[November 5, 2009] Dr. Jon LaPook investigated Duke Integrative Medicine’s non-traditional approach to preventing health issues before they happen. Duke believes this is the future of healthcare.
Mindfulness & Psychotherapy ~ Shinzen Young
Shinzen Young talks about the historical cross-fertilization between early Buddhism and other cultures, and goes on to share how now in the west, neuroscience, physics, contemplative traditions and psychotherapy are being cross-fertilized with mindfulness practice. He goes on to share the similarities and differences between psychotherapy and mindfulness. Filmed in Nov. 2009 at Mt. Carmel Spiritual Centre in Niagara Falls.
Integrative Medicine: Dr. Tracy Gaudet on NPR’s “The People’s Pharmacy”
In case you missed it, Dr. Tracy Gaudet was the guest on yesterday’s installment of The People’s Pharmacy on NPR. Dr. Gaudet is the Executive Director of Duke Integrative Medicine, and she was the inspirational leader of the Integrative Health Coach Professional Training Program that I completed in May. Click HERE to listen to this great discussion.
[Blurb from the People’s Pharmacy site]:
Integrative medicine combines the latest medical techniques with ones that come from centuries-old healing traditions, such as acupuncture or yoga. What is the evidence behind such approaches?
Learn how integrative coaching can turn good intentions into practice.
Guest: Tracy Gaudet, MD, Executive Director of Duke Integrative Medicine. She is also Assistant Professor of Obstetrics and Gynecology at Duke University Medical Center. Her books include Consciously Female and Body, Soul and Baby.
“Integral?”
Question: What does “Integral” mean? What’s the difference between integral, integrative, holistic, mind/body, wellness, etc.?
My answer: As I use the term, “integral” refers to any approach that brings together multiple perspectives in an effort to address the multiple dimensions of human life. In this sense, the term “integral” is basically interchangeable with “integrative” and “holistic.” As a matter of personal preference, I like the term “integral.” I graduated from the California Institute of Integral Studies, which is grounded in the Integral Psychology of founder Haridas Chaudhuri, and I’m also a big fan of Ken Wilber’s “four quadrant” integral theory.
In general, however, the terms integral, integrative, holistic, mind/body, and wellness are all meant to convey “whole person” approaches to health and healing, as opposed to the disease-focused system associated with conventional medicine.
Keeping in mind that most, if not all, healthcare practitioners—whether in conventional settings or integrative health centers—would claim to be treating the “whole person,” I agree with the following distinctions Dr. Elliott Dacher makes between conventional, complimentary and alternative, integrative, and integral approaches:
[Article featured on Davi Nikent.org]
The evolution of medicine in modern times has been from allopathic or conventional, to alternative and complementary, to integrative and now to integral.
These can be defined as:
Conventional: The traditional approaches of medical science.
Alternative and Complementary: Healing approaches outside of the mainstream of western medical science.
Integrative: The merging of conventional, alternative and complementary approaches under a single “umbrella” of care.Each of the preceding approaches, as they are currently and predominantly practiced in western culture, primarily focus on the biological or physical aspects of healing, emphasizing the role of professionals and their specialties, remedies and therapies in the treatment of physical disturbances. It is the recognition that these approaches have not addressed the whole person and therefore limit what can be achieved in health and healing that has driven the development of an integral approach.
Integral: The expansion of the health and healing process to address the entire range of the human experience: biological, psychospiritual, relational and cultural. All are seen to contribute to the disease process and to health and healing. The expansion of consciousness, the inner aspect of healing, rather than the outer “medical tool kit” is a central aspect of the integral approach. The aim of integral medicine is broader than all preceding approaches to health and healing. The aim is to gain freedom from suffering and to experience the flourishing of the full potential of our humanity – the natural arising of an inner peace, wholeness, love, compassion and joy – that can sustain itself throughout the life cycle irrespective of the presence or absence of disease. This can only be achieved with an integral approach to healing that considers all aspects of the human condition.
From the Practitioner’s Perspective:
As a conventional practitioner I would approach the individual from the perspective of the physical symptom and disease, limiting my diagnosis and treatment options to those of western science. As an alternative and complementary practitioner I would approach the physical symptom and disease from the perspective of my particular training (acupuncture, chiropractic, nutritional, etc.) and formulate a diagnostic and treatment plan in relationship to my specialty. An integrative care approach combines conventional and alternative approaches to offer a broader spectrum of choices when treating the individual’s symptoms or disease. As an Integral practitioner I would approach the patient first looking at their entire life circumstance – biological, psychosocial, relational and cultural – focusing on the whole person rather than the disease, symptom, or my particular specialty, my diagnosis would include concerns in each of these areas of life and my healing plan would cover the broad range of needs and possible approaches necessary to move towards a larger health of the whole person. Because as an integral practitioner my vision is broader so also is that which can be achieved, a human flourishing vs. a physical healing. As an integral healer I must be in a transformative process myself as the driving force for a larger healing is not merely biological knowledge but an understanding and growth into a larger consciousness. An expanding consciousness is a key ingredient of an integral process.
