The Illness-Wellness Continuum, developed in the 1970.
The Illness-Wellness Continuum, developed in the 1970s, illustrates that health is a dynamic state; there are several degrees of health. “Good health”, or High-Level Wellness, is achieved through awareness, education and growth, and is found on the right of the horizontal Illness-Wellness Continuum diagram. Signs, symptoms, and disability, which are evidence of worsening health (and eventually Pre-Mature Death), are found on the left side of the Illness-Wellness Continuum illustration as “Poor health”. In the center of the continuum is a “Neutral Point”, at which there is “no discernible illness or wellness”. (Travis, 2004).
Congruent with the Illness-Wellness Continuum, the Constitution of the World Health Organization defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. (World Health Organization, 1946). It is interesting to note that this definition has not been revised in more than six decades. This definition describes the integration of physical, mental and social well-being as health, and differentiates the state of health from the lack of disease.
Wellness can be considered as “the integration of mind, body and spirit. Optimal wellness allows us to achieve our goals and find meaning and purpose in our lives. Wellness combines seven dimensions of well-being into a quality way of living. Overall, wellness is the ability to live life to the fullest and to maximize personal potential in a variety of ways. Wellness involves continually learning and making changes to enhance your state of wellness. When we balance the physical, intellectual, emotional, social, occupational, spiritual, and environmental aspects of life, we achieve true wellness.” (Nordqvist, 2014).
Harvard-trained Andrew Weil, MD wrote that humans become familiar with health when they are ill or have a disease (page 41). (2004). It is important to realize that the traditional valuations of health as good and desirable, and illness as bad, are not necessarily clear-cut; “health is the expansion of consciousness that transcends the illness-wellness dichotomy”. (Koerner, 2011). “Health is wholeness – wholeness in its most profound sense, with nothing left out and everything in just the right order to manifest the mystery of balance. Far from being simply the absence of disease, health is a dynamic and harmonious equilibrium of all the elements and forces making up and surrounding a human being.” (page 41) (Weil, 2004). Health, then, encompasses both wellness and illness and/or disease. Health and healing may be examined in a number of ways, including through the models of the physical body and the body-mind-spirit.
Models of Health and Healing
Larry Dossey, MD pointed out how the perceptions and beliefs about health and illness have changed over time (Koerner, 2011). In Era I, which began in the 1860s, science was assimilated into the practice of western medicine. Health and illness were considered in the context of the physical body; the consciousness of individuals was a result of biochemical, structural, and physiological facets of the brain. Illness was considered to be “physical in nature”; therefore, treatment had to be physical in nature. Surgery and medications treated physical illness. The term “physical” refers to the body of a person, rather than their mind, and existed in a tangible form which could be touched or seen. It was reasonable to conclude that the physical body was a basic component of each individual’s identity. The consciousness, or mind, of a patient was connected to the role of the brain.
In the 1950s, Era II arose as practitioners expanded their considerations of health and noticed that thoughts, feelings, personal principles, attitudes and values impact physical health. Hypertension, myocardial infarctions, and ulcerations of the gastrointestinal system were attributed to emotional stress. During this time period, treatment modalities began to address the mind consciousness. (Dossey, n.d.). It has been said that many people still hold this perspective. (Koener, )
Based on the quantum physics pattern, the current perspective, Era III, identifies the consciousness which is not limited to a person’s body, but is described as “infinite, immortal, omnipresent”. (Riley, 2011). A nonlocal mind is one without limits; consequently, an individual’s consciousness can influence and be influenced by others’ emotions, including love and compassion. This meshing of consciousness creates unity, or “oneness” among all humans; we have the ability to influence each other through connections which can be made in the nursing profession by nurturing transpersonal activities.
Discussion. A significant distinction is found by comparing the mind in the physical body of Era I to the consciousness of Era III. In the 19th century, the mind was considered to be entirely separate from the neurologic function of the brain. In the modern Era, the limitless mind has been expanded to
Body-Mind-Spirit and My Professional Presence
Nurses are human beings, just like their patients. To truly partner in relationships that advance wholeness in patients (p. 18.) (Korner, 2011), nurses must be “authentically present” (Falk-Rafael, 2005). Rather than focusing on past or present events to explain physical and emotional states, nurses can assist patients to “stay with their feelings and learn to observe…without reaction, description, or interpretation.” (p. 18) (Koerner, 2011). This nursing presence creates the opportunity “for real transformation and growth.” (p. 18) (Koerner, 2011).
Nursing theorist Jean Watson’s caritas illuminate that “at its core, transpersonal recognizes that the power of love, faith, compassion, caring, community and intention, consciousness and access to a deeper/higher energy source, i.e., one’s God, is as important to healing as are our conventional treatment approaches, and is possibly even more powerful in the long run” (Falk-Rafael quoting Watson. See reference #30) http://eds.b.ebscohost.com.wgu.idm.oclc.org/ehost/pdfviewer/[email protected]&vid=1&hid=104 The framework of Caring Science “is grounded in the ethic of ‘Belonging’ to that which is greater than our ‘Being’; it goes beyond medical science, acknowledging the relational, life force; they philosophical, unitary field dimensions underlying all of humanity.” (Watson & Browning, 2012).