Illness Explorer is based on seeing persons as wholes, not as sets of minds, bodies, and other compartments.
This is a very complicated subject! Want to get into this? Then we suggest you print it out!
Western medicine tends to see a patient with a disease in terms of the biomedical model which sees the person-as-a-machine, as a complex fascinating biological machine, which one can ‘lubricate’ with drugs, or repair, remove and replace parts.
Illness Explorer is based on a different model: The Person as I AM
The following is a summary of the concept of I am-ness.
In persons with diseases we must address meaning and disturbed physical structure and function as different aspects of the ‘whole’. I call this ‘whole’, or unified territory of personal being the ‘I am.’ This use of I am has ancient warrant when one thinks of the Old Testament self-description of Jehovah (“I am that I am”) or the words of Christ who said “before Abraham I am”. But for more contemporary precedent and justification we can call on Shalom (1985) who argues very cogently for the notion of existent being (the “I”) as more fundamental than the categories of mind and body. In a useful essay Ravindra (2000) argues for personhood which is “less ‘I am this’ or ‘I am that’ and more as I AM’… .”
This phrase the I am captures both our consciousness (or subjectivity) and our physicality. It allows me to say “I am physical” and “I am conscious” at the same time. It does not divide me into compartments of mind and body. It is intuitively strong in that it matches my human experience.
It avoids some of the misunderstanding which has built up around words like mind, body, spirit, self, consciousness—though of course these are very useful categories capturing certain dimensions of human experience, the experience of the I am.
The ‘I am’ language gives dignity to our subjectivity (feeling, thinking, and consciousness) and physicality (our bodies) without making one or the other more important or more basic. It allows matter and subjectivity to coexist as dimensions of the same unitary dynamic reality. It emphasizes an underlying deep unity to ‘being’, and insists that there is a level of description of our personal reality which is not to be compartmentalised.
Yet it does not outlaw other levels of description such as mind and body which serve us in the rough and ready world of sorting ‘things’.
Modern cognitive science (Lakoff and Johnson, 1999) and post-modern theory demonstrate that in a variety of ways, and at a variety of levels, we actually ‘construct’ reality. The very processes of human sensing, thinking, and language create categorical structures. As a result we carve the I am up into bits (that are not really bits at all) we call mind and body. But the I am is still one amazingly complex whole. It is physical and subjective at the same time.
I propose then that it is crucial that clinicians and health workers should see patients as I ams. Disease emerges in an I am, a whole which allows the physical aspects and meanings aspects to be there in the same space. It follows that disease will commonly demonstrate both physical and meanings aspects (as well as relational, family, social, cultural, spiritual, and ecological aspects)—it cannot be any other way. Clinicians must accept the multidimensional nature of disease, and begin systematizing their clinical work around disease in ways which allow meaning and the physical aspects of disease to be together in the same ‘space’.
Put simply, the categories of mind, body, and spirit, are, in a very real sense, constructs of our peculiarly human combination of sensory range, neural processing, symbolic capacities, and so on. We carve reality up in certain ways to suit our type of functioning. We create categories like ‘clinical depression’, ‘quantum mechanics’, ‘chronic fatigue syndrome’, ‘remote viewing’, ‘criminal recidivism’—these are ways of labeling and talking about ‘real’ or recurrent patterns we observe in the whole. But they are ways of looking at aspects of the whole. They are limited ‘cuts’ through the data of the whole.
Few of us would resist this idea that our ‘I am-ness’ includes physicality and subjectivity. Most of us go further and also think of ‘mind’ and ‘body’ as separate ‘things’. But do we have a separate thing called a ‘body’ and a separate thing called a ‘mind’, or have we categorized our very real experience of our physicality and our subjectivity, and then gone on to making them into ‘compartments’, or ‘things’, thereby creating a whole host of problems?
This is not a minor issue. These problems include ‘the mind/body problem’, and the endemic, simplistic, opting for a reductionistic emphasis on one compartment or the other. The physicalists preoccupy themselves with the body. The others let them get on with that and preoccupy themselves with the mind, or spirit, or whatever. Getting the split-off dimensions back together again turns out to be an Herculean task. If the reality of the person ‘out there’, beyond the constraints of our processing, is unitary, and the splitting or separateness of mind and body is a function of our categorizing, then the whole enterprise of trying to connect mind and body is in vain.
One cannot connect that which was never disconnected.
Some might argue that the I am language may appear to overly emphasize the ‘I’ as subject, and devalue physicality and embodiment. I resist that potential criticism as reflecting the outdated dualistic notion of a disembodied mind, which automatically tends to cast the notion of the self or the I into a non-physical compartment. For me the I am is both very physical (embodied) and very subjective. The I am is full of multidimensional possibility and constitutes a necessary correction of the over-emphasis on the ‘it’, the objects of ‘mind’ and ‘body’. The latter emphasis leads to the intractable mind/body problem and also all loss of subjective meaning from the field of the physical—leaving us incapable of understanding diseases where meaning seems to play a very obvious role.
All the discussion so far presupposes a focus on the individual with disease. I have reported (Broom 1997) a six year old girl enmeshed with her sexually-abused mother who presented with a two year history of severe vulvitis, which ceased immediately when I acted to increase the separation-individuation of the child from the mother. The implication is that meaning can be projected into various dimensions both intra-individually and inter-individually. Therefore another criticism, in the use of I am, might be that I am over-emphasising the separated-individuated ‘I’, rather than seeing the wider connectedness of persons to family, culture, the environment and so on. Actually I contend that human experience is mostly a rich tapestry of meaning, feeling, and physical expression emerging as the many ‘I ams’ (human and non-human) jostle together to satisfy and fulfil their multidimensional needs, drives, instincts, values and purposes. The limited ‘I am’ (individual) notion does not preclude the wider notion of the ‘We are’ (community). Indeed the latter enfolds the former, and I have previously described various situations (Broom 1997) where individual disease is an expression of the We are.
The work of theoretical physicist David Bohm (1980) gives credence to this notion of the I am emerging in the context of the We are. I am referring to his propositions that separated-individuated explicate reality rests on or emerges from the wider implicate reality which is a field of connectedness or holomovement. Persons are in the explicate sense individuals so constituted by means of relatively stable boundary conditions which serve to create a degree of separation-individuation. In this view persons (and indeed non-persons) are diverse, structured, separated, individuated, emergent expressions of the wider connected whole. This important defining of explicate (emphasis on the individual) and implicate (emphasis on connection and wider field groundedness) realities is beyond the scope of this summary.
The many clinical examples on this site emphasise the reality that physical diseases can have inherent meaning, and the I am conceptualization suggests this is to be expected rather than seen as a rarity or a marvel.