Wholeness, Health Awareness & Health Assessment

A stone with 'Wellness' written on it sitting in sand.
by Rico Sneller, PhD and assistant professor of Philosophical Anthropology, Institute of Philosophy, Leiden University, the Netherlands
August 15, 2017

Why be healthy? Is it obvious that health is an implicit goal in human lives? And if it is, what is health anyway? For, in trying to stay or to become healthy, people may be striving for a conditioned notion rather than for a known condition. Variegated conceptions of health exist, sometimes even being mutually exclusive (e.g. “physical” versus “mental” health), not to mention that the adverb “healthy” is always attributed ambiguously. This point was already noticed by Aristotle and Thomas Aquinas, who stated that the adjective “healthy” is applied by way of analogy. This is the case, so they continued, of body, medicine or urine, the first being possessive of, the second conducive to, and the final expressive of, health. When William James, in his Varieties of Religious Experiences, made a distinction between a “sick soul” and a “healthy mind,” he may have wisely avoided attributive precision. The healthy mind-set, according to James, refusing to accept the burden of sin as an agency-governing principle (cf e.g. Puritan Protestantism), can either be someone’s property or a useful asset that brings them health, or even both.

In this contribution I will start addressing what I believe to be presuppositions of the notion of “health.” Next, I will discriminate between analysis and synthesis, the former being heavily reliant on historical and philosophical presuppositions, yet predominates the average scientific approach. In conclusion, I will address some significant implications.

 

Presuppositions of Health

“Health” derives from “whole.” “To heal” is to restore wholeness. A need to heal entails an experienced lack of wholeness. When I say “experienced,” I want to exclude pretending that wholeness can be objectively testified. Perhaps more than anything else, the assessment of health is affected by “subjectivity” or “subjective” experience. If I consider myself healthy, no doctor is entitled to treat me against my will. If a doctor thinks I am healthy while I insist that I suffer, he may have a hard time convincing me that I had better go back home.

The whole implied by health, therefore, cannot be identified with something objective, irrespective of the subject whose wholeness is at stake. Though it would be premature to conclude that it must then be wholly subjective, at least the wholeness at hand tends to bend towards (“subjective”) experience. If a person continues complaining even if their physician is unable to find anything, it is likely that their health is affected, albeit in the form of a sick imagination. On the other hand, if someone who is “objectively” ill but bravely neglects it, there will be a moment at which they succumb to their disease without the possibility to deny it.

Interestingly, the wholeness of a healthy person, rather than being mathematical, rests upon subjective or, better, inner experience. I would even argue that this experience’s reliability is enhanced by its degree of inwardness. Someone can tenaciously persist in the denial that something is wrong with them, thereby proving, however, that they refuse to gain more self-awareness. The stubborn denial of having health problems can only be maintained by producing symptoms that are indicative of this self-awareness. If “health” and “wholeness” are mutually implicative, and if gauging them relies on inwardness, outward health assessment, at least in theory, should never be fully impossible: The dishonesty blocking genuine inner experience will always be compensated by symptoms betraying the said dishonesty. Obviously, both inner and outward health assessment are easier said than done; they require acerb discernment.

The type of wholeness entailed by health may be difficult to comprehend, yet easy to understand. Full “comprehension” would erroneously imply exhaustive conceptual grasp – which is impossible, despite claims by scientific materialists, religious fanatics, sect leaders and other fundamentalists. On the other hand, an idea of health will always be implicitly had by people who try to live their lives honestly, whether or not they are “healthy.” “Health,” I believe, though always out of our conceptual reach, is the condition of possibility of experiencing illness, disease or dismay. “Wholeness,” while being intellectually undelimitable and always incomplete, is susceptible to implicit experience. In order to access it, immediate experience should be unfolded. The complete unfolding of immediate experience forms the unmistakable backdrop against which disease can be distinguished.

In sum:  Health equals wholeness, which is a state beyond comprehension yet accessible to understanding, albeit implicitly. Discerning disease requires inner awareness (if the self is at stake) or outer attentiveness (if the other’s health is to be assessed).

 

Synthesis versus Analysis[1]

Though this may seem obvious, it is not. Modern subjectivity is haunted by deaf-muteness as regards our inner life, and by fugacity and partial attention as regards the other’s. Scientific research favors analysis over synthesis and reduction over constitution. Analysis is indispensable, yet disregards the wholeness or health of a whole. Analysis may be qualitate qua incapable of “diagnosing” health while only being susceptible to malfunctioning of particles. If there are, fortunately, many good physicians today, this is certainly not due to their analytical skills but solely to their remaining synthetic sensitivity.

I will argue that any scientific inquiry into the anthropological impact of health improvement, in so far as it is analytical, necessarily misses the mark. It starts at the wrong end. Therefore, it is blind to an implicit assumption: the unquestionable character of “analysis.” Another word for “analysis” is “reduction.” As long as this assumption is ignored, discussions about health will be kept hostage by a self-induced predicament.

The reductive “flaws” of analysis are repaired by the causality principle. The latter largely determines scientific research as though it were beyond question. But it is not since causality draws on analysis and vice versa. Studying this complex relationship between analysis and causality, and how their rise was concomitant with the rise of “modern science,” would lead us too far. The concept (or rather conceptualisation) of causality is by far too complex to be discussed exhaustively. Let us for the moment equate the notion of causality with a “justified account of change.” This is at least how Aristotle started sorting out four different types of such an account in his Physics:  a material (τὸ ἐξ οὗ γίνεταί), a formal (τὸ εἶδος, τὸ παράδειγμα, ὁ τοῦ τί ἦν εἶναι), a final (τὸ οὗ ἕνεκα) and an efficient (ἡ ἀρχὴ τῆς μεταβολῆς ἡ πρῶτη) account. Note that Aristotle’s language here is rather descriptive, if not allusive, than technical (as in scholastic thinking).

