Reviewed by Magdalena Ball
Essence of Health:The Seven Pillars of Wellbeing
by Dr Craig Hassed
Random House, Sept 2008, ISBN 0781741667042, RRP$34.95
One of the problems with modern healthcare is that, at least in my experience, it tends to treat each person as a set of disparate symptoms. This is particularly true of specialists: your neurologist doesn’t want to know about any gynaecological issues, and your skin specialist isn’t interested in your eye problems. But of course we are just one person, and our health issues are intrinsically interlinked. So the medication my neurologist gives me may well have gynaecological repercussions. A general practitioner should be looking at the total person, but they are often busy, and cure focused. So they usually aren’t going to have time to address things like diet, exercise, or stress management, at least in anything other than a cursory way. That’s why Essence of Health is such an important book. Designed primarily for training health practitioners, it uses the “ESSENCE” acronym to remind practitioners to take a more holistic, integrative perspective on health.
The book is also structured so that it can be used by individuals to help improve their own health and well-being, and it’s quite simple to use, but the fact that it seems to be addressing a professional practitioner can make it a little jarring for the layperson with his or her own interests or family interests in mind. This is only a minor complaint though, as the information it contains is still valuable, and probably more so if it is actually taken up by GPs.
The core of the book is the “Seven Pillars of Wellbeing”: education, stress management, spirituality, exercise, nutrition, connectedness, and environment. Part one of the book goes through each of these areas, providing information on their importance, and the impact on health when one of these pillars goes wrong. Some of the areas, such as stress management and nutrition, contain a staged 8 week program towards improvement, with daily practices – a hint of the final program which provides an 8 week program for everything. Other areas, such as spirituality or connectedness, are reminders that certain aspects of our lives such as how we feel about our lives, or our relationships, are equally important to our health. Hassed treats spirituality in its broadest sense, and doesn’t refer to any specific faith. It’s more about having a sense of meaning and purpose. Part two of the book looks specifically at how behaviour can best be changed, and it contains a number of effective tools like SMART goal setting, working on behaviours and attitudes, and keeping a journal. There is nothing new about these tools, but Hassed puts them in the context of how they can be used in conjunction with “ESSENCE”.
It is in Part three where everything is pulled together. This part of the book provides a compendium of common diseases, and the way in which each of the pillars can affect, or improve these conditions. Diseases like Heart disease and stroke, Cancer, Diabetes, Multiple Sclerosis, Asthma, Chronic Fatigue, and Dementia, are all explored against the impact of stress and how reducing it can benefit the condition, the power of spirituality, exercise, nutrition, connectedness, and environment, making practical suggestions on how to change each of those things for better function within this condition.
For those who don’t have a disease, there are also chapters on healthy aging, mental health, healthy immunity, and genetics. The book explores things like which foods can help you develop a stronger immunity, how exercise can improve overall mental health, and how to improve our environment to ensure a longer, more enjoyable life. The book finishes with an eight-week course, that provides a means by which individuals, groups, or classes can improve each of the pillars in a staged, coordinated way. The course uses the tools of changing behaviour discussed in chapter two, including SMART goals, personal assessments, cost versus benefit analyses, and journal keeping, to put into practice the suggestions made in the book. Hassed suggests that you start with one pillar at a time and make small changes.
Overall, the need for this kind of educational program for the medical profession is becoming increasingly critical as the population continues to age. It’s obvious that the nature of our conditions are interlinked, and treating problems in isolation, or through the dispensing of a single pill, is not going to help improve our overall well-being. The Essence of Health is a really good, scientifically oriented book which provides practitioners with tools to improve their ability to help patients do more than just get better, and individuals with tools to help them take greater control of their health.