The Emotional to Physical Wellness Pipeline
March 13, 2024
Writer: Helen Hannan
Editor: Lexie Meltzer
How, in a medical system that we are often left feeling disillusioned in as patients, do we make our individual experience better? How can we take control of our care and leave our next doctor’s appointment feeling like we were listened to? The answer might lie in exactly the opposite of what we’d expect— emotional vulnerability.
Accepting our vulnerability as patients — our fear of judgement, disappointment, and not being understood— is the first step in establishing a cornerstone of productive care called a therapeutic alliance. Think of a therapeutic alliance like a rapport with your provider— an emotional connection that allows you to understand one another to help you feel as though you’re working towards a common goal together. It is widely accepted in mental healthcare practices, but it has only recently become integrated into physical healthcare (Sondena, 2020). This is an alternative to feeling like you are blindly trusting your provider and crossing your fingers it’ll all work out, and establishing a therapeutic alliance has actually been shown to contribute to positive health outcomes (Baier, 2020). You can only get here, though, if you are capable of feeling entirely vulnerable and comfortable with your provider, which is much easier said than done. To remedy this, holistic medicine might be just what the doctor ordered.
Holistic doctors can be your primary care physician, or they can bolster the care you receive from more typical practitioners. These doctors attempt to see you not just as a problem but as a person; the desire to build a therapeutic alliance with you is intrinsic to their practice (Ventegodt, 2004). By finding a doctor you can trust and developing an emotional connection with them, you will likely have better health outcomes (Baier, 2020). Doctors who see you as a whole person will see your emotional needs in addition to your physical ones. Personally, seeing a non-traditional doctor has been the most healing experience of my life, and I have come to know myself at a deeper level through my therapeutic alliance with my doctor. There are also the lucky few who find that therapeutic alliance with their traditional doctor.
Having supportive care does not end with promoting only our emotional well-being: emotional well-being transcends the psychological and vivifies the physiological. Of particular interest to me recently has been the cross-talk between our gut-brain axis and the immune system, a tryst so surreptitious only Chaucer himself could have dreamt of it (D’Acquisto, 2017). A stunning relationship exists between the makeup of our gut microbiome, certain mutable traits of our immune system (our immunophenotype), and how resilient we are from physical and emotional stress (Dantzer, 2018). In the reverse, we can strengthen our immune system by practicing mindfulness. Activities as simple as writing about one of the most positive things in your life for a few minutes or spending one hour a day doing guided meditation practice have been shown to increase immune function (Davidson, 2003). We’re not sampling diseases from around the world or taking our vitamins, we are simply training our mind and emotions, which causes a direct effect on our immune system function. If this does not prove the gravity of that illustrious mind-body connection we hear so much about, I truly don’t know what could.
Good emotional well-being might just be the most potent prophylactic method of all. That emotional well-being starts within yourself, and it continues on in your relationship with your doctor. Unlearning how to be a good patient for your provider and learning how to be a good patient for yourself— how to be emotionally vulnerable enough to build that therapeutic alliance— is likely the best way that you can take control of your care and, thereby, your health.
References
Baier, A. L., Kline, A. C., & Feeny, N. C. (2020). Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. Clinical psychology review, 82, 101921. https://doi.org/10.1016/j.cpr.2020.101921
Dantzer, R., Cohen, S., Russo, S. J., & Dinan, T. G. (2018). Resilience and immunity. Brain, behavior, and immunity, 74, 28–42. https://doi.org/10.1016/j.bbi.2018.08.010
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic medicine, 65(4), 564–570. https://doi.org/10.1097/01.psy.0000077505.67574.e3
D'Acquisto F. (2017). Affective immunology: where emotions and the immune response converge. Dialogues in clinical neuroscience, 19(1), 9–19. https://doi.org/10.31887/DCNS.2017.19.1/fdacquisto
Søndenå, P., Dalusio-King, G., & Hebron, C. (2020). Conceptualization of the therapeutic alliance in physiotherapy: is it adequate?. Musculoskeletal science & practice, 46, 102131. https://doi.org/10.1016/j.msksp.2020.102131
Ventegodt, S., Morad, M., Press, J., Merrick, J., & Shek, D. T. (2004). Clinical holistic medicine: holistic adolescent medicine. TheScientificWorldJournal, 4, 551–561. https://doi.org/10.1100/tsw.2004.112
