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To the Heart of the Matter
That the factors, which damage the heart, are the physical, psychological and social challenges
that accompany the demand for effort.
In their conclusion they reason that the treatment of CV illness should include: “…[psychological]
strategies for anticipation and prevention …[of CV illness] … integrated with the reactive tactics of
conventional cardiovascular medicine and surgery" (Nixon & King 1997, p. 63).
Similarly, in the field of psycho-physiological research, many studies have been carried out
examining the relationship between emotion and cardiovascular illness. This work generally
concludes that negative emotional states disturb the CV system control mechanisms and predispose
to CV illness (Scheier & Bridges 1995); (Hemingway & Marmot 1999).
The general understanding of the approaches that are presented here can be described as being
holistic, in that they argue for a non-specific aetiological approach, which encompasses psycho-
social aspects in the description of CV activity and disease processes.
A philosophical discussion of the cultural influence of the reductionist biomedical approach to CV
illness adds another perspective to the holistic argument. In removing the holistic understanding
from the discussion of heart disease, modern biomedical science has effectively reversed the image
of the heart as a socio-symbolic icon. Hillman (1979) writes: “The heart is still king, still the pace-
maker, but now a tyrant, for heart and circulatory diseases are ‘the number one killers’, usually
striking in the night. It cannot be trusted; we cannot have faith in the very organ which once was the
source of faith”.
The holistic attitude to CV illness is at the centre of the proposed hypothesis, as it offers a multi-
aetiological approach which can facilitate the comparison and discussion of the concepts of
understanding employed within traditional WHM and PNE.
It could be debated that this evaluation of the comparative understanding of traditional WHM and
the modern biomedical approach to treatment could be interpreted as a non-holistic process, in that
the subjects under discussion are placed in a juxtaposed objective perspective. However, it is not the
aim of this work to argue for a holistic approach, but to demonstrate a basic commonality in
understanding, which transcends the context of the concepts, which are employed in the discussion.
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