A Publication of the World Chiropractic Alliance
 From Chiropractic Journal February 2005

Wellness and beyond...
Developing the lifetime wellness practice 
by Dr. Donald Epstein

Wellness is not just a vague philosophical concept, but an evolution of thoughts, ideas, dreams, and possibilities for individuals and for humanity. The challenge we face in our practices is making wellness REAL for our practice members. 

Wellness isn't just a concept to discuss, it's a process and experience to be lived. You can't give it to people, it's something they must own themselves. Wellness is about continually enhancing and deepening an individual's life experience. 

Look at the practice, and more importantly the life, you're designing and developing. Does it fulfill your thoughts, ideas, dreams and possibilities for you, your family, community and practice members? Can there be more out there? Is there more possibility? Is there room for growth beyond your current practice and life? Or, as Jack Nicholson said in "As Good as it Gets" ... "Is this as good as it gets?"

What happened to health?

It's pretty obvious that wellness has begun to surpass health as today's cultural buzz word. So many people are talking about health it's become a "flat" concept. Health for most people lacks depth. It's just a bunch of numbers on some blood screening or doctor's test, devoid of any real meaning in their lives. 

The 2003 "Physician's Desk Reference" defines health as "a state characterized by anatomical, physiological, and psychological integrity; the ability to perform personally valued family, work, and community roles; the ability to deal with physical, biological, psychological and social stress; a feeling of well‑being and freedom from the risk of disease and untimely death." 

This is the definition of health developed for reference by pharmaceutical companies (ouch!). Then why is it many health practitioners only consider health in terms of the presence or absence of symptoms? And then, these symptoms are usually broken down into parts (regionally or segmentally) and are considered separate from the entire individual. How do you create more wholeness by looking at smaller parts?

This doesn't even begin to consider the relations to the stresses the individual must negotiate in his or her life. For those practitioners who do consider patient or client stress in their intake and recommendations, is there consideration of the life the individual is living, or the internal journey of the client/patient as a major force in the process? The broader we paint the picture of influencing factors on the individual, the broader we can also see our influence outward in the client's life, and the more exciting the practice becomes.

"Clearly the biomedical as well as the social science community now acknowledges, theoretically, if not empirically, the multifaceted and complex nature of health and well‑being." (Schuster T, Dobson M, Jauregui M, Blanks R. "Wellness Lifestyles II: Modeling the Dynamic of Wellness, Health Lifestyle Practices and Network Spinal Analysis." Journal of Alternative and Complementary Medicine 2004;10:357-367)

Moreover, Schuster et al note that a consensus is developing, in which health includes several domains embracing the physical, psychological, mental, emotional, intellectual, social, and spiritual. The life a person is living, the choices that must be made for the point in the individual's path, stresses to be negotiated, human resources available at that moment in time, the person's structural capacity, and his or her personal beliefs ‑‑ all do more to influence symptoms, illness, or wellness under most circumstances than "abnormalities" found in a medical examination. From this expanded perspective, treatment of a condition is very limited in its potential outcome. 

The modern academic construct of health care is a significant cultural shift from disease care, and similarly wellness care is a significant departure from that of health care. Considering this, immediate and massive action must be taken by practitioners to understand and apply what's considered by many to be the greatest future trend in the consumer marketplace. 

In today's rapidly changing world, not transforming is no longer an option, whether in relationship, business, or life. But when you are developing a lifetime wellness practice, your practice will always be growing more fully as well as more rewarding and satisfying for practitioner and client alike.

What is wellness?

In order to establish a lifetime wellness practice it's first necessary to define wellness -- to be able to understand its attributes, speak its language, know its experience, measure its outcomes, and have clinical systems that can produce the benefits desired. 

A practitioner can't simply add wellness care to a therapeutic or prevention model and expect an individual to pursue lifelong care. This is like trying to build a rectangular house on a triangular base. The client is lacking the cultural and clinical foundation. When short term palliative or therapeutic goals are at odds with long‑term goals, it's highly unlikely the patient will be retained through the transition to wellness care.

The lifetime wellness practice is geared to the individual's personal self-perception/belief and experience of his or her inner life journey. As Schuster et al defined wellness, following an extensive review of the literature, it's a higher order construct relative to and integrating the physical, psychological, mental, emotional, intellectual, social and spiritual health domains. The latter depends on the level of an individual's self‑perception. 

Self-perception and self-reporting are not just "other" approaches within history taking. They are central to the wellness and wellness education paradigm. Clinical application of care in the wellness process includes a client's participation through self-reports of wellness, changes in body, energy, and consciousness. The development of sensory acuity and the ability to identify body sensation and emotions are not adjuncts to wellness education but the basic foundation.

