Who is Responsible for Your Health?

Who should take responsibility for you health? Sounds like a straightforward question, doesn’t it? But I get so frustrated when complex issues get squashed into simplified, silo-thinking, ready for twitter or media sound bites, or the under-girding of political ideologies.

So….just as the economy is not just made up of the interplay between business and the household, but is in fact far more rich and complex, so too the interplay of responsibility for our own health.

Kate Raworth, really helpfully uses the following diagram to help us rethink the components of the economy. I would like to suggest that we use it to think about health, also.

So…who is responsible for your health and wellbeing?

  1. Your Family/Household
  2. Society/The Commons
  3. The Market
  4. The State
  5. You

In some ways, I feel like all of these are obvious, in their own way, but I will just unpack each one a little bit more.

 

Your Family/Household

We all have needs. We need to know we are provided for (water, food, clothes etc), safe, loved, welcome, encouraged, disciplined and given place to dream and live those dream out. It is the role of our families or the household to which we belong to ensure those things happen as we grow. So much of our ill-health, our brokenness and our long term physical and psychological pain is because these basic needs were never met and left us without a sense of wholeness. The lack of met need, has a huge impact on the development of our personality and character. When we speak of ‘personality disorders’, each type has it’s roots in early life when needs were unmet and therefore parts of the personality remained undeveloped. Let’s face it – no family is perfect! And so, I would argue, that all of us have ‘disordered personalities’, and until we confront the shadow parts of ourselves that are trying to overcome this sense of loss or inadequacy, we continue to project an ego version of ourselves to those around us. We do so to cover over this pain, but facing it head on and allowing ourselves to fess up to our deepest needs, would actually lead to us being a great deal more healthy.

When I work with head teachers and ask them what the biggest need they have in their school, the answer is almost always ‘parenting classes’. However, there are very few providers of this available (due to cuts at a county council level) and the classes available are often very ‘middle class’ in their approach. We need to completely rethink parenting classes in the context of the poverty-truth commission and think about less twee ways to really engage with communities about how we raise happy and healthy kids. The truth that Adverse Childhood Experiences are our greatest public health crisis is not going away. Grasping this nettle is going to be painful but really necessary if we are to breathe health and wellbeing into our society.

 

Society/The Commons

Just as we get our needs met by those in our immediate household, the same is true of society. The way we treat children, the things we expose them to, the way we love them and educate them has a massive impact on their current future health and wellbeing. It’s becoming clear that social media is causing significant harm to our mental health as a nation, particularly our young people, and yet we don’t know how to curb our enthusiasm for all our technology…let alone the rise of the robots…

The commons is fast disappearing, too easily privatized and made available to those who can afford it. How do we safeguard the commons and use it for the benefit of all? What would the Diggers say to us now? The breakdown of our communities, with increasing isolation and loneliness is having a detrimental effect on our wellbeing. What can we do to recover the spaces that belong to us all and help us rediscover the joy of connecting and being together?

The commons is also about our corporate voice. It is only really vast people movements, speaking with one voice that can really cause governments to sit up, listen and take heed of the needs of the people. It is only together, that we will make enough noise to change the health and wellbeing of all of us for the better. How might we speak and act together in a way that will take corporate responsibility for all our health and wellbeing?

 

The Market

Oh the benevolent hand of the market! If only…. But the Market plays an absolutely key (though currently over played) part in our economy and our health and wellbeing. We know for a fact that advertising is deliberately trying to misinform us so that we make irrational decisions. A key component is to make people feel worse about themselves so that they buy things they simply do not need. Supermarkets are being challenged for the ways they deliberately place products and arrange their stores to cause people to buy more unhealthy things and food chains are constantly trying to ‘up-sell’ their unhealthy products and downgrade our health in the process. They evangelize the masses with the idea that we are all free to make our own choices, but if this were so, they would not spend the billions of pounds involved in socially engineering our choices, so that we ‘freely’ choose that which harms us! Oh for a market that might redefine it’s moral code! The market could do SO much good, but unharnessed and left without true accountability or consequences, it serves to damage our health – something it is truly responsible for.

 

The State

The state has a vital role and responsibility in caring for all of our health and when it washes it’s hands of that responsibility or tries to pass it over, we see a massive rise in health inequalities and overall worse-health for all. The NHS in the UK is one of the great triumphs of the state. Providing brilliant healthcare for those who need it whenever they are unwell is truly amazing. Imagine not being able to afford this because it depended on keeping up with insurance bills. It is not uncommon for us to see people in General Practice, who literally cannot afford to feed their families any more and are having to make some incredibly difficult choices (made far worse by long school holidays). Easy to point the finger and start creating a narrative about how it’s “all their fault”, but far harder to hear the truth of what it is really like to be a lived-expert in poverty and the trap it creates and harder still to look to alternative solutions, rather than believe the austerity narrative. There is clear evidence that the more unequal a society becomes, the worse the health outcomes – both physical and mental. When the market is allowed to behave exactly as it wants, we also see the health of people suffer. It is only through the right kind of government that the market can be tamed. It is only with the right kind of legislation that the economy can be skewed towards redistribution and regeneration of the resources needed – this would need to include a radically feminist approach that works on behalf of women, in particular, for equal opportunity, pay and recognition of just how much the ‘household economy’ contributes to the overall wellbeing of the nation. It is only the right kind of leadership that will tackle the inequalities we see and refuse to be wined and dined into maintaining the status quo. It is only brave leadership that will take the ecological issues, like plastic in the oceans, massive over antibiotic use in animals, and ongoing air and river pollution that will give us a healthy planet and human population in the future.

