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A Body-Mind-Spirit Model in
Health
a b
Cecilia Chan PhD, RSW, PhD, RSW , Petula Sik
b c
Ying Ho & Esther Chow MSW, RSW
a
Faculty of Social Sciences , University of Hong
Kong , Pokfulam Road, Hong Kong
b
Department of Social Work and Social
Administration , University of Hong Kong , Pokfulam
Road, Hong Kong
c
Department of Applied Social Studies , City
University of Hong Kong , Tat Chee Avenue,
Kowloon, Hong Kong
Published online: 17 Oct 2008.
To cite this article: Cecilia Chan PhD, RSW, PhD, RSW , Petula Sik Ying Ho & Esther
Chow MSW, RSW (2002) A Body-Mind-Spirit Model in Health, Social Work in Health
Care, 34:3-4, 261-282, DOI: 10.1300/J010v34n03_02
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A Body-Mind-Spirit Model in Health:
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An Eastern Approach
Cecilia Chan, PhD, RSW
Petula Sik Ying Ho, PhD, RSW
Esther Chow, MSW, RSW
jury, insect bites, poison, overeat and overwork), and the seven emotions
(joy, sorrow, anger, worry, panic, anxiety and fear). The authors have
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ners are trained to appreciate the dynamic interaction between the inter-
nal and external systems of a patient, his/her individual uniqueness,
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inter-relations and reactions, and the circular effect within the overall
unified wholeness (Tsuei, 1992; Yin et al., 1994). By observing, listen-
ing, smelling, pulse reading, as well as inquiring about the patient’s
family relation, work and emotions, traditional Chinese medical practi-
tioners are able to make a comprehensive, in-depth diagnosis (Yin et al.,
1994). Treatment typically consists in a prescription for herbal soups,
recommendation for physical and therapeutic exercises, and some sug-
gestions on how to improve the patient’s family relations–the so-called
mind-body-family wholeness treatment (Koo, 1982, 1989, 1989a;
Sheikh & Sheikh, 1989; Topley, 1978). This may sound esoteric to the
practitioners of Western medicine. But the fact is alternative approaches
to healing, such as qi-gong,2 tai-jiquan,3 yoga,4 nutrition, aromatherapy,5
herbal medicine,6 acupuncture,7 acupressure,8 moxibustion,9 massage
and temple healing are now being practiced widely by patients and their
family members around the world (Chan, 1997; Harold, 1994; Lee, 1978,
1984; Ng, 1995; Sheikh & Sheikh, 1989; Yang, 1995).
Dualistic Western philosophy splits the spiritual and physical realms
into two hostile and mutually exclusive spheres and attaches greater
value to the former (Reid, 1989). Under the influence of the Western
medical model, health care professionals in Hong Kong, including so-
cial workers in most health care settings, tend to see themselves as the
caretakers of their patients’ physical health. The psychosocial and spiri-
tual needs of patients are often neglected (Chan et al., 1996a, 1996b;
Chan, 1997; Chang & Chan, 1994). Growing up in a predominantly
Chinese society, social workers in Hong Kong are aware of the wide
adoption of traditional Chinese medical practices as complementary
methods to healing. However, as professionals, they have little to con-
tribute in this area, because they are not familiar with the analytical
framework concerning an individual’s total well-being within the con-
text of the balance of the five elements,10 the attainment of yin-yang
equilibrium, and its associated interventions (Lei, 1988).
In this article, we introduce several useful concepts in traditional
Chinese medicine and discuss how they can be applied in clinical social
work interventions with patients and their family members in Hong
Kong (Chan, 1997, 1997a, 1997b). By working with patients suffer-
ing from cancer, stroke, Systemic Lupus Erythematosis (SLE),
Rheumatoid Arthritis (RA), diabetes, bereaved wives and post-di-
vorced single mothers in groups (Chan et al., 1996b, 1998; Lee, 1995;
Man, 1996; Wan, 1996), we have developed a model of an individual’s
264 SOCIAL WORK HEALTH AND MENTAL HEALTH
et al., 1998), aims at empowering the client at a personal level. (For de-
tails of the body-mind-spirit intervention, please read Appendix 1 and 2.)
Pre and post intervention research results show significant improvement
among patients who participated in treatment and self-help groups. They
score higher on both physical health and communication with profession-
als, and develop a sense of control of their illness and emotional well be-
ing (Chan et al., 1996b, 1998; Chow, 1995; Man, 1996; Wan, 1996).
