Detailed guides to painful problems, treatments & more

Be careful what you wish for! The overzealously holistic physician

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

The stereotypical doctor has no interest in “holistic” medicine beyond obligatory exhortations to quit smoking, lose some weight, and take it easy on the salt. There’s some truth to the stereotype, but I think it mostly exists because of the anti-medical propaganda constantly churned out by alternative medicine. The medical system deserves plenty of criticism, but this problem has been blown way out of proportion.

All my family doctors, about five of them over the last 25 years, have obviously taken lifestyle factors in health seriously. I couldn’t get through an appointment with any of them without being asked about exactly the kinds of things doctors are supposedly clueless about. I think I’ve been somewhat lucky in this regard, but most doctors these days are fully aware that health is a complex tapestry.

One specialist I saw was especially keen on defying the medical stereotype. In fact, he was keen on holistic doctoring to a fault: he wouldn’t let up! Even after I’d fully and repeatedly acknowledged the importance of getting enough sleep, not drinking too much, and staying fit, he pressed on until it choked out all other serious conversation — about the reasons I’d made the appointment, for instance — and became tedious and patronizing. Be careful what you wish for!

Speaking of being holistic to a fault:

This image is a recreation of a popular “viral” image from a wellness guru, widely and uncritically shared on social media (back in 2015). Obviously there’s something to be said for the style of advice given in the image, and by no means am I saying that doctors should not discuss these options with their patients. But it’s also a great example of “shoulding” on someone who may well have serious socioeconomic challenges that make such advice tone deaf and trite at best, the tyranny of wholesome expectations, or downright offensive at worst (sexist, racist). Massage therapist Alice Sanvito:

I look at this and I see an older, patronizing white male authority figure dispensing a prescription for failure to a young woman whose life is probably so different from his own that he can barely imagine her problems.

Her thoughts are more thoroughly quoted in The Tyranny of Yoga and Meditation: Do you really need to try them? How much do they matter for recovery from conditions like low back pain?