FRANCE

Pierre Le COZ

- Qualified Professor of Philosophy
- Member of the National Consultative Committee for Life Sciences and Health,
- Teacher at the Marseilles Faculty of Medicine, Ethical Medical Department

Evolution of the concept of health and the new religious movements

Introduction

A sectarian movement does not arise within a professional field of activity like a ray of light in a clear blue sky. It is impossible for it to contaminate the workings of a social institution, which would be too mixed for it. The beliefs of karma, occult or demonic energy running alongside each other, for example, will doubtless remain completely foreign to the scientific and philosophical community for a long time : the door to these institutions is completely closed off to them. To surreptitiously infiltrate the health sector, therapeutic cults have, one way or another, had to find some common ground – an atmosphere conducive to their taking root in the filed of healthcare. The door had to have been left ajar.

Among the many factors liable to encourage the infiltration of nebulous pseudotherapists within the medical world, we immediately think (an not without good reason) of the psychological suffering of healers. Health professionals are incontestably placed in a highly vulnerable position, thanks to the profession's tough conditions that constantly put them into contact with whole world of violent emotions : patients who moan, others who die, families that cry, not to mention the inner conflicts that rage between departments (disagreements between the head of department and their staff, etc). Compassion fatigue, "affective vampirism", the contagion of emotions counts as one of the factors most likely to make people working in healthcare more receptive to psycho-mystical aids and offers of alternative therapy offering them a range of new abilities to better face up to their responsibilities. Nothing that presents itself to be a means of easing professional suffering (burn out) can be ignored.

However, this psychological explanation does not explain the late arrival of this successful trend of New Religious Movements in the health sector. Why has psychotherapeutic phraseology become so widespread over recent decades? Why has it taken until now for health to become a Trojan horse for cults?

The hypothesis outlined here is that, independently of any psychological suffering endured by healthcare workers, ideological psychotherapy has seeped into the healthcare environment for cultural reasons : the rise of psychologism. We understand "psychologism" to mean the widespread trend of interpreting illness through psychological factors, at all levels of society. We have entered into a new phase in the history of the Modern Age, a psychological Modern Age that sociologists sometimes call "post-modernism" and sometime "ultramodernism". The trend of including pathologies in psychology is driven by increased reliance on new medical techniques for psychotherapeutic reasons (choice of a baby's gender, embryo transfer enabling a woman to experience the pleasure of bearing her orphan, help for conception in menopausal women, etc). The concept of health has not reduced its biological dimension. In the time-honoured way, this is qualified as "a healthy soul is a healthy body". Proper spiritual cures, putting emotions at harmony with themselves and the cosmos is the surest way of warding off illness. This ever-more fashionable theory changes the traditional concept of health designed to be a "silence of the organs" (Leriche). Therapeutic cults profit from this psychological elevation of the concept of "health", leading to an increasing number of our contemporaries to believe that the body's well-being is determined by the state of the mind. That cancer, for example, is caused by a psychological shock.

Some healthcare workers' openness to similar beliefs and to sects or cults can be explained in view of this generalised psychological outlook onto health problems.

1. From Hippocratic medicine to modern medicine

Being too close to our subject often prevents us from seeing the whole picture, and from distinguishing the non-essentials from the essentials when we are studying things that are right in front of our eyes. The surest way to protect ourselves against the risk of near-sightedness caused by this narrow confrontation with reality is to look back over a period of several centuries. At present, we must view the nebulous concept of psychotherapy in a wider historical context.

At the dawn of the Modern Age, from the 17th century, ailments of the spirit, happiness and the human condition in general became the major preoccupations of philosophical literature. These objectives of new subject sounded the death bell for the traditional Judeo-Christian scholasticism and dogma of good health through religious faith.

Recurrent themes in contemporary cult rhetoric – surpassing the finite, the accomplishment of all possibilities, instant gratification – have never been invented by visionary minds: the secular, rationalist instigators of the Modern Age promoted them. To give a true illustration of faith in the unlimited power of human reasoning that drives our spirit of conquest and adventure, we should take a look at a writer who typifies this revolutionary philosophy: Francis Bacon (1561-1626).