TABLE 1. Categorization of the Body and the Mind Under the Symbiotic Inter-
action of the System of Five Elements
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ness was a manifestation of the grief she felt for the loss of her
mother.
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mood swings, dryness of the eyes, knee pain, rough lines on her
nails and poor liver functions. These symptoms were all related to
her excess emotions of anger. She participated in a Reiki class
(hands-on-healing) and started working on her anger by putting
her hands on the right side of her lower rib cage where the liver
was situated. She learned that she would have to let go of her anger
to regain her health. She immersed herself into volunteer services
and finally came to forgive her husband for his infidelities. Her
condition improved two years after the therapy.
From Table 1, we can see that the relief of emotional strain can be
achieved through physical training of the body as well as spiritual re-
flection on the meaning of life (Barnard, 1990; Frankl, 1984). Indeed,
practitioners of traditional medicine under the influence of Buddhist11
and the Taoist schools of thought are always ready to preach by telling
Chan, Ho, and Chow 269
their patients what to do and how to live (Chan, 1995, 1997; Lei, 1988).
For them, benevolence, helping other people, lovingkindness, respect
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for humanity, forgiveness and finding new meanings in life are the
cures for excess “anger,” while trust in other people, sincerity and re-
spect for nothingness can reduce excessive “joy.” Resorting to reason,
discounting gains and losses, as well as humility is antidotes to exces-
sive “worry” (Leung, 1988; Yin et al., 1994). This reflects the heavy in-
fluence of the Buddhist teaching that “the more one wants, the more one
suffers” (Chan, 1997b; Yang, 1995a), and the Taoist philosophy that
one should accept life as ever changing and unpredictable (Chan,
1997b; Yang, 1995).
This growing interest in the link between one’s emotional and physi-
cal well-being is not confined to Chinese societies. In the West, there is
an increasing number of books and publications on spirituality and the
meaning of life, such as Chicken Soup for the Soul, and Inner Simplic-
ity, which address the issues of morality and value. Given such zeit-
geist, clients may be more receptive to a holistic,
body-mind-spirit-environment intervention. But before we set out to
help our clients to get in touch with and control their innermost feelings,
we may have to do some soul-searching on our own first.
BODY WORK
ies, their mind, and their spirit. The flow of Energy (qi) through the
meridians is one of the most important and unique concepts in tradi-
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SPIRITUAL TRANSFORMATION:
GROWTH THROUGH PAIN
Some of our clients have a hard time getting over their traumatic expe-
riences, loss and pain. Overwhelmed by a strong sense of loss of control,
they are resentful of their God, the supernatural creator, who had made
life so difficult for them. By turning depressed and angry, sad and fearful,
dispirited or aggressive, bitter and cynical about life, jealous and suspi-
cious, revengeful and unforgiving, self-pitying and socially destructive,
they are a miserable lot stuck with the negativities in life (Barnard, 1990;
Chan et al., 1998; Kleinman, 1988; Miller, 1983; Ngan et al., 1994).
But there are clients who behave otherwise. Despite their misfor-
tunes and bad experience, they come out positive, charming, energetic,
loving, forgiving, generous, kind and full of life. They are the winners
272 SOCIAL WORK HEALTH AND MENTAL HEALTH
who grow and learn through pain and suffering by transforming their
traumatic experiences into a platform for personal growth (Chan,
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1986; Cheung et al., 1984; Cheung & Lau, 1982; Lau et al., 1981). As
pragmatic people, Chinese are always willing to comply with medical
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CONCLUSION
NOTES
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1. The Qi Energy is a cosmic life force that flows through the human body in a very
orderly and logical way. Balance and harmony of the flow of Qi results in health. On
the contrary, the imbalance or disharmony of the flow leads to illness (Lei, 1988).
2. With a history of 2000 to 3000 years, Qi-gong exercise combines motion with
stillness and involves different forms and demands. Qi-gong can be done in the form
of a kind of walking exercise for relaxation, respiration training, breath control and
mental regulation (sometimes referred to as meditation). It consists of five kinds of
regulation exercises: regulation of mind, posture, respiration, voice production and
regulation of combined exercises. New Qi-gong is proven to have a definite effect on
chronic diseases, including cancer and cardiovascular disease. The principles of round-
ness, softness and extensiveness in movement should be observed in practice. Essential
attributes for doing New Qi-gong exercises well are confidence, determination and
perseverance (Tsuei, 1992).
