Health is a 4 Quadrant Affair

Health is a 4 Quadrant Affair

Health is a 4 Quadrant  Affair


Perhaps it doesn't need stating, but then perhaps it does; that we need to look at health in terms of all 4 quadrants of the AQAL model.

It is a sad fact of modern/conventional (as opposed to post modern/post conventional) health care that we look at health from a very reduced and limited view point. In fact for a large percentage of those following a western health (read illness) model, only one quadrant is given any serious consideration. The others are either discounted or fruitlessly reduced to 'belonging' to the only quadrant  recognised by 'scientific medicine'.

For those of you who haven't come across the AQAL model before you can look at any of Ken Wilber's work, a short intro to which is here

This model is the simplest model that can describe the truly essential elements of a wholistic approach or view of life. Looking at all the quadrants, lines, levels, states, and types of a given individual or situation. It involves the cultivation of body, mind and spirit in self, culture and nature. 

The quadrants look at the internal and external aspects in the individual and collective aspects or dimension perspectives of every holon or whole/part such as atoms, molecules, cells, organs, organisms. Only by looking at these 4 irreducible aspects as co-arising and affecting and supporting one another, do we start to get a complete picture of what is going on.

In health, our orthodox or conventional model is only looking at the Upper Right (UR)quadrant, the external of the individual. the physical organism, using physical intervention. That which can be seen and observed and measured from the outside on a person. But even this partial view is still very partial because it fails to recognise and include the energy systems of the body which also belong in this quadrant, the meridians, chakras and subtle bodies. Although the measurement of these systems is not conventional, it is something that can be done from 'outside' the individual.

The view from here is that all dis-ease has only physical origins and therefore only needs physical intervention. But as we increasingly see, this is a failing system that is not dealing with health and disease in many cases. The answer to why is simple, its is ignoring the other quadrants that exist and must therefore have a contribution to both the cause and the cure of dis-ease.

The development more formally over the last 30 years of forms of alternative/complementary care and the rise of psychoneuroimmunology and metaphysical causation show us quite clearly that a persons individual interior states (emotions, attitude, intentions etc) have a significant role to play in both cause and treatment of illness. This represents the Upper Left (UL)quadrant, the interior of the individual which cannot be reduced or removed if successful treatment is to be given. In fact if successful prevention of illness is to to reached then this is a key area to work in. It has now been shown time and time again that interaction with and healing in these areas can play a significant role in management and healing of a person.

But we must also remember that our state of mind is not something created in isolation, it has grown with us through our exposure to our culture and the beliefs and worldviews that are held within it.  How our culture (in the Lower Left (LL) quadrant) views an illness (with compassion or scorn) can have direct and significant impact on how any individual or society copes with that illness. This can then have a direct and significant effect on the individual's state of mind regarding the illness (UL) which will then change the progression of the illness at a physical level (UR). The lower left also contains the range of inter subjective interactions that may take place with an individual such as communication with Doctors or healthcare providers, attitudes of friends and family to the illness and how that is expressed or communicated to the individual. The cultural acceptance (or not) of the illness can also have a significant affect here. If there is rejection of the individual because of the assumptions about how the illness was created (e.g.AIDS) or perhaps an over acceptance of the illness such as the fear that surrounds cancer and the inevitability of it killing you if you don't use the conventional methods of treatment. Or the repeated lack of dietary advice for say colon cancer patients who are told by their oncologists that it makes no difference to their situation. All of these factors have some level of both causative and corrective quality to them, simply because every occasion has the four quadrants present.

In this, as with all the quadrants, we also need to focus on those aspects that can effectively be engaged such as communication between care providers and the individual, support from friends/family/support groups and an overall understanding of how cultural judgements have an effect on health and illness. For example studies show that cancer patients in support groups live longer than those with less support.

The Lower Right (LR) quadrant highlights all the material, economic and social factors that are perhaps the least recognised to have both a causative and a curative contribution. For example a social system that cannot provide food will kill you. More functionally, lack of suitable nutrition (LR) will not provide the body with the resources it needs to heal (UR). This would also affect state of mind (UL) due to inability of the body to produce neurotransmitters because of the lack of nutrition. So a social system that cannot deliver the treatment options to you for the illness you have will also affect your ability to overcome it. The LR quadrant also includes such factors as economics, insurance, social delivery systems and things like environmental toxins. Aspects of both cause and cure are seen in each quadrant.

But remember none of these quadrants arise in isolation. Wilber's term for this is that they 'tetra-arise', they all happen together. All 4 quadrants have both causative and curative aspects to them which need to be considered together to give the most complete assessment for the 'why' of any illness as well as the source of the 'how' we change that.

So regardless of the cause of the illness we must ensure that we are considering all the physical (and environmental), emotional, mental and spiritual aspects if we are to create the most complete treatment programme we can. This by the nature of its inclusion will also be more likely to give the most stability to an individual after illness and potentially create the conditions to prevent further dis-ease in the future. The most comprehensive and effective treatment plan will always take into account these dimension perspectives. Giving us a much more complete model of health, where every tool has a value and a partial place in the health of the holon. To continue to ignore these aspects or perspectives will continue to give us a failing health system which is limited in its ignorance of the complete range of factors contributing to health and dis-ease.

Back to blog posts