Elliott Dacher, MD
March 2005
Integrative Health Coaching Training at DUKE: Module Four
It’s hard to believe, but Sunday my training came to an end and my friends and I were sent out into the world, certificates in hand, as Integrative Health Coaches. This last four-day module flew by, but fortunately we had plenty of time and space to reflect on and celebrate our four months together.
As with the previous modules, there were fascinating presentations (on Genomics, Spirtuality and Health, Business and Marketing) and opportunities to learn, practice and review coaching skills. It was the final module, though, so the major theme was “next steps,” as in: “What are you all actually going to do with this training, and how are you going to do it?” Of course, each of us has a unique answer to that question, and some of us (me!) are still trying to figure it all out.
To all those who’ve been following these posts to get the “inside scoop” on the training program, here’s the bottom line: It’s excellent. If you came across the description on the Duke website and thought to yourself, “This sounds amazing, but I wonder if it’s really worth it”—It’s totally worth it. There were a few participants who struggled at times and voiced some minor criticisms of the program privately, but everyone of them also expressed deep gratitude for the experience as a whole. Of course, no training will meet everyone’s needs and expectations. That said—I’ve been around the block a few times and have participated in trainings sponsored by mainstream, respected institutions, as well as a few interesting, yet kinda New-Agey/Woo-Woo affairs. This Integrative Health Coaching training at Duke Integrative Medicine has been hands-down, THE BEST. Solid, grounded in rigorous research, expertly crafted and delivered, and yeah, a little touchy-feely at times. But the mushy stuff came from a place of such open-heartedness and authenticity that it softened even the prickliest of us.
Most of all, though, this training was about the people—both those who instructed us and the forty or so of us who came from all over the country to form this community of kindred spirits. Many of us will continue to network and work together as we carry our visions forward in the world. What an amazing group of people! Thank you all.
If anyone has further questions about anything, feel free to comment here or email me at “bob at integralhealthresources dot com.”
Jon Kabat Zinn’s Science of Mindfulness
I recently listened to this great discussion between Speaking of Faith host Krista Tippett and secular meditation teacher and clinical researcher Jon Kabat-Zinn.
I’m a HUGE fan of Jon Kabat-Zinn. He has a way of cutting through the fog and getting right to the essence of what mindfulness is all about. He doesn’t rely on jargon or woo-woo spiritual concepts. He expresses an embodied understanding of what it means to be present to one’s life, to pay attention to the here and now of direct experience. He also has a firm grasp of the growing body of scientific evidence on the many health benefits of meditation.
One day I will attend one of the retreats/workshops he gives through the UMASS Center for Mindfulness.
Enjoy the discussion!
[Also, check out this October 11, 2007 Google Talk—one of the best introductions to mindfulness I have ever seen]:
Greeson Presents Duke Integrative Medicine Research to US Lawmakers
The following is a news update from Duke Integrative Medicine:
“Dr. Jeffrey Greeson Presents Duke Integrative Medicine Research to US Lawmakers: Improving the Nation’s Health through Behavioral and Social Sciences Research Poster Session Sponsored by National Institute of Health
Dr. Jeffrey Greeson was invited to present the research underway at Duke Integrative Medicine on April 28, 2009 during a session on Capitol Hill sponsored by NIH. The focus of the session was the role of behavioral and social science research in producing change — including change in health and behavior.
Greeson was one of only three people representing the National Center for Complementary & Alternative Medicine (NCCAM). Among the 27 NIH agencies represented, others included the National Cancer Institute, National Institute on Aging, and National Genome Research Institute.
Greeson presented preliminary findings from his study on how Mindfulness-Based Stress Reduction (MBSR) works to enhance emotional well-being and sleep, two factors associated with cardiovascular disease risk. He is collaborating on the study with Drs. Ruth Wolever, Jeffrey Brantley, and Janna Fikkan, all of Duke Integrative Medicine.
The Coalition for the Advancement of Health Through Behavioral and Social Sciences Research (CAHT-BSSR) planned the event featuring social and behavioral science research supported by the National Institutes of Health (NIH). The event – NATIONAL INSTITUTES OF HEALTH: Improving the Nation’s Health through Behavioral and Social Sciences Research – featured posters of NIH-funded research. Members of Congress, their staff, the biomedical, the behavioral and social science research community, and the public attended the event.”
Integrative Health Coaching Training at DUKE: Module Three
It’s been about three weeks since Module Three, which means it’s only a few weeks until the fourth and final module. Things are happening so fast that it’s hard to keep track of what happened during Module Three, what happened in the weeks since, and what’s happening in my own head from moment to moment. Off the top of my head:
Module Three was awesome, as the entire training has been. We learned more coaching skills—specifically, how to work with people who have psychological issues, and how to do “group coaching”—and we practiced those skills on each other. The always inspiring Tracy Gaudet (Director of Duke Integrative Medicine) gave us an update on what she’s been up to lately. In February, Dr. Gaudet presented at the “Summit on Integrative Medicine and the Health of the Public,” in Washington, DC, where she made the case for Integrative Health Coaching’s place in the future of Integrative Medicine. Dr. Evangeline Lausier gave a fascinating presentation on “nutritional supplements and botanicals.” Janet Shaffer taught us all about acupuncture and oriental medicine, and Dr. Jeff Brantley (Director the Mindfulness Based Stress Reduction Program) did another wonderful session with us.