Modern science tried to eliminate the formal and the final cause as meaningful and cogent justifications of change, and restricted itself to the sole material and efficient ones (thereby narrowing down both the concept of “cause” and that of “explanation” to the latter).[2] Philosophy, however, underwent an opposite development. Oddly enough, causal pluralism or teleology has been reintroduced by several thinkers. Let us consider a few cases.

One of the most profound examples of reintroduced teleology is without doubt Hegel’s (1770-1831) philosophy, which was centered around the Geist as history’s ultimate telos. The same applies to any post-Hegelian philosophical future-orientedness, whether Marxist or liberal capitalist as defended by Francis Fukuyama.

The hermeneutical project of Wilhelm Dilthey (1833-1911) consisted of preserving teleology and finality for the humanities.[3] The Geisteswissenschaften, according to Dilthey, are “hermeneutical;” they study meaning (Sinn). Science, on the contrary, searches for analytical and causal explanation.

Another example of reintroduced teleology can be found in 19th Century thinkers of the unconscious. Eduard von Hartmann (1842-1906) and Carl du Prel (1839-1899) interpreted the unconscious as a leading principle in human physical or spiritual maturation, thereby also relying on teleology, albeit one that cannot be dialectically mastered (as in Hegel). One of the most astounding examples of an uncontrollable yet verifiable goal-orientedness in human agency could be identified in what Wilhelm Wundt (1832-1920), Germany’s first psychologist, had called “heterogony of ends” (Heterogonie der Zwecke):  While acting on purpose, the agent “develops” new, albeit unforeseen, ends. Discoveries enhance invention. Carl du Prel states that sometimes human artefacts, while presupposing intelligent reasoning, display properties that cannot be accounted for on the sole basis of intention.[4] Today, we could perhaps think of the internet as a major example; originally invented for military purposes, it is used for ends that could not be anticipated consciously.

Fourthly, vitalism or Lebensphilosophie supplemented efficient causality with forms of finality. Biologist-philosopher Hans Driesch (1867-1941), for example, reinstated the time-honoured Aristotelian notion of “entelechy” as a steering morphogenetic principle while philosopher Ludwig Klages (1872-1956) passionately defended Urbilder (original images) as original syntheses governing any organism’s basic drives by eliciting them rather than producing them.

Finally, let us not forget to mention what is called today “transpersonal psychology,” an approach of the human psyche that is largely endebted to Carl Gustav Jung, and that tries to do justice to future-orienting concepts, such as maturing or self-elation.

Each of the thinkers mentioned here tries to overcome, if not ignore, causality and to minimize the value of analysis in favor of synthesis. Concerned with the fullness of phenomena, they favor pull over push. If 20th Century philosopher Paul Ricoeur (1913-2005), criticizing Dilthey’s bifurcation of “sciences” and “humanities,” tries to reunite causal explanation and understanding, at least for the humanities, this also shows a felt need to do full justice to phenomena and bring the best of both worlds together. The fact that the Anglophone world has familiarized itself with a sharp distinction between “science” (note the singular!) and the “humanities” is of deplorable significance:  What starts as mere nomenclature imperceptibly continues by imposing its own normativity. As if the “humanities” were not “scientific,” or worse, as if they cannot bring true knowledge (scientia, scire). On the other hand, science pretends to control change only in virtue of its previous reductionist account. The experiments it justifies this account with presuppose the reduction that enables experimental research itself, thereby closing the vicious circle.

 

Conclusion

In conclusion, let me present some implications of what has been outlined above. A first implication would be that health, provided that it entails experienced wholeness, asks for an integral approach. This insight as such is not revolutionary, albeit it is not always practiced, nor is practicing it always possible (for financial or organizational reasons). Health care needs to consider experienced wholes. Defining such wholes is impossible and elaborating on them would be the task for another article. It would not be far-fetched, though, to associate experienced wholes with social, environmental and spiritual conditions that partly make up for them. How to focus on wholes, in other words, how to synthesize? The contemplation of art and nature seems to be one of the first requisites here, since art and nature affect our synthetic faculties.

A second implication asks for a phenomenological, “holistic” approach of health. Physicians cannot dispense with intense attentiveness to the “patient.” Even if the doctor is empathic, frequent exposition to diagnostic practice can numb their sensitivity for difference and novelty. Moreover, there is no attentiveness to another human being that does not immediately affect self-awareness. The fact that there are always too many reasons to neglect the latter impedes the former.

A third implication ensues the previous one:  A meticulous analysis of modern analytical approaches, and of the structure of subjectivity at large, becomes inevitable. The gains from taking a “neutral,” “objectifying” stance as regards diseases may well be lost, if they are accompanied by a lack of synthetic capabilities and a disregard of one’s own subjectivity. For example, sometimes a professional bias may prevent doctors from seeing a disease as a healing process that takes time and should be endured. Again, simplification is to be avoided at all costs, and the virtues of pain reduction should not be underestimated.

[1] Part of this section comes from my contribution to a book on human enhancement and its limits, to be published in 2018 at Cambridge Publishers, by Tatjana Kochetkova, Sergey Kleftsov, and Rico Sneller.

[2] Cf. among many other studies Louis Dupré, A Passage to Modernity. An Essay in the Hermeneutics of Nature and Culture, New Haven & London, YUP, 1993.

[3] “Die Natur erklären wir, das Seelenleben verstehen wir.”

[4] Carl du Prel, Die monistische Seelenlehre: Ein Beitrag zur Lösung des Menschenrätsels, 1887, IV, 75f.