Treating who not what

Treating Who not What, the Whole Person not DiseaseWhole person self disease name identity consciousness

Treating the problem (a disease name) in medicine does not cure and never will. Treating the part, say a knee, will never cure either. Like treating weeds in a garden, unless you treat the soil and environment you will never remove the weeds, they just keep returning. As Dr Hahnemann showed, disease is dynamic and affects the patient in a number of ways and the totality of the disease symptoms has to be treated at once, with one medicine only (and certainly not like a herbalist or naturopath who treats “holistically” by treating all the various parts with different remedies!). Therefore, in the rational art and science of medicine called homeopathy, we consider the whole person – past and present, their underlying patterns and what their symptoms mean. To treat a sick person it helps to know what it means to be a healthy person.

It’s like the teacher when asked, “what do you teach?” replying with wisdom said, “I teach students.” Likewise a physician can answer; I treat people. As much as the allopath might want to admit this, in reality they can never treat the person, only a part or a number of parts of the person. We know that the whole is more than the sum of its parts. This was explained very well by Prof Edward Craig, professor of philosophy at Cambridge in his nice and concise book Philosophy: A Very Short Introduction. Craig, referring to Indian philosophy, explains that a chair has something that all the independent parts of the chair, all together, do not have. It has a quality which goes beyond the collection of physical parts. A chair needs the parts but is more than all the parts. Canadian philosopher and theologian Bernard Lonergan put it thus,

Then, each part is what it is in virtue of its functional relationship to the other parts; and the whole possesses a certain inevitability in its unity, so that the removal of any part would destroy the whole, and the addition of any part would be ludicrous. Such a whole is a structure. (Bernard Lonergan, Collection)

This disparity can mislead the physician when a patient says either: “My…” referring to a part, or “I feel…” referring to their whole self. Either way, as homeopaths, we still consider the whole person.

Personhood and Memory

The idea of personhood originated in ancient Greece¹ where a person was someone who was a free property-owning person rather than a slave. The person had a persona which is like a mask, a front presented to society and therefore not the real or full person. There’s more to a person than what meets the eye. Boethius considered the person to be of an individual substance of a rational nature. But we can’t reduce people to rationality. Let’s just say we are always more than… Then the British philosopher Locke brought in the notion of identity. We get our identity from our memory. But what of those without a memory? Will modern science answer the question? No, according to prof Moran, no brain investigation will suffice. Dr James Tyler Kent mentioned the will, not that he defined the person by the will but recognised it’s role in being who I am and this was acknowledged (albeit unknowingly) by Baroness Greenfield in her book ID: The Quest for Identity in the 21st Century. She explains that when an Alzheimer’s patient (there, she’s defined a lot of persons!) has lost their memory, they still have a will. So will goes deeper than memory.

Prof Moran introduces other modern notions of personhood. 1 The person as autonomous, able to make free choices. 2 Philosopher Harry Frankfurt says we are a person because we have second-order desires, a belief about belief. Again this is not all inclusive. 3 We are made up of different elements e.g. various elements, bacteria, viruses etc. 4 Animalism (we have no spiritual nature), 5 Speciesism, and 6 Narrative; that our story gives us our identity. But which comes first? – there has to be someone who creates the story. But If I wasn’t me I would have created a different story. While we all have a story and a good physician will listen to that story and put together all the hidden connections to find a meaning, we are more than a story. For the physician, do we treat the sick story of the whole story or the person telling the story? Who or what is to be treated? has to be answered.

None of the above mentions our relational side, our consciousness, dynamicness or desire for transcendence. These qualities of the person are found in Lonergan and developed by Brendan Purcell². Referring to Lonergan, Purcell explains the existence of three types of dynamic structure (see Lonergan, above): static, extrinsically dynamic and intrinsically dynamic structures. Static are physical objects, material parts like a radio, t.v., bike etc. Extrinsically refers to parts of a whole which have activity. These could include the steps in a dance, the moves a football team take in a game, the notes sung by a singer. These unities are active dynamic wholes, says Purcell. But since the unity of a dance or football match comes from a source outside them (If one footballer can’t perform it affects the team), we can call this type of externally caused unity an extrinsically dynamic structure.