3. Tai-jiquan , which has its origins in the Taoist philosophies, accords with the
principles of traditional Chinese medicine. It stresses the need to harmonize with na-
ture, and is a Chinese health-enhancement practice for the prevention and treatment
of disease. Tai-jiquan should be practised on a regular basis, which takes about thirty
minutes to complete one circle of exercise consisting of movements linked together
in a series of continuous steps. It requires a focused mind with a strong sense of pur-
pose, and coordinates with deep, calm breathing pattern (Nash, 1996).
4. Originated in India over four thousands years ago, Yoga means “union,” being at
one, at harmony with oneself and everything in creation. It is a holistic training for the
body-mind-emotions-spirit that emphasizes self-control through a series of exercises,
levels of breathing, postures, relaxation and meditation (Sheikh & Sheikh, 1989).
5. Aromatherapy is an ancient mediated practice recorded in the writing of early
civilizations including Egypt, India and China. It is a treatment of common ailments
and health problems with highly concentrated oils that have been extracted from
plants and trees. These oil essences are believed to contain properties of natural heal-
ing power. They are often used in massage, or hand and foot baths. There are more
than 130 different oils whose uses can be classified into the following three major cate-
gories: refreshing and uplifting, regulating and toning up of body, and relaxing and
soothing. Essences of the aromatic plant have been used for beauty and healing pur-
poses (Nash, 1996).
6. Herbal medicine had been used by different cultures of ancient civilizations
such as Egyptians, Greeks, Romans, Chinese and Indians. Herbal medicine is basi-
cally the Chinese ancient pharmacology, is heavily influenced by Taoism, in its ac-
cordance of the Yin and Yang practices. It has been used as a natural way of
improving health with great emphasis on the holistic approach in treating the physical,
emotional, and spiritual needs of the patients. Basically a plant-based medicine, its in-
gredients compose of minerals, animal components and extracts of the flowers, fruit,
leaves, roots, stems and seeds. It is especially used for strengthening and regulating the
deficient properties of the patients’ body systems (Lei, 1988).
7. Acupuncture, the best-known Chinese therapeutic technique, is a way of influ-
encing bodily functions by inserting needles in the xue (meridians). According to the
traditional Chinese medicine, there are 14 main meridians running from the hands
and feet to the body and head. Acupuncture helps to maintain health and restore the
balance between the physical, emotional, mental, and spiritual aspects of the patients,
the yin-yang balance and the Law of Five Elements, helping the individual to arrive at a
Chan, Ho, and Chow 275
natural state of harmony. There are many factors which could upset the balance, disturb
the flow of Qi and cause the disharmony and ill-health, including excess emotions,
poor eating habits, drugs, environmental and occupational conditions, change of
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thoughts (caring for others and everything in nature), Right speech (tell the truth and
kind in words), Right action (do not kill, steal, or hurt), Right livelihood (do not cheat
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or harm others), Right effort (practise and work hard to follow the path), Right mind-
fulness (be aware of the consequences of thoughts and actions), and Right concentra-
tion (calm, peaceful state of mind) (Lei, 1988).
12. Reflexology is a kind of natural therapies, applies massage to major reflex areas
on the soles of the feet. It is believed that there are spots on the feet which are associ-
ated to different part of the human body. Treatment consists of applying special mas-
sage techniques to the appropriate spots (Nash, 1996).
13. Bioenergetics was developed by Lowen and is a way of understanding the per-
sonality in terms of the body and its energetic processes. These include breathing,
movement, feeling, sexuality and self-expression. Lowen’s well-known exercise is the
bow, which aims to build up the energetic charge of the body (Lowen, 1975).
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280 SOCIAL WORK HEALTH AND MENTAL HEALTH
The social workers attempt to bring about change in the patterns through intervening at five
levels of cognitive, behavioral, physical, emotional and spiritual dimensions, Each session
of the group meeting deals with a few dimensions and the group is run as a ‘Cancer Fighter
Training Course.’ Patients are more willing to come to a training course than a counseling
group. Pre and post group research results show significant improvements among group
members on their physical, emotional and social well being.
* Meditation in each session was based on the same theme as that of the session.
(Source: Leung, 1997, p. 100)