We owe the first reflections on the nature and issues of modern science, as it started to appear in Europe in the 17th century, to this London Chancellor. At the end of one of his masterpieces – which is, at the same time, a utopia – entitled The New Atlantis, Francis Bacon listed the human desires that medicine would be able to grant in the future: "Prolong life. To a certain degree, restore youth. Delay the effects of ageing. Cure illnesses said to be incurable. (...) Change height. Change features. Increase and raise the intellect. Change one body into another. Create new species. Change one species into another. (...) Restore happiness and induce a good disposition." These lines show Bacon to be the precursor of what, four centuries later, we came to call biotechnology – controlling and manipulating living beings, changing the genetic structure of organisms. Nothing seems to have escaped this visionary's gaze: GMO, organ transplants, transgendering, cloning, etc.

This list of futuristic scientific feats show that it isn't simply a question of maintaining health. The human potential that Bacon hoped would bring fresh knowledge on the functions of the human body that would go far beyond the (negative) objective of maintaining good health. As of the first half of the 17th century, the first breakthroughs in modern science, in the spirit of their precursors, immediately gave rise to the concept of a revolutionary medicine that could not only serve to maintain health, but also to rid man of his former frustrations and guarantee the psychological conditions for his well-being. Medicine received a new vocation: "to lift the spirits".

Along with a new level of understanding of medicine, this was nothing less than changing the human condition: "The aim of our institution", as we can read in The New Atlantis, "is the expansion of the human empire until we achieve all that is possible (...)". Scientific knowledge and its fruit therefore appear as vehicles for changing the views of man on his fellow man. The dominant image (Judeo-Christian) that man had of himself was that of a demeaned creature, stained with the original sin and doomed only to seeing the remains of true happiness, awaiting eventual otherworldly rapture. With the rational Modern Age, a new cultural landscape was depicted: man ceased to be a being bearing evil within himself. It was no longer the case that "Man was Wolf to Man" (Hobbes). Thanks to science and its life-extending techniques, particularly in medicine, Man is now set to become a God for Man.

This grandiose piece of imagery broadly summing up modern-day thinking finds its most explicit philosophical formulation with Descartes: "We have to become the master and possessor of nature". Why strive towards such control? Because nature is the enemy of earthly happiness. She subjects Man to her blind needs, to her implacable laws. She forces children on those who do no want them, gives others a disfigured child, while other people are sterile. Curbing the forces of nature in order to escape her arbitrary shackles – such is the conquering philosophy of the Modern Age. To scientifically understand the laws of nature is to grant oneself the means of overcoming hindrances and of satisfying one's desire to "have a joyous spirit and a good disposition", as Bacon put it.

In his preface to Discourse on Method, Descartes warned that he had merely "scattered the seed" of this science of salvation. This science would only bear fruit after several centuries had passed. As the offspring of this new science, the medicine of tomorrow would be at the service of the entire body and mind – extending its objectives over and above the simple conservation of health. It will no longer be exclusively for her, as was the case in the Hippocratic tradition, to correct organic disorders, but rather to encourage a previously unknown well-being.

Unlimited faith in the powers of reason is reinforced by the modern representation of the human condition where lifetimes are extended, where to grow old is no longer synonymous with suffering, where we can rid ourselves of bleak, melancholic moods at any time by taking pills acting s stimulants on the brain.

Such is the premise of this expansion of the concept of health, moving beyond the bodily sphere into the psychological register. This dream, which has now partly become a reality, heralds the end of the age of Christianity. Pascal had a premonition which Descartes declared to be "useless and vague".

2. The WHO definition and its apology for New Age advocates

The Baconian representation of the vocation of medicine runs throughout modern history and won international recognition through the definition of the World Health Organisation (WHO) in 1947 – the dawn of an era where, for the first time, medicine assumed the means for its ambitions: "The Bulletin of the World Health Organisation (...) hopes to record the stages lining the road of human progress leading to a world where everybody may enjoy good health, which will no longer be defined as the "absence of disease or infirmity", but rather as a state of complete mental, physical and social well-being".[1]

This WHO reference to a state of full ontology, although it was in no way directed against religion, did not have a bearing on the area of health to which it was supposedly reserved. We must not forget that the Latin "salus" means "complete". Up to this point, medicine saw its priority as bodily health. The full ontology to which Man aspired was reserved for religion – a belief in the afterlife. In other words, modern medicine had chosen an objective for life on earth that religion was promising for the Kingdom of Heaven. Marylin Ferguson, the principal theoretician of the New Age doctrine made no mistake in enthusiastically describing this definition of health by the WHO as a cultural revolution, an early sign of humanity's entry into what she calls a "new paradigm" – a new "holistic" way of human thinking, a new pattern of anthropological understanding that would put an end to 2000 years of Christian civilisation (see Children of Aquarius A New Paradigm).

