We look at the whole picture, the entire lived experience that influences health.
Our work examines health through many lenses that intersect, and it often helps people who are underserved or experiencing trauma — for example, veterans suffering from PTSD, children with serious illness, low-income residents grappling with systemic racism and neglect, and others.
In the Milbank Quarterly, Nova Scholars Kurt Stange and Rebecca Etz and colleague William L. Miller discuss the current state of primary care and ways that policies can improve the industry for practitioners and patients. This interview highlights the critical role of primary care in the American healthcare landscape and the intersection with policy, and influence of policymakers, that has the power to help or hinder the health and access to care for Americans.
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Over the past thirty years, we’ve been part of a movement to shift the primary approach to health from a focus on disease to a more complete approach. As reflected in our tagline, “For Health of People, Places, and Planet,” how we are building on “person health” and looking at the context of peoples’ lives and communities as well as the health of the planet we all share.
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Healing is facilitated through safety, persistence, and trust.
Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”
“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad.
When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.)
“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”
Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.”
Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”
In varying degrees, “they were able to transcend their suffering and in some sense to flourish.”
Suffering is the ongoing pain from wounding.
There is debate about whether or not one actually needs to experience suffering on the path to healing.
Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors.
“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”
Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.
Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.
Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.
