Thanksgiving is a time for many of us to reflect on what’s good and what’s right in our lives, and in our world. While this forum has often focused on what needs fixing in the world of children’s health care, I thought it would be nice for today to focus on the positive.
I think it was Jon Kabat-Zinn at the recent Bravewell Awards luncheon who spoke about the power of hope and positivity for optimal health and healing. Too often we concentrate on fixing what’s wrong – attacking the disorder, the disease, instead of building up and nurturing what’s right in people. I think of this often when working with children with chronic illnesses; especially with those with autism or other neurodevelopmental disorders. Parents are often asked to identify what the problems are – what’s going wrong at home and at school. Many times I catch myself when asking these families if they have any concerns. I’ve been trying to reframe the questions as, “Do you have any good things to share with me today? How about any areas you’d like to work on strengthening?” Too often we blame the child, the individual for not fitting into his or her environment. Why do we not focus more on the “fit”? Scott Shannon talked at the recent AAP NCE about the “ecology” of the child; Leland Kaiser at Pangea riffed on what he called the “habitat.” Both were saying the same thing, in essence; much of what we “diagnose” in children as disease (ADHD for example) is often the product of or certainly exacerbated by a poor child-habitat fit. In thinking about effecting change, why do we ask so much of the child and so little of the environment?
We are trying to shift our health care paradigm towards a system of promotion of wellness and healing and nurturing, away from simply treating disease after it occurs. This is especially important for chronic health conditions, like obesity, diabetes, asthma, and cancer. There is literature, in fact, which proves that positive outlook – hope – is associated with positive health outcomes. Jerome Groopman’s “Anatomy of Hope” contains numerous examples of this phenomenon and discusses the mind-body medicine linked to this phenomenon. Hope, I believe, is now more needed than ever when we are constantly faced with reports of what’s wrong. How often do you turn on the news and hear about something positive? It’s rare. I think one of our greatest challenges in transforming the health care system is this balancing act – keeping our sights set on where we need to go, addressing what needs tweaking, and noticing what’s right and building on that.
As for me? I’m optimistic about the future.