 

You

And where possible, and for some given various health issues, this is more possible for some than others – we do not all have an equal starting place or a level playing field – where we can  – we do have a responsibility to ourselves and to the wider society to care for our own health and wellbeing, so that when the health and social services are needed, they are available for all. It also means using the health and social care services in a way that creates sustainability, being grateful for them and ensuring they and the people who work in them are not abused.

 

It’s complex, but it’s vital that too much emphasis is not put on any one area. We must not play the blame game, especially not towards individuals when we haven’t taken the time to hear their story, nor understood the wider context of the role of the other vital players on the field. Each aspect of the economy plays a massive role in the health and wellbeing of the nation, and it is high time that each plays it’s relevant part to its fullest ability.

Share This:

FacebookTwitterGoogle+Share

Personality Health

imgresWe often talk about physical, mental, social and even systemic health, but we don’t often think or talk about the health of our personalities. Our personalities are shaped by our self-esteem, our values, our truths, our needs, our struggles, our instincts and our gifts. They impact every part of our lives, relationships and interactions with the world at large and although we give some focus to understanding them through tools like Myers-Briggs, the Enneagram and Strengths-Finder, (perhaps to make us more successful), we give little thought to how healthy we are when it comes to this subject.

 

enneagramdisordersNow, what is particularly interesting to me as a doctor are 2 things related to this. Firstly, our personality type is hugely linked to the kind of mental health problems we might be more likely to develop. I wonder how often clinicians see the presentation of a mental illness and are able to talk with the person in front of them about which aspects of their personality might need therapy in order to help their mental health improve? As the whole area of positive psychology develops, it is vital that there are learning environments in which clinical teams can learn about innovative approaches in psychology that avoid the over prescribing of medication, especially in our younger population.

 

14516526_OPiwmgUE_c_large.jpgThe second area of interest is to do with how we can be more self-aware of how healthy we are or when we have reached a point at which we can no longer really help ourselves but need others who love us or care about to to intervene.  Below is a chart (of sorts) which I learned about during a weekend on the Enneagram. It helps to explain aspects of personality health. I recognise that at times I am functioning more healthily than at other times, due to a combination of internal and external factors. I think there are behaviours we can be aware of, or ways in which we are operating in relationships and situations which should serve as a WAKE UP CALL to us. When we notice more negative patterns, we need to take stock of where we are and work out our lines of responsibility to help us back into a more healthy state. However, if we don’t, things can continue to worsen until we reach a point at which we need others to intervene on our behalf and rescue us from our self-destructive and damaging sickness.

 

We can make a comparison with heart disease. For much of the time, our hearts MIfunction healthily. However, through a mixture of internal and external factors, our hearts can become less healthy. When this occurs, our body will fire some warning shots to us, giving us a chance to change before something more serious occurs. This might be signs and symptoms do do with our weight, nutrition, fitness, level of breathlessness, vague chest pains, markers in our blood tests – like high cholesterol and high sugar, rising blood pressure etc. However, if we ignore the opportunities to change and continue with our unhealthy choices, eventually we will reach the point at which we have a significant event, e.g.the start of angina, a heart attack, a stroke, the development of diabetes. At that point we need the help of someone else – we can no longer do it on our own. Of course, we still have choices and can reject the help on offer, but if we do, we risk our own demise and ultimate death.

 

images.jpgMy point is this. If we do not take the health of our own personalities seriously, there are serious and significant consequences, not only to ourselves but those around us and the world we live in. Many of us reach a point when we need help, but might not even face up to this, due to the poor health we are in. In those times, we need those who love and trust to be brave enough to reach in and offer us a life line. We may have even reached the place where we need resuscitation, when all our pride has gone. When we have ignored the red flag, we need those around us who will risk our total rejection of them to love us enough to offer us a way back to health. We need to take the health of our personalities seriously – it actually has a huge bearing on all the other aspects of our health. We also need

 

enneagram-health

 

HEALTHY

  • 1. Level of Liberation – Ego transcended – balance/freedom – i.e you become a gift
  • 2. Level of Psychological Capacity – Ego as particular mode of being – choice of how to be
  • 3. Level of Social Gift – Ego operating in constructive way – sublimating ego

 

Wake up Call – need to listen to internal warning bells

 

AVERAGE

  • 4. Level of fixation – Ego role assumed – falling asleep (not self-aware) – losing contact with presence
  • 5. Level of interpersonal conflict – Ego controlling environment to support self – manipulative/defended
  • 6. Level of overcompensation – Ego inflation, demanding others and reality support it – aggressive defence

 

Red Flag – need of help from others

 

UNHEALTHY

  • 7. Level of violation – Ego willing to violate self and others to maintain itself – abusive/desperate
  • 8. Level of Delusion and compulsion – Ego loses touch with reality – out of control – personality disorder
  • 9. Level of pathological destructiveness – Extreme pathology and/or death

Share This: