintain a higher level of health. The conventional mode of healing puts the primary focus on the practitioner. The naturopathic approach maintains the focus on the patient. The practitioner has an educative and facilitative role versus a corrective role.

The role of the practitioner is to provide a road map to facilitate the healing process. Healing is work. It requires a patient taking personal responsibility and being willing to change. It requires attention to all aspects of the body, especially those that are displaying patterns of disharmony. A naturopathic doctor balances the need for medical intervention with allowing the healing power of the body to follow its natural course.

The treatment strategy that chosen for a patient depends on the assessment outcomes, as discussed in Chapter 9, the diagnoses, as well as the health goals of the patient, the risk to health, the healing intention, and the patient’s constitution, vitality, and will. The aim of this chapter is to highlight the considerations that determine a treatment strategy. Reviewing the range of treatments used in naturopathic medicine is beyond the scope of this book.

SATISFACTORY VERSUS OPTIMAL HEALTH

There is a difference between satisfactory health and optimal health. Satisfactory health is based on what a patient desires at a specific point in time. For example, a patient might be satisfied if their pain or discomfort is manageable, versus making the necessary changes to ensure that it is completely resolved. Many patients pay attention to their health only when there is a problem, and stop paying attention to it when the immediate concern is alleviated. For many, a healthy lifestyle involves minimizing pain and discomfort, and doing what it takes so that their physical body doesn’t interfere with their desired lifestyle.

Satisfactory health often is based on short-term objectives. For example, patients who eat a poor diet and have an unhealthy sedentary lifestyle do so because it is convenient and easy; either because of lack of awareness of the long-term consequences or without regard for the long-term effects. Or a patient who desires to look younger and therefore takes a lot of supplements and medications or does injection therapies. The patient might achieve their short-term ideal health, but in the process they might have impacted their health in the long run. It is not uncommon for patients who desire to lose weight to choose a weight loss scheme that is not healthy and that has nothing to do with addressing the reasons they are carrying excess weight. They might be successful in losing weight initially, but if the underlying cause is not addressed, they often will decrease their overall health and gain the weight back.

Optimal health involves achieving the highest level of health you can in all aspects of your life. It is based on addressing the root causes of symptoms and diseases, living a life that has the building blocks for long-term health, and having a lifestyle that is based on spiritual, mental, emotional, physical, community, and environmental health. Optimal health involves making life decisions with long-term health as the priority. It requires work and attention to all aspects of life and works through health concerns not just suppresses them or gets rid of them. Optimal health relates to the body as a form of two-way communication. As you are able to interpret the message of the body and respond appropriately, you move closer towards optimal health.

Many people live somewhere between searching for satisfactory health and optimal health. The role of the practitioner is to match the treatment plan to the goals of the patient. It is not helpful for a practitioner to offer a treatment that will provide short-term benefits by suppressing the symptoms when the patient is looking for an understanding of the root cause. Likewise, it is not helpful for a practitioner to provide recommendations to a patient to address the root cause when a patient is interested in getting rid of the symptoms. In the latter example, chances are the patient will stop the treatment plan as soon as the symptoms subside.

RISK TO LIFE

To determine the type and treatment strategy that is required, the potential of cure, and the prognosis of any disease, it is helpful to understand the severity of symptoms and the degree to which health and life are at risk. The aim of all treatments is to address the initiating and aggravating factors and to reestablish harmony within the body. How those factors are addressed, the degree of intervention depends on the risk to life and the vitality and healing potential of the individual. Disease exists on the spectrum of mild to incurable.

• Mild. When the risk is mild; treatments that address the initiating factor and the building blocks to health and that involve gradual changes often are what are required to restore health.

• Moderate. As the progression of disease increases and the disease becomes more chronic, treatment involves lifestyle changes, as well as other supportive therapies. The healing potential of the patient determines the degree to which they are advised to make major changes to their lifestyle and the degree to which they are encouraged to address unresolved issues.

• High risk situations arise in two ways: when disease becomes more ingrained in the body and there is degeneration of tissues and organs that are threatening life, and when there is a sudden impact on health. When the risk is high, the aim of treatment is first to save a patient’s life. The focus is on alleviating the risk to life, followed by addressing root causes and aggravating factors.

• Palliative care is about maximizing quality of life. At this stage, the progression of disease, or the risk to life, is severe and the disease or symptoms are deemed incurable. Palliative care often is associated with the elderly or the end-stage of chronic disease, but it can involve any age group. The aim of treatment is to support the patient, to minimize pain and discomfort, and to provide comfort to the patient.

HEALING INTENTIONS

Intention is the direction, purpose, aim, or goal that we have for doing something (Quinn 1996). Intentions are set both consciously and unconsciously. They are based on a patient’s belief system, their expectations and their desire for a specific outcome (McTaggart 2002). The outcome of any treatment depends on the intention of the patient and the practitioner, the depth and accuracy of the assessment, the motivation and ability of the patient to change, the progression of the disease, and the treatments that are used. The intention to ‘cure’ or ‘heal’ encompasses the treatment strategies of balance, support, manage, palliate, suppress, or radical intervention.

All modes of treatment cause a shift in health, and they all have their value and purpose. When a patient is bleeding internally because of a ruptured abdominal aorta, initially a radical treatment that focuses on saving their life is more appropriate than one that addresses their deep-seated anger and frustration. The following paragraphs review the different modes of healing. The intention to balance or support health works with the healing power of the body. Treatments that manage, palliate, suppress, or involve a radical intervention might provide the relief that is required for a patient to make the necessary changes in life, but do not directly support the healing power of the body or address the root causes of disease. A patient is able to move from one intention to another. For example they can move from a management strategy, to a supportive and eventually to a balancing strategy if the patient is willing and the healing potential is strong enough.