Many years ago, an integrative colleague and adviser – my spouse! – explained something to me about an important part of her lengthy integrative intake process. The time is needed to build trust to have the patient divulge what is going on at the time a chronic condition set its hooks so that the freeing might commence. The past half-century was witnessed a slow, cultural recognition of the power of trauma in micro and macro ways. The “shell-shocked” of WWI became, post Vietnam, a potentially actionable PTSD. The women’s movement opened the lid on pervasive sexual abuse, emotional abuse, and rape. Adverse Childhood Experiences (ACES) emerged as powerful determinants of life chances and choices. George Floyd’s murder ripped open reckoning on police battery, slavery, Jim Crow, red-lining, and mass incarceration.
In recent weeks, two influential integrative health organizations each chose to feature presentations on the expansive, multidisciplinary, and remarkably patient-choice integrative pain pilot associated with the University of Vermont Medical Center (UVMC). The presentations for the Academic Consortium for Integrative Medicine and Health and the Alliance to Advance Comprehensive Integrative Pain Management (AACIPM) featured the project’s remarkable, multi-stakeholder partners: the state’s dominant payer, Blue Cross Blue Shield, the Vermont Department of Health, and the academic medical center. Included in the latter was the project’s research leader, longtime integrative health policy activist and prior NIH National Center for Complementary and Integrative Health adviser Janet Kahn, PhD, LMT. The parties shared early outcomes from the unique bundled payment model. Many consider the strategy a potential pilot for the nation. What is being discovered? Can it be implemented elsewhere?
A week after the murder of George Floyd, I published brief accounts of some of the integrative health community’s response. I quickly learned that I’d missed statements from some key players. Subsequently, many others were called to make statements. These are evidence that some of white people – and most in the integrative fields are white – in present day parlance, that some are “woke” or waking. The next question, as interviewer Brian Carter put it during a June 21 Seattle Arts & Lectures dialogue with Emory University professor Carol Anderson, author of White Rage and One Person: No Vote, is: “They may be woke – but are they getting out of bed?” There are signs below among some of new actions to make sure there is ongoing, systemic engagement to address the chronic, systemic abuses, micro and macro. Here is a second overview, with links where available. The good news is that many show signs of getting out of bed . Many were called to make public commitments. (In addition, for reference, a include links to two statements from organizations in the dominant school of medicine.)
In a recent conference organized out of Prague and moved online, a presenter from the United Kingdom shared a list of concerns that seemed to go on forever of all that is frightening people these days. Foremost on his list were Covid19, what seem to many like authoritarian governmental measures to control its spread, uncertainty about the economy, and the questionable competence of world leaders in the face of a mounting global crisis. In the United States, these are compounded by unrest over police brutality against Black people forcing many to re-examine the legacy of 400 years of what historians call our “peculiar institution” of slavery. Author and clinician James Lake MD is an integrative psychiatrist who has witnessed the effects of this “perfect storm” close up. For Psychiatry Times, Lake authored a column on what he calls A Mental Health Pandemic: The Second Wave of COVID-19. He urged a re-think of typical mental health responses to include integrative solutions in his “Call for a National Strategy.” I reached Lake to explore what has steered his vision to make such dire predictions, and to explore how integrative methods might best figure into solutions.