The Hierarchy of Healing

Many of you who are familiar with naturopathic medicine have probably heard of the seven principles guiding our approach (if you haven’t, check it out here). You may see it in latin (vis medicatrix naturae) or english (the healing power of nature). It may sound familiar (first, do no harm), or all-encompassing (prevention).

But there is another code guiding our medicine. Although ten different naturopaths may have ten different treatments for the same patient, the hierarchy of the treatments often remains the same.

There is always room for exception, especially considering the focus is on the individual and not solely on the disease or symptoms. But here is the naturopathic therapeutic order:

1. Establish the conditions for health

“Identify and remove disturbing factors”

When health is the baseline, and physiology prevails over pathology, then removing factors that perturb these conditions is an essential first step. The most common “disturbing factors” are poor diet, excessive stress, toxins, and last but not least, spiritual disharmony. Thinking about it another way, the foundations for good health begin with a nutritious and fulfilling diet, adequate ability to manage and cope with stress, minimizing toxin exposure, and finding ways to nourish the spirit (this can be anything from meditation and yoga to walking in nature or expressing gratitude for the loved ones in your life).

2. Stimulate the self-healing mechanisms

“Vis medicatrix naturae – the healing power of nature”

This one overlaps with one of the principles mentioned in the intro, and is based on the recognition that the body has an innate wisdom and, if given the opportunity, the ability to heal itself. Once the disturbing factors are removed, the “vital force” can do amazing things. Helping ignite this self-healing power can be accomplished in any number of ways. One of the most basic of these methods is hydrotherapy, or the application of water (often contrasting hot and cold) in the therapeutic setting. Other modalities that can stimulate the vital force include, but are not limited to, acupuncture, herbal medicine, and homeopathy.

3. Support weakened or damaged organs or systems

While for some cases removing disturbing factors and stimulating the body’s self-healing powers is enough to re-establish optimal health, in many this is not sufficient. The chronic stresses of modern life tax the adrenal glands, the accumulation of toxins in the diet and environment overwhelm the detoxification abilities of the liver, and the accumulated pressure to succeed in this ever-changing society can disharmonize the spirit. In these circumstances, additional support is required. Fortunately, naturopathic medicine is equipped with a vast and extensive “tool-kit” to address these problems, including botanicals, nutraceuticals, and counselling.

4. Address structural integrity

The body has a fundamental balance and alignment that can be altered in myriad ways. A fall or injury is a clear cause-and-effect example. Poor posture is another major source of structural imbalance. Many of us spend our days hunched over a computer, resulting in what is known as “upper-cross” syndrome. But structural alignment can be thrown off in other, more subtle ways. Chronic stress is often held as tension in the shoulders, which over time pulls the spinal segments in that region out of place. Emotions are not often thought of as a cause for structural imbalance, but they too can be held in different regions of the body, resulting in chronic pain and structural misalignment.

Once again the naturopath has many tools at their disposal to address these imbalances. These include a combination of soft tissue massage, spinal manipulations, trigger point release therapy, and more subtle forms of physical medicine such as bowen technique and craniosacral therapy.

5. Address pathology

In conventional medicine, addressing pathology is usually step numero uno, but if the therapeutic order is followed there is often no need to specifically address the pathology. 
When the pathology does not resolve itself after the previous steps have been taken, naturopaths employ the least invasive therapies (remember, first do no harm) that will act on the level of the pathology without adding to the toxic burden of the individual. For example, anti-microbial herbs may be utilized in conjunction with herbs that support the immune system in a persistent bacterial infection.

More recently, naturopathic doctors in BC have gained the rights to prescribe pharmaceutical medications (after attending a certification course and passing the exam). While there is a time and a place to use these medications, due to their side effects (once again - first do no harm), they are not usually the first thing a naturopath will reach for when treating most patients.

6. Suppress the pathology

At the bottom rung of the ladder of healing is suppressing the pathology. A common example of suppressing the pathology would be using a corticosteroid cream to treat a skin disorder such as eczema. While this strategy will sometimes work initially to relieve symptoms, it does not address the underlying cause. And this can often result in harm (did I mentioned that old saying, first do no harm?), such as a compromised immune system, or the pathology expressing itself somewhere else (i.e. corticosteroid use for eczema leading to asthma). So, except for certain severe or life-threatening circumstances, this option is our last resort.

Yours in health,

Dr. T