‘Wellness’ isn't a dirty word, it's just a word.
Yesterday I heard an interesting interview on Life Matters (ABC RN) where Dr Norman Swan was discussing his new book which is dubbed an ‘ultimate health guide’. In the interview Dr Swan commented that the ‘whole wellness thing drives him completely bonkers’ and that essentially, it’s unpractical and unrealistic to truly feel well and eat ‘green gunk’ all the time.
I get it, I really do. Even though I work in the industry and love what I do, the ‘wellness industry’ also infuriates me at times, mostly because of misinformation and the heavy load of unrealistic expectations placed on people. I agree that we need to call BS on wellness wankery when it arises, but I disagree that it is unrealistic to feel truly well, and I disagree that to get there you need to eat ‘green gunk’ all the time or go to extremes.
The thing is, 'wellness' is about SO MUCH MORE than smoothies and supplements, or kombucha and crystals! It’s well documented that individual’s wellness encompasses physical, emotional, social, spiritual, vocational, financial, and environmental dimensions. In other words, there are many elements that contribute to a person's health and wellbeing.
Safe to say the interview prompted me to think about all of this in a bit more depth, and I was obviously compelled to blog about it! ;)
So why has wellness become a dirty word?
Not dissimilar to ‘holistic’ and ‘sustainable’, ‘wellness’ is a word that is being used a LOT, and with this surge in use, comes misuse.
The wellness industry is part of a huge specialist wellness economy, where commercial interests can take preference to the actual health and wellness of those that take part. As a previous lecturer of mine and certified wellness expert Dr Liza Oates once said “The wellness industry has become mostly hijacked by commercial interest”. In other words, profits over people. This doesn't apply to the whole industry obviously, there many individuals and companies who work with integrity and DO put people and planet over profits.
As it stands, the global wellness economy is currently valued at $4.5 trillion. That's correct, $4.5 TRILLION. Interestingly, traditional and complementary medicines only take up a small section of this economy, with wellness tourism, personal care/ beauty and fitness and weight loss sectors taking up much bigger slices of the pie.
Add to this the varying levels of wellness related evidence, ranging from terrible to top notch; and wellness “gurus” with confusing credentials, ranging from zero training to many years of graduate/ post-graduate study and experience. There is a whole lot of noise in this space and of course, not all of it is genuine.
Wellness also means different things to different people.
It’s important to dial back for a moment and remember that ‘wellness’ can and does mean different things to different people. Whilst personal situations may be complex with how the dimensions of wellness influence someone's health, the actual concept of wellness doesn’t have to be complex. At its core, wellness is about implementing strategies to live life more fully.
I also worry that when someone from the conventional medicine arena paints the entire ‘wellness industry’ with the same tainted brush, it has the potential to create more of a divide between conventional and complementary and alternative medicine (CAM). This is extremely unhelpful to the two thirds of Australians who use some form of CAM (Steel et al, 2018), most of whom already avoiding telling their medical doctor about their use of CAM. It’s incredibly important that people feel safe enough to share all health-related information to all health professionals, without judgement or commentary on areas outside of their scope, or false assumptions about a particular modality (and scare-mongering won't help bridge this gap).
In my humble opinion the “us versus them” (conventional vs CAM) attitude is the opposite of a true patient-centred approach. We have the evidence to show that people are already opting for INTEGRATIVE approaches, so why not support them through this in a safe and balanced way? People can have kombucha with cake, take safe supplements alongside conventional medications, practice yoga and consider a specific surgical procedure. People should never have to choose sides if they prefer an integrative, multi-disciplinary approach.
The illness-wellness continuum.
Have you ever wondered why some people, regardless of major stressful situations and severe setbacks, stay healthy while others do not? I have, and so did a gentleman by the name of Aaron Antonovsky, an Israeli American health sociologist, who developed a model of human health centred not around pathogenesis (disease/ illness), but rather on ‘salutogenesis’; the origins of health.
In his own words, ‘Given the ubiquity of pathogens—microbiological, chemical, physical, psychological, social, and cultural—it seems to me self-evident that everyone should succumb to this bombardment and constantly be dying’ (Antonovsky 1979, p. 13). Antonovsky’s insight was that despite the pathogenic onslaught of all these factors that threaten health, remarkably, most people are able to remain well and live happy and productive lives; most of the time.
This sort of model essentially reframes our perspective towards the generation of positive health as an alternative to the disease-focused approach to health. Instead of ONLY asking, “What caused a person to get a given disease?” — a salutogenic approach would be to ALSO ask, “What are the factors involved in at least maintaining one’s location on the continuum or moving towards the healthy pole?”.By using wellness as a guidepost (whatever that looks like for you), you shift to a more salutogenic perspective, generating positive momentum towards higher positioning on the health continuum.
