Medicine has undergone several radical shifts in the past 150 years. Entering the turn of the 20th century, medicine saw the power of science and technology as a key towards the conquest of disease. While indisputable progress resulted from the marriage of science and medicine, the worship of objectivity came at a cost to the culture of medicine. By the 1960’s, people recognized that there was a difference between the treatment of disease and the care of people. Medicine needed to address the subjective and personal. With this recognition came several important movements to make medicine more person-centered. Dame Cicely Saunders, the founder of the modern hospice movement, saw that supporting a person living with serious illness required addressing the total pain of illness, including physical, emotional, social, spiritual and practical struggles.
Medicine has long-recognized the need to not only treat disease but to prevent it and to promote optimal health. While this was also largely tied to the objective health of the body, several pioneers in the field of psychology began to recognize in the 1960’s that there was significant potential for good in expanding their focus from treating mental illness to studying and promoting positive emotions and growth. In 1998 Martin Seligman coined the term ‘positive psychology’ to capture and stimulate this work. Entering the 21st century, we are on the cusp of another paradigm shift, namely the birth of positive medicine. Areas that I see forming the foundation of this field include:
- Flourishing as a reimagining of the goals of health. Rather than look at health in terms of deficits and normal, we can aim for positive formulations of wellbeing. Read more about this concept here.
- Positive psychiatry as an expansion of the field of psychiatry beyond mental illness to also encompass and encourage positive mental health. Read more about positive psychiatry here.
- In my own clinical work in palliative care, I have become increasingly interested in how encouraging joy and growth can be helpful for persons living with serious illness, even towards the end of life. There have been others who also have observed opportunities for positive palliative care. Read more about positive palliative care here and here.
This is an emerging interest. I have a few research projects underway to test and support my ideas around the importance of joy in improving the quality of life of patients, families and clinicians working with neurologic illness and other life-changing diagnoses.
Here is some of my past research if you’d like to learn more about positive medicine.
Spiritual wellbeing has rarely been studied amongst individuals living with Parkinson’s disease. We found that higher spirituality was associated with better quality of life, lower anxiety, lower depression, fewer non-motor symptoms, reduced palliative symptoms, and less anticipatory grief.
Although we framed this paper around caregiver burden, one could also look at it from the perspective of what factors were protective to caregivers. Interestingly, patient spiritual wellbeing, specifically faith, caregiver mood and caregiver perspectives on the patient’s quality of life all influenced burden and suggest targets for positive interventions.