Diseases of meaning, manifestations of health, and metaphor

Disease and health are commonly thought of as distinct opposites. We propos e a different view in which both may be seen to be facets of healthy functi oning, each necessary for the other, each giving rise to the other. Thus, d isease may be thought of as a manifestation of health. It is the healthy re sponse of an organism striving to maintain physical, psychologic, and spiri tual equilibrium. Disease is not necessarily to be avoided, blocked, or sup pressed. Rather, it should be understood to be a process of transformation. The process should therefore be facilitated because it is an integral part of the dynamic equilibrium that we ordinarily think of as health. In many c ases, perhaps all, people get ill because there is something going "wrong" in their lives. This could occur in a whole range of ways-relationships, en vironment, food, or job. Our view, however, is that disease is a meaningful state that can inform health workers how to help patients to heal themselv es. In this way, instead of being meaning less, people's problems become di seases of meaning, enabling people to see that things are not necessarily " going wrong" but are, in fact, helping them become stronger, to live more f ully and with more understanding. Seen from this perspective, depression; c ancer; heart disease; neurodegenerative and autoimmune disease; dementia; a nd conditions such as community violence, genocide, and the problem of envi ronmental devastation are "diseases of meaning." World Health Organization forecasts make it clear that diseases of meaning will continue well into th e next millennium to be the major cause of suffering and death worldwide. T o deal with them, the world needs to reformulate the biomolecular paradigm that has been exploited in the last two centuries. It does not address the reasons why these diseases arise, attending mainly to their molecular conse quences. A paradigm that includes the importance of meaning must now be giv en top priority. The concept that diseases are a manifestation of health-a call to a different relationship with ourselves and our environment, both a nimate and inanimate-is in itself a different approach. Programs for care a nd education based upon it would have immediate application in medicine, in dustry, education and ecology. We believe that this model would have far-re aching consequences for the understanding, treatment, and prevention of dis eases and behaviors that lead to violence and environmental destruction.