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The Iceberg, the Boat and Your Health

Speaking metaphorically helps people connect on a more tangible and personal level instead of on general or theoretical terms. It helps people see and feel what is going on with them, specifically, in a deeper way.

I want to introduce two visual metaphors with the goal being your deeper understanding of how I try to approach problems both from a diagnostic and a treatment point of view.

The first image I’d like to invoke is the iceberg. You know the old saying; “Well, THAT’S just the TIP of the iceberg!”

The general meaning of this is that what one sees is not really the whole subject, and just like the real iceberg, the part under the waterline is usually much larger and broader than what floats on top.

There are other ways to think of the iceberg. The “tip” (the part above the waterline) can represent the conscious part of our existence and the part under the waterline can represent the unconscious, another example could be the representation of our outer social self versus our inner personal self.

I like to use the image of the iceberg to help people understand the difference between outer symptoms of illness and the underlying causes of illness.

Your “tip of the iceberg” includes all physical, mental and emotional signs and symptoms. It also represents your lab data, x-ray reports and most other information health practitioners can otherwise measure, probe, or get out of you.

Under the waterline are all the things that actually promote and cause what you see and experience outwardly.

Much of medicine today spends its time evaluating and treating just the tip of the iceberg. The true test and proof of this is actually simple, particularly when evaluating a drug treatment. If the treatment or drug is stopped, does the problem stay away, or does it come back? For most chronic conditions, you know the answer; the problem comes back. This can happen with natural and holistic treatments just as easily.

So, if the tip of the iceberg is just signs and symptoms and the parts under the waterline are the actual causes, why not then shift our approach to evaluating and treating that? Shouldn’t we always try to get to the root of the problem?

For the most part, most health practitioners, particularly holistic ones, believe that is exactly what they are doing (or trying to do). We all have our methods or techniques that attempt to do this, all with varying degrees of success.

I include myself and my techniques with this group too. The difference though is that I try to stay conscious to the fact that my abilities to see and understand underlying causes are inherently biased. It is biased by my training, my experience and my belief system. So, what is the solution?

I believe it is up to the practitioner to continue questioning and improving his/her techniques, assumptions and though processes. From the patients view, he/she should be given a clear understanding as to “what part of the iceberg” is being evaluated and treated by their practitioner.

Sometimes treating “the tip” is necessary to achieve much needed symptom relief. Sometimes this approach may be the only reasonable one if underlying causes cannot be determined readily or are known but irreversible.

Whenever possible though, searching for and attempting to reconcile underlying causes should be the goal. Ultimately, achieving a state of health that requires little to maintain it other than good diet and healthy living habits is my goal with all my patients.

Read my next blog entry The Leaking Boat and Your Health to continue the conversation.

Dr. Esquivel :