Modern medicine thereby contributes to ushering in the end of the "Piscean Age", it accepts the end of the Christian Age, or the end of traditional anthropological dualism which, through the separation of the body and soul, had dissociated the spiritual search for health from the somatic treatment of illness. Up to the middle of the last century, health, in its medicinal sense, was clearly distinguished from the salvation offered by religion. Medicine set about restoring unwell people's bodily health who, in accordance with God's wishes, was or was not cured (in which case the priest took over from the doctor at the patient's bedside). However, from the 1950s/60s onwards, this barrier between the person helping to restore bodily health and the one preparing the soul for salvation gradually became less easily identifiable. While the concept of salvation for souls has become obsolete and churches stand empty, psychology has developed and leads medical practitioners to take their patients' psyches and personalities more into account, without solely limiting themselves to their illnesses. Psychiatry experienced its first successes during the second half of the twentieth century, playing a role in the development of a medicine which, in accordance with Bacon's wishes, committed itself to taking into account the issue of "restoring happiness", and re-instilling good dispositions. A medicine integrating relief from individuals' psychological suffering into its designs started to appear. We even saw doctors trying their hand at psychoanalysis.

It is true that health professionals would be right in criticising the WHO's definition of health as being over-ambitious. It has not escaped many doctors of the deficiencies of doing this ("I'm happy to take the psychological aspect of the patient's life into account, but don't ask me to grant him a state of complete well-being!"). There remains a faction within the medical body that strongly rejects this – a faction that is resolutely hostile to the increasing psychological input to therapy. For advocates of rational, scientific medicine, the practice should remain the technique of curing the body's ills. And if the patient no longer views the priest in the same way as before, he should refer himself to a psychoanalyst. It is not up to the doctor to try to restore psychological balance in the patient: to each his own field of expertise.

However, the contemporary experience of medical practice is there to show us that this opposition to a "holistic" treatment of the patient is far from unanimous. Scientific medicine is currently being called into question by a second stream of medical thinking, which says that medical practitioners should take mental disorders more seriously. Some elements of the healthcare community show themselves to be accepting of this uncompromising "state of complete well-being" approach to health. Some of them are now convinced that doctors should no longer simply relieve a patient of his illness, but should rather concern themselves with the psychological source of complaints.

A minority of these people go even further, and believe that taking care of psychological problems should make up most medical activity, based on the (highly doubtful) premise that illnesses are often psychosomatic in nature ("it's all in your mind!"; "be better in your mind and the pain will go away!"; "if your child has earache so much, it is because he has had enough of hearing his parents arguing!", etc). [2]

3. The contemporary 'psychologisation' in medicine

The international definition of health as a "state of complete well-being" prophesies a new understanding of "health" in terms of "mental and bodily development" which has become commonplace, as well as an article written into law. This bears witness to, amongst other things, the formulation of the French abortion law of 1975: "all human life should be protected from the time of conception. However, under certain conditions of distress..." women are permitted to put a stop to the pregnancy. We should note that with this distress, she does not have to be on the psychiatric register to be taken care of. If it is true that pregnancy is not an illness, we must recognise the fact that the doctor is legally taking action for psychological reasons. At the same time, prenatal diagnosis techniques have been developed. For example, amniocentesis enables us to detect if a fœtus has Down's Syndrome. In other words, any medical abortion offered to a couple is not aimed at safeguarding the unborn child's health. This is not about treating the fœtus, but rather removing it from the path of existence. The ethical reason for medically put a stop to a pregnancy is compassion for the distress suffered by the affected couple following the bad news regarding the health of the fœtus.

We do not lack ethical reasons for the decriminalisation of halting pregnancies: the very fact that this can avoid pointless suffering is enough solid, convincing justification. Yet it has always been controversial: every solution brings with it a problem, which in turn creates further problems. In the circumstances, the problem faced by medicine right from the moment of starting to deal with psychological disorders, has been knowing how far to go in this direction. At what point does distress begin and end ? Who can be permitted to decide this ? Is this "distress" a form of depression ? Supposing we accept this as being true – is it possible to agree on the meaning of the word "depression" ? Periods of distress do exist, some intense but limited, others less harsh but dull and more insistent.

