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A few weeks ago, I taught a seminar for clinicians in Pennsylvania. During the Q&A period, someone asked what I think is a very important—and underrated—question: what is health?
The concept of health is so familiar that many of us have never thought much about what it really means. That was certainly true for me prior to my decade-long struggle with chronic illness that began in my early 20s.
If asked, I suspect most people would define health as "the absence of disease." And in fact, if you look up "health" in the Merriam-Webster dictionary, you'll find a very similar definition: "the condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain."
Is health really just the absence of disease?
While this common definition of health certainly has merit, I think it's too limiting and reductionistic.
Imagine someone (Person A) who is the picture of physical health: he has boundless energy, perfect digestion, a sharp mind, no chronic, inflammatory conditions, and rarely (if ever) get colds and flus. But in other areas of life, this person is a wreck: he has terrible relationships, he's selfish and doesn't contribute to the lives of others, he has no sense of humor, rarely has fun, and is miserable most of the time.
Now consider someone (Person B) that is in many ways the opposite of Person A: perhaps she has an autoimmune disease, she struggles with low energy, her digestion is weak, and she sometimes has difficulty sleeping. But unlike Person A, her life is incredibly rich and satisfying: she has deep, nourishing relationships with others, she does meaningful work that makes a difference in the world, she is full of joy and humor, and she loves to have a good time.
Which of these people is truly "healthy"? Both? Neither? If you had to choose between these alternatives, which would you choose?
Of course, there is another possibility: Person C. Person C is healthy physically as well as mentally, emotionally, and socially. This is certainly what most of us aspire to, and it's a perfectly natural and valid goal.
The problem is that it's not always attainable.
When "perfect health" isn't possible
During the course of my long struggle with chronic illness, I had a lot of time to think about this question of what health is and what it really means to me.
At one stage in my journey, after trying everything I could possibly imagine to get well without a lot of success, I had a breakdown. I reached a point where I just couldn't see the future I had always imagined for myself when I was a "healthy" person: a successful career, a family, and an active and energetic life. These things no longer seemed possible for me, given how sick I was.
This led to a period of deep depression and despair—and it was without a doubt the darkest and most difficult time of my life.
But as the saying goes, the darkest hour is just before dawn. At some point during this "dark night of the soul," I realized that the depression and despair I was feeling was the direct result of comparing my actual experience with an idea of what I thought my experience should be. I saw that I was striving for an ideal of health that was—at least at that point—unattainable, and that this was the cause of most of my suffering.
How we define health has tremendous power
These realizations led to a profound shift for me. Up until that time, I had been focusing almost exclusively on figuring out the cause of my illness and "fixing" it: I saw doctors all over the country and the world, I took countless medications, herbs, and supplements, and did every special diet you can imagine.
But after this "dark night," my focus began to shift. I continued to eat well, but I let go of "finding the answer" for a while. I stopped seeing doctors, taking supplements, and obsessively researching new treatments.
Instead, I focused on bringing more joy, pleasure, and meaning into my life. I spent more time with my friends. I took regular walks in the woods and surfed as much as I could. I volunteered to teach meditation at the San Francisco County Jail. I signed up for an improvisation class. I did a massage trade with a friend and got acupuncture once a week. And after a while, I decided to go back to school to study integrative medicine so I could use what I had learned to help others.
Several months after making these changes, the depression and despair were gone, and I was feeling more connected, alive, and hopeful than I had in a long time. But that's not all that changed; my physical health started to improve as well. I had more energy, my digestion was better, my sleep was less interrupted, and I began to put weight on again (which had been impossible until then). These improvements rejuvenated me and gave me the boost I needed to continue searching for new treatments that ultimately led to further physical recovery.
This time in my life taught me a very important lesson: how we frame and perceive our experience has tremendous power—even the power to change it.
If I had continued to define health only as "the absence of disease," what would my life have been like? A constant experience of disappointment, "not enough," frustration, and failure.
But as my definition of health expanded and became more inclusive, new possibilities opened up. I was able to find ways to experience joy, pleasure, meaning, and ultimately, health—even in the midst of physical pain and discomfort. What's more, the reframing of my definition of health didn't just lead to more happiness, it ended up improving my physical health as well.
An alternative definition of health: the ability to live your dreams
Several years have passed since the period I described above, but I continue to think a lot about what health means to me. It's a subject I am fascinated by and never stop learning and reading about.
In all of that time, I think the best definition of health that I've come across is "the ability to live your dreams." This comes from a man named Moshé Feldenkrais, the creator of the Feldenkrais method (designed to improve human functioning by increasing self-awareness through movement).
I like this definition because it does not refer to the absence of pain, discomfort, or disease. Instead, it points more toward a quality of life and way of being in the world.
An example that comes to mind is my late Zen teacher, Darlene Cohen. She had rheumatoid arthritis, an autoimmune inflammatory condition affecting the joints, for more than 30 years. When the disease first struck her, she lost 40 pounds and was forced to stay in bed. She couldn't dress herself, hold the phone receiver, or get up from the toilet unassisted. From her book:
In four months of deterioration, I lost everything that meant anything to me: reliance on a strong, young body; my achievements and the sense of self-worth they brought me; my pleasure in being a sexually attractive woman; my identity as a mother; and my ability to do the required practices and sustain myself in the community in which I lived as a student of Zen meditation. I became isolated from everyone I knew by my pain and fear and ultimately even by the consuming effort I had to make to do any little thing - like get up from a chair, pick up a cup of tea.While Darlene eventually recovered from the worst of her symptoms described above, she continued to struggle with the severe pain, stiffness, and reduced mobility that many people with rheumatoid arthritis experience.
Yet Darlene never let her physical limitations stand in the way of living her dreams. She was one of the wisest, funniest, most joyful and vibrant human beings that I ever met, and she dedicated her life to relieving the suffering of others.
In my opinion, this is true health. Not boundless energy, or perfect digestion, or being able to run a marathon, or living until you're 120, but the ability to live your dreams regardless of your circumstances.
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