What Is Functional Medicine?
Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century.
By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms.
Functional medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease.
In this way, functional medicine supports the unique expression of health and vitality for each individual.
The Functional Medicine Tree
The Institute For Functional Medicine use a tree to visually represent the core aspects of the functional medicine paradigm and highlight the difference between conventional medical care and functional medicine.
In order to keep a tree healthy and allow it to flourish, you need to support the most basic and essential elements first, the foundation: the roots and soil. Similarly, if a tree is not healthy, the first place you should look for answers is those same foundational elements.
So the same approach applies to patients.
The most important factors, and the ones we should examine first when gathering information about the patient, are the foundational lifestyle factors: sleep, exercise, nutrition, stress levels, relationships, and genetics.
These are the roots and soil.
These lifestyle factors are in turn influenced by specific predisposing factors (antecedents), discrete or not so discrete events in our lives (triggers – infections, bereavement, exposure to a chemical/toxin,), and ongoing physiological processes (mediators) and may then result in fundamental imbalances at the trunk.
This can eventually result in the signs and symptoms that are grouped into a diagnosable constellation that we call disease, represented by the branches and leaves.
Conventional medicine tends to look at the constellation of symptoms first, which usually results in a disease diagnosis. Often, this diagnosis is associated with a drug or drugs that can be prescribed to treat this constellation of symptoms, and that is the end of the story.
But this approach neglects the most fundamental aspects of health – the roots and the trunk. It treats all patients that present with similar symptoms the same and completely neglects both the inherent differences between patients as well as the myriad possible causes that a “disease” can have.
The Functional Medicine TimeLine
The timeline simply provides a tool to understand someones health history. Considering the research that discusses adverse childhood events and their connection to health conditions in adulthood, having time to hear the client’s story is a key part of our work.
Add to this the concept of Narrative Medicine, it becomes increasingly clear we need to invest time with our clients, and our clients need to invest time with us, if we are to experience true healing and optimal health.
Part of the client’s timeline includes their family health history. Various levels of evidence demonstrate that our parents lives and their state of health, and even our grandparents lives and state of health, can influence our health, throughout our life span. This is often discussed via the term transgenerational disease.
A family history of cardiovascular disease for example may lead us to investigate genetic predispositions to cardiovascular disease. When present, it allows a more personalised nutrition, lifestyle and supplement approach to be taken.
One other point I will make here is transgenerational behaviour. This is based on my studies on Transactional Analysis (TA). TA is partly based on the concept that we have three ego states: the parent, the adult, and the child. Throughout our interactions we are continually fluctuating between these three states. The key is to stay in our adult state as often as possible. Being aware of the concept, being mindful, day to day, what ego state you are in have a profound influence over our behaviour and the results we will experience. This is discussed in depth, when appropriate, during the programmes.
The Functional Medicine Matrix
The final document is way of plotting all the information collected in the initial consult that can then be used to decide how to proceed.
A lecturer of mine described it as a way to organise your understanding and approach:
Functional Medicine is a human orientated heuristic approach to help organise thinking about biological systems
That’s it! FM is a brain storming technique!
The science you wish to incorporate within this system is up to you!
The Matrix allows/encourages the practitioner and client to explore certain concepts including Antecedents and Mediators. The below extracts are taken from The Institute For Functional Medicine:
These may be thought of as congenital or developmental. The most important congenital factor is gender: women and men differ markedly in susceptibility to many disorders. The most important developmental factor is age; what ails children is rarely the same as what ails the elderly. Beyond these obvious factors lies a diversity as complex as the genetic differences and separate life experiences that distinguish one person from another.
Congenital factors may be inherited or acquired in utero. They can most readily be evaluated from a comprehensive family history, including mother’s health before and during pregnancy. Genomic analysis, which is now commercially available, can supplement the family health history as a tool for investigating unique nutritional needs or individual variability in sensitivity to environmental toxins
A mediator is anything that produces symptoms, damage to tissues of the body, or the types of behaviors associated with being sick. Mediators vary in form and substance. They may be biochemical (like prostanoids and cytokines), ionic (like hydrogen ions), social (like reinforcement for staying ill), psychological (like fear), or cultural (like beliefs about the nature of illness).
These are just some of the tools and systems we use to support our clients through their journey. Time and time again we are reminded of the importance of listening to their story, allowing them time to think, to share, to lean in. When we are given space and time, we are given the opportunity that we rarely give ourselves – time to think. Most of the time, when we access parts of ourself that we simply can’t when we are maniacally running from one responsibility to the next, we tap into a more intuitive higher-self. We find the answer we were seeking. The answer we had all along.
A lovely quote from Leo Galland that summarises all of this is:
A patient’s beliefs about health and illness are critically important for self-care and may influence both behavioral and physiological responses to illness. Per- ceived self-efficacy is an important mediator of health and healing. Enhancement of patients’ self-efficacy through information, education, and the development of a collaborative relationship between patient and healer is a cardinal goal in all clinical encounters.
This is a great article by Cleveland Clinic: click here.
I also recommend the book Disease Delusion by Jeffrey Bland.