By investing in the psycho-therapeutic sphere, medicine is certainly working on shaky ground. Some years ago, a woman was euthanised at her own request, in the Netherlands, because expert psychiatrists had diagnosed her depression as being incurable. In the decade that followed, we have seen doctors specialising in reproduction allow parents to choose the gender of their child in the United States and in Europe (in Birmingham in England and in Gent in Belgium), through the use of sperm selection techniques. The "medical" reason invoked is that of family balancing. It is believed that for the psychoaffective development of members of a family unit, it is better if the gender balance of the parents' immediate descendants is not too lopsided. For example, it is preferable for a family of four children to have two girls and two boys. As for the woman who has the child of her preferred gender, she does not have to bear the heavy disappointment of the newly-born child not being the gender that she would have liked.

Similarly, when both members of a couple are infertile, French law allows an embryo kept at the back of a freezer to be transferred into the uterus of the infertile woman, with the permission of the donating couple. This means that reproductive medicine can deliberately create genetically orphaned children. The first of these children will be born in France in a few months time. For what reason would a group of reproductive experts allow this kind of assisted birth, if not to allow the mother to have felt the presence of her orphan child in her belly? A purely psychological element is entering into play here – to know the feeling of pregnancy.

These examples illustrate the psycho-therapeutic direction taken by the healthcare profession. We are right there in line with this understanding of the concept of "health" in terms of "mental and bodily development" set in motion by Bacon and Descartes, and gained acceptance through the WHO definition.

Conclusion

Along the course of this simplified version of events, we have attempted to show how modern medicine has left the door ajar through which the psychologist's subject of holistic treatment for the whole person has established itself. The distinction between bodily health and that of the soul has, little by little, been clouded over the course of modern history. The gender confusion this leads to, the wavering between therapy and psychotherapy we are currently seeing in, profits gurus who have spotted the market niche. These people can now put themselves forward as another type of "doctor", capable of healing using gentle methods and traditional, forgotten knowledge.

The identification of health at a biological state of balance is the central point of gravity for medicine. Will we get further and further from this in the decades to come? There are several possibilities: carers will turn to psychotherapists for esoteric tools in order to take into account the "holistic" dimension for their patients. Or they will refuse to lend their support to the myth of total health and will unambiguously set out limits for their profession.

This second solution would naturally involve reaffirming the difference between therapeutics and psychotherapeutics, confining care for the inner self only to clinical psychologists, limiting non-technical medical services only to ethical issues. However, we must not lose sight of the fact that a refusal (legitimate or otherwise) to dilute the concept of health into a psychosomatic muddle could be just as counterproductive as the opposite extreme. The radical rejection of the psychological aspect of the carer/patient relationship has led some rationalist doctors to convert themselves into body mechanics. The patient becomes a machine, whose faulty parts require the attention of an engineer. In this way, sent into solitude in disarray, the patient becomes easy prey for alternative medicine peddlers where they will find someone who will listen, stay with them, give them continued customised treatment and offer them tact and emotional warmth. This is why we would be wrong to present the absurd character of the pseudo-therapies with derision. "Neither laugh nor cry, but understand" recommended Spinoza.

Against the two extremes we have described – with 'psychologisation' on one side, and its rejection in favour of mechanisation on the other – there is space for critical rationalism, as espoused by Kant who used this as the basis for his Critique of Pure Reason in 1781. The German thinker passed on this precious idea that reason can be unravelled, that it can become arrogant and dogmatic. Modern ideologies that carry weight around the powers of science and medicine have shown that belief did not necessarily belong on the side of the charlatan. Unconscious belief also exists among those who fight hard to defend the values of reason. What more subtly irrational than belief in the all-encompassing power of reason?

Marseilles, March 2004

Footnotes:

[1] Bulletin of the World Health Organisation, constitution and structures, Volume 1, 1947, WHO publication, pub. New-York, Editorial, p. 2
[2] While smoking one packet of cigarettes per day for fifteen years increases the risk of lung cancer 25 times, traumatic shock increases the risk of cancer by 0.2%.