For the client, this approach is believed to foster a heightened sense of personal responsibility for his or her health, and a greater sense of participation in evaluating the benefits of care and the personal transformation that occurs as care progresses. 

These outcomes also assist the practitioner to complement clinical observations with client observations in the overall plan of care. In the lifetime wellness practice, greater patient/client involvement in care, and utilization of information derived from this approach is essential.

Wellness care is provided to enhance the interrelationship of body, mind and spirit. Wellness is an integral state, and illness is a loss of this integral relationship. Wellness drives us to deepened states of wholeness and more effective choices for our growth and development. Illness insulates us from these states and actions. Wellness and illness are independent of symptoms or circumstance. Wellness and illness are about an individual's resourcefulness, not resources. 

Wellness is manifested as movement toward deepening states of perception regarding one's total environment, refinement of adaptive responses, and an evolving pliable sense of self. Moreover, wellness is accompanied by an increased sensitivity to emotions or actions involving gratitude, forgiveness, empathy, love and compassion in relation to the person's life experiences. It's recognized that individuals will realize these experiences in a progressive manner as the journey toward wellness unfolds. 

Somatic anchors to stressful events

I'm suggesting there are somatic anchors and triggers to stressful events worn or expressed as defense posture. The inability to fully experience and digest an event or circumstance is associated with characteristic spinal structural adaptations. This is the etiology I propose for the vertebral subluxation. 

The subluxation and structural adaptations are signs of a conflict between one's experience of life and the optimum structure of the body. When viewed in this way, clinical care is directed to assist in enhanced somatic and spinal awareness, exercises to optimize the internal experience, and for applications to assist the clients in moving from defense into safety, and from safety into growth.

Illness is associated with a more rigid, less flexible spine, utilizing autonomic sensory motor strategies inconsistent with change, growth, wide range of perception, emotion and adaptive responses. To the degree that we're able to participate with ourselves, our spine, and our awareness of our body, we're able to participate with the world. Wider range of motion appears in relationship to a wider range of emotion and available adaptive energy and repertoire of responses. 

It's through the shift out of stress physiology and its attending defense posture, that our higher brain function can engage, enabling us to reassess our lives, and experience greater connection to the transcendent source of awareness and one another. 

I suggest that the vertebral subluxation is evidence there are adaptive challenges impeding one's movement between illness and wellness. Increasing wellness is associated with experiencing a wider circle of participation of the self in the world. Clinical care, outcome assessments and office communications can be designed to enhance this understanding and dynamic.

Developing the lifetime wellness practice

The lifetime wellness practice program explores the culture of wellness, wellness education and caring for clients in the process of human transformation. Wellness education care is needed for everyone, regardless of their condition. People with advanced cancer, and degenerative disease need to employ wellness education care just as much, if not more, than those without health issues or concern. Many in our culture have the belief that wellness is a luxury, but it's not. Wellness is a necessity for everyone. 

Our Lifetime Wellness Practice Seminar, teaches an integral spinal and neural wellness model for assessments and reporting to clients. It includes client self‑reported wellness outcomes, and information on applying wellness‑specific spinal care and other wellness applications. Also discussed is the wellness consultation and wellness‑ specific office communications. 

The key to the lifetime wellness practice isn't just what you do, but also how the practice member is involved. Remember, it isn't your life at stake, it's also the practice member's life. While you can assume the role of facilitator, partner or coach, ultimately it's the individual and the person's development along all lines of his or her being that's at the center of any lifetime wellness practice. 

Wellness can't be obtained from any product sold because wellness is an internal state of experience. Few systems have been developed that really assist people in discovering wellness and the education and culture to support it. Wellness education will be the greatest industry on earth. Providing services that help individuals find meaning about themselves, their lives and their choices will be the central focus in the next decade. 

The lifetime wellness practice helps those looking to influence lives toward more enriching, transformative actions and experience, which drives individuals to ever greater levels of wholeness and life expression. Wellness is not some theory, it's real and everyone deserves it -- NOW! 

(Dr. Donald Epstein is the developer of what has now become Network Spinal Analysis (NSA), as well as the Somato Respiratory Integration (SRI) methodology. He is the author of numerous articles, publications, and books including "The 12 Stages of Healing," and "Healing Myths, Healing Magic." Dr. Epstein, a 1977 graduate of New York Chiropractic College, established two successful practices in New York before relocating to Colorado and committing to full time research, development, and instruction. Visit his official website at www.donaldepstein.com.)