Wholeness Through Participatory Medicine
Mobilize your own deep interior resources as a full partner in healing
Kabat-Zinn's vision of participatory medicine reframes the patient from passive recipient of medical treatment to active collaborator in their own healing. The conventional medical model treats the body as a machine: when something breaks, you find the problem and fix it. But the body is not a machine. Many chronic conditions do not have clear causes or simple fixes, and the 'machine model' leaves patients feeling helpless when their conditions do not respond to standard treatment.
The participatory model asserts that regardless of what medical treatment is required, patients have vast interior resources for healing that go largely untapped: the capacity for learning, growing, self-regulation, and transformation. These resources are accessed through systematic training in mindfulness and body awareness. As Kabat-Zinn tells every new MBSR class: 'As long as you are breathing, there is more right with you than wrong with you, no matter what is wrong.'
This is not anti-medicine or alternative medicine. It is complementary medicine in the deepest sense: patients maintain all their medical treatments while simultaneously developing their own capacity to influence their health through awareness, stress response, lifestyle choices, and attitude. The research consistently shows that patients who practice MBSR show improvements above and beyond what medical treatment alone provides.
- As long as you are breathing, there is more right with you than wrong with you, no matter what is wrong
- You are the world expert on your own life, body, and mind, or at least in the best position to become that expert
- Active collaboration with medical treatment through self-directed awareness practice produces outcomes superior to passive treatment alone
- Healing is defined as coming to terms with things as they are, not as the absence of disease
- Wholeness is not contingent on the absence of illness; it can be experienced no matter what is wrong with your body
- Reframe Your Relationship with Your ConditionStop identifying as a 'chronic pain patient' or a 'sick person' and begin seeing yourself as a whole person who happens to have a medical condition. Remind yourself that you are not your diagnosis. Your condition requires intelligent attention, but it does not define who you are.Pro tipThe phrase 'as long as you are breathing, there is more right with you than wrong with you' is not sentimental. It is a factual reorientation that points attention toward the vast resources of the body and mind that are functioning well.WarningThis reframing does not mean denying your condition or abandoning medical treatment. It means expanding your identity beyond the illness.
- Commit to Doing Something for YourselfEngage in the MBSR curriculum or equivalent mindfulness practice as a complement to your medical treatment. The key word is complement: you are adding your own active participation to whatever your healthcare team is doing, not replacing it.Pro tipThe pilot study comparing MBSR patients with standard pain clinic patients showed the meditators achieved 36 percent pain reduction versus zero for the non-meditators, 87 percent mood improvement versus 22 percent, and 77 percent psychological distress reduction versus 11 percent, all while receiving the same medical treatment.
- Focus on What Is Right, Not Just What Is WrongDeliberately shift attention to the aspects of your body and life that are functioning well. This is not positive thinking or denial; it is a rebalancing of attention. Most medical care focuses entirely on pathology, creating a disproportionate emphasis on what is broken while ignoring the vast territory of what works.Pro tipIn MBSR classes, symptoms are not discussed as woes to be eliminated. Instead, participants learn to tune in to the actual experience of symptoms with wise attention, which paradoxically leads to significant symptom reduction.
- Use Your Body as a LaboratoryPart of the adventure of meditation is using yourself as a laboratory to find out who you are and what you are capable of. Observe carefully. Your daily meditation practice becomes your healing laboratory, a place where you develop increasingly precise knowledge of your own body and mind under various conditions.Pro tipAs Yogi Berra put it: 'You can observe a lot by just watching.' The precision of your self-observation will grow naturally with sustained practice.
In a controlled study, patients with psoriasis receiving ultraviolet light therapy were randomly assigned to either meditate during their treatments or receive light therapy alone. Both groups received identical medical treatment; the only difference was that one group practiced mindfulness during the light sessions.
Multiple research groups have shown that eight weeks of MBSR leads to measurable brain changes: thickening in regions associated with learning, memory, emotion regulation, and perspective taking, and thinning of the amygdala (threat response center). The degree of amygdala thinning correlated with improvement in perceived stress.
The Stress Reduction Clinic was founded in 1979 specifically to serve as a safety net for patients 'falling through the cracks' of the health care system. These were patients with chronic conditions that had not responded fully to years of medical treatment. Rather than adding more medical interventions, Kabat-Zinn challenged them to 'do something for themselves as a complement to whatever their doctors were doing for them.' The radical proposition was that the very first class began with: 'We are going to pour energy in the form of attention into what is right with you, and let the rest of the medical center take care of what is wrong, and just see what happens.' Over thirty-four years and twenty thousand patients, the results consistently validated this approach.