Adaptive thriving: Bringing coaching to medicine

There is a tension today between an illness versus a wellness approach to health care.

The illness approach is often described as reductionist – focusing more on understanding and fixing the problems people have.

Whereas a wellness approach is an extension of preventive medicine and looks to help people those factors into their life that a thought to make them healthier.

Classic examples of this are symptom approaches vs strengths approaches – what is broken vs what is working.

Of course this is a simplistic and polarised caricature of a complex discussion about health and wellness.

The reality is the positions on each side of this discussion are far more nuanced and there is often far more overlap than seems at first glance.

Nevertheless, there are some real differences based on the prime intent behind interventions and the diagram below shows how the two approaches often seem to be at odds with each other.

However, there is a third perspective we can take where these two positions cease to be opposites – but actually work together towards a common goal.

This perspective is based on a view of health as “dynamic … [and] based on the resilience or capacity to cope and maintain and restore one’s integrity, equilibrium, and sense of well-being … the ability to adapt and to self manage.” (Huber et al.2011)

Simply said, from this perspective, health can be thought of as a state of adaptive thriving which refers to a person’s capacity to adapt to the ongoing challenges of life.

Adaptive thriving occurs when a person assesses their resources and appropriately uses them to apply to resolution of their challenges.

This means a person must be aware of:
• their internal and external resources
• how to grow their resources
• how to use them flexibly and appropriately in given situations.

Just as the challenges of life come in all shapes and sizes – so do the resources we have to draw on.

From this perspective, health and wellbeing is a resource, and both interventions that aim to fix what is broken, and those that aim to promote health and wellness are both trying to achieve the same thing: increasing a person’s resources that they can use to adapt to the challenges of life.

What this means is that every intervention is really designed to help a person get better at adapting to the challenges they face in life.

So any professional trying to help another person with their health and wellbeing, really needs to be thinking of themselves as helping a person improve their adaptability.

This is an empowering and person-centred approach that is truly holistic. As well as seeing the person as a whole – it does not ignore the very real need we have to manage illness. And as sophisticated as we get at treating illness, it reminds us that this is not health for health’s sake – but to help people be better placed to manage their lives as a whole – and live according to their values and what gives them meaning, purpose and joy.

Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., . . . Smid, H. (2011). How should we define health?

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