Healthy by Nature: Using ‘Therapeutic Order’ to Navigate Health Choices
By Dr. Marika Geis, BSc, ND
It starts out gradually enough. You hear that vitamin C is a good thing to take during cold and flu season or that as Canadians, we are deficient in vitamin D. The next thing you know you’re taking 20 different supplements every morning. Often, our clients will bring in their supplements to regain some clarity as to what they should take and why. Usually they’re unsure whether they need them anymore or are unclear as to their benefit. Using natural health products is certainly preferable to using harsh chemical treatments to manage troublesome symptoms, however, just like pharmacologic therapies, natural treatments need to be administered appropriately; the right supplement, in the right dosage for the right person at the right time via the right delivery method. The model that defines the naturopathic approach, the ‘Therapeutic Order’, takes this one step further by addressing the environment which created the dysfunction in the first place. Take, for example, a cut finger. We can either create the conditions required for healing or we can create the conditions that result in infection. Both are equally complex, however, as long as conditions that foster infection persist, no amount of medication will heal the cut. In the context of chronic diseases: adult onset diabetes, high blood pressure, elevated cholesterol, unexplained infertility, fibromyalgia, chronic fatigue syndrome or autoimmune disorders (to name a few), you simply cannot drug a body back to health. Dr.’s Pizzorno and Snider wrote: “We are natural organisms, our genomes developed and expressed in the natural world. The patterns and processes inherent in nature are inherent in us”. In the case of our cut finger, even in the presence of the proposed antibiotic ointment (natural or pharmacologic) which would push back the bacteria creating the pain, swelling, and inflammation, your body is ultimately responsible for the final step of healing. Naturopathic Medicine is fundamentally oriented to restoring health as opposed to ‘treating disease’. We tend to see illness as a process. Nature cure assumes, correctly, that illness manifests as a result of factors that disrupt health and that ‘symptoms’ are the body’s attempt to achieve equilibrium based on the conditions at the time. By creating the framework for health, we make it harder for ‘disease’ to manifest. To this end, we use Dr.’s Jared Zeff and Pamela Snider’s ‘Therapeutic Order’. This not only helps us prioritize which modalities would best serve our clients but also let’s us know when we can move on.
Chronic Illness generally takes hold when any or all three of the following conditions exist.
- The persistence of so-called ‘disturbing factors’, most notably poor diet and long term stress,
- The body’s reactive potential is blocked, usually by pharmacologic treatments (e.g.: acetaminophen for fever) and,
- The body’s constitution is too weak in order to mount an appropriate response.
The cumulative effect is such that our tissues sustain damage leading to chronic inflammation and possible scar tissue or tumor formation. Reversal of chronic conditions can rarely be accomplished through drugging the disease state. The more that you or your clinician can identify these ‘disturbing factors’ the more we can slowly peel back the layers that led to the development of the disease in the first place. We use every opportunity to establish the conditions for healing and tap into the body’s tendency to healthy balance. With this in mind the first step of the Therapeutic Order is to 1) remove obstacles to health, specifically, diet/sleep, stress and spiritual disharmony. How can we stand a chance at treating mental exhaustion and fatigue when we are eating whatever comes our way, falling asleep in front of the television and feeling isolated because we’ve moved away from our family home? An antidepressant can help with the symptoms of depression (a sometimes necessary respite) but we run the risk of ignoring the ‘disturbing factors’ that could lead to more serious consequences.
Next, we are tasked with 2) stimulating the body’s self healing mechanisms. Modalities such as hydrotherapy (various methods that combine the use of hot and cold water), movement (Tai Chi or Qi Gong), Traditional Chinese Medicine, and Homeopathy work with whatever vitality is present in order to augment the body’s response to the now absent obstacles to health. Given that we exist as complex patterns of matter, energy, and spirit, exposure to the appropriate rhythms and forces of nature strengthen our vitality, stimulates the healing power of nature and is thus a natural ally for our clients. Alerted to this momentum, our bodies are in a better position to respond to our attempts to 3) strengthening weakened or damaged systems. To this end, nutraceuticals, botanical medicine and glandulars, are indispensable resources when trying to restore function. Occasionally, attempts at restoring function are blocked by 4) derangements in structural integrity. Some ND’s, more so south-of-the-border, use ‘Naturopathic Manipulation’ or ‘Naturopathic Bodywork’ to address this issue. However, should this need attention, more often than not, clients will leave with a referral to a physiotherapist, osteopath, registered massage therapist, or chiropractor. At this point, many find that steps 1-4 are enough to bring our clients to a place of independence and flexibility, all with a minimum of supplementation. Additional treatments may be warranted though in which case we aim to 5) address true pathology. Natural health products provide a vast arsenal in which to treat everything from headaches to parasitic infections, to endometriosis, to allergies, but unless applied in the context of the Therapeutic Order, one cannot expect long term results. We would essentially be practicing what Naturopath’s call ‘green allopathy’, i.e.: using natural products as substitutes for pharmacologic intervention.
What comes next may surprise some of you. So long as steps 1-5 are addressed it can be further indicated to use 6) pharmacotherapy and/or surgery to preserve life and limb. This is the reasoning behind the expanding scope of Naturopathic Medicine in Canada. In fact, the original intention behind using drugs and surgery was only to use them when diet and lifestyle failed to yield results. In this limited context, one could say the naturopathic and allopathic models are aligned and that perhaps it isn’t necessary to differentiate between them. We could collectively refer to either of these models as ‘people medicine’ thus establishing the foundation for future collaboration among all professionals in the health care field. Lastly, at times it may be necessary to 7) supress the pathology altogether, in order to preserve life and limb, but as you may have already concluded, these methods keep you alive but with long term consequences (prednisone as an example).
So how do we decide which system to prioritize? In a society that routinely normalizes malaise and encourages us to ignore our instincts, deciding where to focus our energy may be the first hurdle. How much sleep is enough sleep? What makes a healthy diet healthy? Keeping true to the guiding principle of ‘docere’ or ‘doctor as teacher’, the Cathedral Centre for Wellness offers several courses to help guide you through the labyrinthine world of superfoods, supplements, detoxification, diets and even supports for the spiritual/emotional issues that impede the health strategies we know will serve us well. Throughout the year, I will be offering a curriculum that addresses the ‘whys’ and ‘wherefores’ of healthy living at every stage of life. The topics range from optimizing fertility, to the link between gut health and allergies, to bolstering immune function, to aging healthfully, and everything in between. Allopathic or Naturopathic, my newly coined ‘people medicine’ respects the individual’s unique healing order and their values as a context for applying the Therapeutic Order to clinical decision making. This, combined with a frame of reference that clarifies what optimal function looks like, you will become your own best advocate. You will know where you are in relation to healthful function, when to recognize disruptions in that balance and how to get yourself back on track. I look forward to sharing my evenings with you as we embark on your own unique, healing journey.