Thirdly then we have intrinsically dynamic structures. Here the activity, the dynamism need not be restricted to the parts. The whole itself may be self-assembling, self-maintaining, self-reproducing. Such internal activity characterises all living things (see my posts on vitalism and vital force). Let’s say they have a constitutional integrity. Animals are more complex than a plant, so we can conclude a rose is a deeper unity than Swan Lake which in turn has a deeper unity than a Cray computer.

Analysing Structure

To analyse a structure we can ask three questions: 1 What are its basic elements?; 2 What are the basic relationships between these elements? and 3 what is the principle of unity of these basic relationships? The answer to these questions indicate whether the structure is static, extrinsically dynamic or intrinsically dynamic.

In exploring the human person as structure, Purcell makes the three following observations which neatly sum-up in a more inclusive way – dynamically, relationally and by incorporating consciousness – what it means to be authentic and autonomous while also being interpersonal and self-transcendent. He also acknowledges affect, intellect and responsibility (morality), all of which unfold as a unique I:

• It’s not possible here to do more than suggest as the basic elements in a human person, three distinct orientations and their activities rooted in embodied human consciousness—our perceptive-imaginative-affective orientation towards beauty, our intellectual orientation towards truth, and our moral orientation towards the good.

• Each orientation is interdependent on and intersects with the others, and the intersection of the orientations towards beauty/truth/good form various patterns unique to each person.

• Along with the distinction and interdependence of the orientations, the levels of consciousness are united as the unfolding of a single I, in my self-transcendent reaching out towards aesthetic, intellectual and moral reality, most profoundly in the personal dimension of a Thou, in the existence of other persons.

With this structure, we are most definitely intrinsically dynamic because the static and extrinsically dynamic interpretations of personhood make us less human, destruct our nature. This “attack” on the person is found in mechanical materialistic science, for example, which treat us as puppets subject to external forces which one cannot take responsibility for. There is such a view in Richard Dawkins’s book The Selfish Gene – “Our genes made us. We animals exist for their preservation…” Need I say more?

Purcell is critical of other ideologies which treat us in a less than human way,

Any of the various anthropologies, behaviourist, Marxist, Jungian, Freudian, that stress the economic, zoological, racial, instinctual, emotional, or totalitarian statist aspects of existence, saying that persons are ‘nothing more’ than functions of these aspects, are treating us as extrinsically dynamic, dominated from sources outside what’s most central to our being persons, our capacity for meaning and responsibility. And yet, it’s obvious from our discussion of our three-levelled conscious orientations and their activities that we are at least extrinsically dynamic structures.

But from a homeopathic point, we are usually dealing with the inner dynamic, the unique pattern of susceptibility leading to a unique personal complex of symptoms. However, in infectious diseases (calling for Hahnemann’s genus epidemicus remedy) and disease due to living in marshy areas (like malaria), we are then dealing with an extrinsic dynamic. Otherwise in our healthy state we are intrinsically dynamic and building on other thinkers, Purcell sees “open you-wardness” as the defining characteristic of the human person. In not being open to the Other in my freedom-as-responsibility-towards-you (there’s a tension between the closed self-love and open youwardness), I am relinquishing, at the human level, what makes me an intrinsically dynamic structure and then become passion, mood or thing-driven, i.e., extrinsically dynamic or worse, static.

Persons as Dynamic

Being dynamic, we respond and react. If this reaction becomes a problem, say too intense to cope with or the effects don’t abate, then we develop symptoms. Why should I get these particular symptoms? Who we are dictates those symptoms if who I am is out of harmony with the norm for a person as outlined above by Brendan Purcell and Dermot Moran, then these are the areas to inquire into our clients: openness to the Other, responsibility, maturity, being more than any label, being autonomous from within rather than determined from without, being oriented to beauty, truth and good. Anything less than this depersonalizes us, destructures us and calls for a remedy to facilitate our journey to being fully human.

1.Prof Dermot Moran, UCD, and Joe Humphreys (Irish Times) discuss Who Decides What it Means to be a Person? and listen to Prof Moran explain what it means to be a person as he traces the origins of personhood (link).

2. Lecture notes: Brendan Purcell, professor emeritus of philosophy, UCD, now adjunct professor at Notre Dame, Sydney.

Further Reading
For those interested in the use of narrative in medicine visit Columbia University Medical Center’s Programme in Narrative Medicine 

On narrative and living a life you can consider On Personality by Peter Goldie (Routledge).

Self by Barry Dainton (Penguin) might help explain personhood further, since to be a person requires having a self which animals don’t have.

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