Of all the presenters—all of whom were very impressive—I was particularly impressed with Jon Seskevich, a nurse clinician at Duke Medicine who teaches stress and pain management skills to patients, most of whom are dealing with very challenging health conditions. Jon just blew me away with his gentle nature, his radiant kindness and his boundless compassion for others. He taught me a meditation technique that I used the very next day in the midst of difficult situation—and it was incredibly helpful.
We also met with some folks who graduated from the inaugural training (ours is only the second cohort to move through the training) to discuss setting up a professional association for Integrative Health Coaching. The staff at Duke is very supportive and we anticipate a future website where our community can come together and raise the field to new levels of awesomeness.
Speaking of new websites, Duke Integrative Medicine’s has a great new look, and my own website (Integral Health Resources.com) is shaping up rather nicely, if I do say so myself.
What more can I say. It’s all very exciting, and I look forward to Module Four, graduation, and then bringing all this into the world somehow (I’m still figuring that one out!).
Boo-ya!
Integrative Health Coaching Training at DUKE: Module Two
Another four days of intense training at Duke Integrative Medicine have come and gone. Two modules down, two to go, and I’m feeling very good about the whole process. It was great to see everyone again, especially the other trainees. There was at least as much richness and learning happening during break times and lunch as there was during the training sessions. We were also given a block of program time to network in small groups of folks with similar interests and target populations. Most of the trainees intend to apply this training to their current job settings—places like hospitals, health care centers, schools, fitness centers, yoga studios, etc. My group was composed of the six or seven of us who are looking to start our own businesses/private practices. I know next to nothing about the ins and outs of business, marketing, insurance, taxes and that whole ball of wax, so it was very helpful for me to get the others’ perspectives. I’m pretty sure the trainers plan to cover some of the basics in a future module, but this initial brainstorming session was great. One of my big insights so far is that I don’t have to make everything happen on my own. The sense of community is really powerful at these trainings, and it’s changing the way I understand the idea of what a career can be.
We covered several topics related to Integrative Health in this module: nutrition, exercise, weight loss management, and the importance of one’s physical environment. Mindfulness is always emphasized, which I love. The chef—who’s been serving us fantastic gourmet meals everyday—put on a cooking class and we also practiced with some mindful eating. As always, the trainers gave us a ton of information—very well organized and with references to the supporting research—and the presenters were each experts in their respective fields who are affiliated with Duke Medicine.
Of course, we also spent many hours on coaching practice, breaking up into dyads or triads while the trainers floated around and offered feedback. The trainers also did several coaching demos to model specific skills and illustrate coaching concepts.
At the end, as in Module One, we were divided into groups of three, members of which will be practicing together via weekly conference calls during the month or so leading into Module Three. I’m looking forward to the calls, to the next module, to the networking with new friends and associates, and to working on my business plan and website.
Integrative Health Coaching Training at DUKE: Module One
I’m through the first of four modules of the Integrative Health Coaching Training Program at Duke Integrative Medicine (DIM) and I’m very impressed so far. The strongest impression was left by Tracy Gaudet, the program director (pictured above). This woman is just bursting with passion and enthusiasm for bringing a holistic paradigm into the mainstream of healthcare. Don’t take my word for it though, just check out this in-depth interview on NPR.
I also found this little piece from the local news, which gives a feel for what’s going on at DIM:
The health coach training is divided into four modules, spaced about a month a part, each lasting four full days. In this first module we learned all about the philosophy and research behind DUKE’s practice of integrative medicine. The building itself was designed and built in accordance with this holistic vision, and it has the feel of a retreat center as opposed to a medical facility. The waiting room features a “water wall,” which is basically a glass wall with water flowing down the sides, and every room in the place has a view of the surrounding woods. They have an on-site chef who fed us gourmet, healthful lunches everyday. The food was incredible, and would easily translate into a thirty dollar meal at a nice restaurant.
The participants in the training are very impressive as well. It’s a really diverse group, with folks from all over the country, and some from over seas. Many are nurses, physician assistants, and other health care professionals, but I also met a New York City Firefighter, a dancer from Thailand, a health educator from the middle east, and a whole bunch of other interesting people. It was an intense four days, with lots of information to process and several opportunities to practice the skills we’re learning. We’ll also be practicing our skills via weekly conference calls between modules.
Anyway, it’s been a great experience so far and I’m looking forward to the second module in late February.
What exactly am I going to do with this training, when it’s all said and done? I’m still pondering that one…