Introduction: Why “Rainbow”?
Many have asked about our name, e.g. are you gay? Or hippie? Woo woo? The answer is none of the above. Rainbows symbolize the relief we feel when we see such a beautiful signal of the end of a storm, when the sun is breaking through. Rainbows also suggest inclusiveness, diversity, the “pot of gold”, and (from the Old Testament) renewal and redemption.
What is Integrative Medicine & Why?
With over two decades of experience working with chronic pain patients, I have learned that patient outcomes may be improved significantly when a multi-disciplinary team including professionals with traditional and non-traditional training provides coordinated treatment. A “whole person wellness” approach can reduce recovery time and dependency on pharmaceutical compounds and increase personal productivity.
We are working to develop and to implement a holistic, or integrative medicine, approach to the treatment of persons with chronic pain and related illnesses.
Despite widespread recognition of a crisis in the American healthcare system, what to do about the problem remains controversial. As costs rise inexorably, quality seems elusive. Our failure to adequately address chronic illness, particularly chronic pain, has been a major contributing factor. Every patient with chronic pain represents a failure of our current medical and healthcare system.
We want to apply what we know about improving the health of people with chronic pain and to research the effectiveness of various approaches to addressing their problems. Our goals include reduced pain & suffering, increased quality of life, and net savings in health care expenditures. My colleagues and I seek to combine allopathic medicine with selected “complementary and alternative” healthcare approaches, such as mindfulness practices, psychotherapy and other forms of counseling, chiropractic, body work, acupuncture, Chinese medicine, movement therapies, physical therapy, nutritional counseling, etc. Using a quality improvement model, we plan to evaluate systematically the effectiveness of our work to determine which approaches are most useful for which types of problems and persons.
We welcome the participation of interested individuals. We need ideas, energy, time, and money from like-minded individuals willing to help make transformation of pain a reality.
From Pain to Health:
We know much of what is needed to achieve and to maintain optimal health. Anyone can become healthier. Unfortunately, modern medicine has increasingly focused on disease and injury. Little in modern medical practice concerns health or what health might be. We conceptualize health as “wholeness”. A person is a “whole person”, even with one or more body parts missing. We propose that helping persons to experience and to manifest their wholeness ought to be a central focus of healthcare providers, particularly regarding people with chronic illnesses.
The requirements for good health include good nutrition, bodily movement, adequate sleep, intimate and other social interactions, “spiritual” practices, “positive” attitudes, community involvement, stress management, avoidance of toxins and addictions, a healthy environment/ecosystem, and love for self and others. Medical care, when necessary for diagnosis and treatment of diseases and injuries and for prevention (e.g. immunizations, blood pressure & lipid monitoring, etc.), can make a significant contribution to health and healing. Health-promoting behaviors and life-styles and public health efforts are equally important for both individuals and our communities.
Pain is part of the human condition. Nociception clearly has survival value; humans have evolved nervous systems with elaborate nociceptive and anti-nociceptive networks. Chronic pain, however, unlike the acute pain of tissue damage or threat of tissue damage, has no survival value. Chronic pain in fact can be viewed as a disease (or dis-ease) condition in its own right. Chronic pain may be in fact a mis-perception of ongoing tissue damage, when the underlying condition has had more than enough time to heal. But more than time is needed for healing. Certain diseases such as rheumatoid arthritis, for example, involve on-going or recurrent episodes of inflammation and damage to tissues. Nevertheless, any person, no matter how persistent and/or severe his or her pain, can be healthier, that is to say, more aware of healing and wholeness. The capacity to heal is part of our birthright as humans.
How? On one level, as noted previously, we know many of the factors that are needed for optimum health. Consistently performing behaviors that promote health and healing, however, or helping others to perform these behaviors, remains problematic. For example, nearly every American knows that smoking tobacco is harmful to health, but many begin to smoke every year, and many more smoke tobacco habitually, despite multiple techniques and tools for smoking cessation. Similarly, many others struggle with seemingly intractable health problems, such as obesity, heart disease, cancer, substance abuse/addiction, and so-called psychosomatic illnesses (e.g. fibromyalgia, migraines, etc.). Nevertheless, we can identify some approaches that can help change harmful behaviors or habits into healthful behaviors and habits. Even the best practices cannot help if they are not available, however, and many who could benefit from these practices do not, due to ignorance, financial barriers (including the expectation that health insurance should pay), and insufficient motivation.
One key to success is the approach called mindfulness. Experience and data suggest that people with chronic pain (and other chronic illnesses) who learn and practice mindfulness (e.g. Mindfulness-Based Stress Reduction, aka MBSR) can achieve an “orthogonal rotation” in their perceptions and come to “own” and to manage their health problems, a process that includes reduction of suffering and improvement in overall self-care and quality of life (see Jon Kabat-Zinn’s book, Coming to Our Senses). The capacity for mindfulness, described by Dr. Kabat-Zinn as “an openhearted, moment-to-moment, non-judgmental awareness” is part of being human and is “optimally cultivated through meditation” and related practices.
We can provide healthcare system that actually promotes health and wellness. Typically, chronic pain cannot be completely eliminated. As a subjective phenomenon, pain cannot be measured with much validity. Many experts have proposed that the aim of treatment of chronic pain ought to be increased functionality. This view has merit, as function can be to some degree measured objectively, but patients are interested in more than improved function; they want relief from pain and suffering. Moreover, everyone wants the maximum possible quality of life (QOL), another difficult-to-measure concept. We will seek out the best available measures of QOL and use them as a major part of our assessment.
From our perspective, the most successful treatments for persons with chronic pain involve the “multidisciplinary” approach. Chronic pain is a multifactorial problem, and the most successful approaches therefore address the problem from multiple perspectives, e.g. analgesia (via medications, acupuncture, heat and/or cold, nerve blocks, hypnosis, etc.), cognitive behavioral psychotherapy (to address the emotional, attitudinal, motivational, etc. aspects), physical therapy (&/or other forms of rehabilitation), stress management, chiropractics, exercise, etc. The model commonly used in multidisciplinary pain clinics includes comprehensive assessment by a team of providers with different kinds of expertise and subsequent development by that team of a treatment plan to be carried out by some or all of that team, as well as by others to be determined by the needs of the patient. In our holistic or wellness model, the team will include “complementary and alternative” practitioners, therapists, counselors, nutritionists, etc., as well as allopathic physicians, and the treatment plans will include preventive efforts, patient education, “energy” practices, mindfulness, movement training, counseling/psychotherapy, and others as deemed necessary.