Conundrum – “anything that puzzles”

Root – “the fundamental or essential part and/or the source or origin of a thing”

Cause – “a person or thing that acts, happens, or exists in such a way that some specific thing happens as a result; the producer of an effect”

I’ll be expanding on concepts that I discussed in two previous posts; what does health mean and what it does it mean to treat a client. I personally believe that much of the generalised disappointment that occurs in healthcare boils down to compartmentalising people and their ailments into clusters of symptoms that can be treated/managed with standardised procedures or drugs/supplements. In the “premise of holistic health” article, I mentioned that chronic health complaints tend to be multi-factorial and that a person’s progressive decline in health may have been set in motion by dysfunctional patterns of living/habits. I’d like to take a look at this from a different angle by highlighting that even though people can become progressively “sicker” over time, people can also have fundamental deficits in their physiology that are either causative factors and/or render a person susceptible/vulnerable to experiencing their chronic health complaints.

This also means that the concept of “root cause” needs to be looked at from a different angle as well. Instead of framing the root cause question from the angle of “what is the single most likely thing that is causing this person’s illness?”, I would frame it as

“what are the most likely deficits/dysfunctions I can identify in this person that would be driving their illness?”

Now, the detective work necessary to determine the most viable treatment/s for the client doesn’t resemble some crucible like finding a needle in a haystack. However, the practitioner’s depth of knowledge still needs to come through, otherwise, the therapeutic advice given may only provide temporary relief of symptoms. The therapeutic equation should go from;

1. Identify possible mechanisms behind symptoms — 2. give therapeutic advice — 3. see if symptoms improve

to;

1. Identify major dysfunctions/deficits — 2. give therapeutic advice — 3. monitor rate of symptom improvement/resolution

So what does depth of knowledge refer to exactly; I would describe depth of knowledge as;

“the level of training/understanding that a practitioner has, which they can accurately use to identify the most effective treatment for the individual client”

Pivoting from symptom-based/lifestyle modification-based treatment to “root cause” based treatments requires a shift in praticing philosophy. The fundamental question pivots from “how can I treat their symptom clusters?” to “why do they have those symptoms to begin with?”. I mentioned in a previous post that fundamental tenets of good health are essential for sustaining wellbeing but this does not imply that they alone should be used as sole treatments, especially for more complex chronic health cases. Naturopathic philosophy stems from the idea that a “holistic” approach to treatment can restore wellbeing but then again, a client could follow the longest laundry list of holistic advice to no avail, which would unsurprisingly leave the practitioner feeling puzzled.

And that is the “conundrum” per say; either the practitioner thought the client would simply restore themselves back to good health by doing all the prescribed healthy things or the practitioner actually believed they knew what the core dysfunctions were and that the prescribed treatment would lead to a resolution. At some point in just about every practitioner’s career, a complex case has led to them scratching their head in confusion, thinking “I just wonder what on earth is actually wrong with this client?”. In this scenario, impending feelings of impostor syndrome may arise, as a professional who truly wants the best outcome for their client wonders whether they are delivering on the client’s wishes or whether they’ve hit a dead end and should consider referring the client to someone else. The fact that any one would ask the question, “what is wrong with this client?”, proves that knowing what is wrong in the first place, is an essential component of clinical practice.

I notice that naturopaths, for example, if not most holistic practitioners, seem to simultaneously harbour two opposing beliefs. On one side, they claim that a holistic approach to health is superior to allopathic treatments because allopathic approach doesn’t find and resolve the root cause/s of a person’s illness. And on the flip side, they tend to believe that we don’t really know what the root cause so instead, adopt a more natural/lifestyle-based approach to health and the body will basically resolve it’s issues. So which one is it then?, one cannot pivot their practicing philosophy as they please because it will cloud professional judgment and the scenario I mentioned above highlights the inherent desire that practitioners have to understand what is happening to their client before they recommend a treatment/s. Keep in mind, as I’ve mentioned previously, that in some cases, a lifestyle modification-based approach to treatment does resolve the client’s malady so I’m focusing on cases where this approach did not achieve the predicted outcome.

Essentially, the term “root cause” is nebulous because it lacks context and it reminds me of the saying, “all birds have wings”. Unsurprisingly, health gurus online will use nebulous terms like “root cause” to promote supplement/e-program protocols under the guise of “resolving your health issues once and for all”. Any health-related product that is geared towards the masses cannot be tailored for the individual and this is what practitioners are designed for, individually-tailored treatments. I have a personal rule-of-thumb that I refer to when I think of how good a practitioner’s advice is likely to be;

Could the therapeutic advice given to an individual be given to just about any other client, regardless of their presenting complaint/s?

Here is where I circle back to the concept of depth of knowledge; how well a client is treated is contingent on the level of training/education of the practitioner in charge. The less depth of understanding, the more simplistic/repetitive the treatment/s is likely to be. I’ve referred to this as “girlfriend magazine advice” because it can really resemble the kind of dot-point style advice you see on health-related magazines. If holistic treatments are supposed to be individually tailored, then it makes sense to consider whether the kind of advice that is prescribed seems scripted. I don’t necessarily factor professional experience as a metric in gauging how much depth a practitioner has, because I’ve mentioned before that someone who has practiced for decades could still be preaching the same concepts they learned at school, some of which would be outdated. Practitioners can cling on to concepts over time that they use to see every client through but this can cause tunnel vision and the tendency to prescribe the repetitive kind of advice I just mentioned. So the brass tacks is that continued training/education and a willingness to question, if not replace, former teachings are crucial components behind good clinical practice. This is where professionals gather the depth and detective skills necessary to identify “root causes” behind their client’s conditions and prescribe treatments that are both individualised and effective.