Vecka 24-2013: Hälsa och ohälsa

Vivi: Ibland upplever människor det som en lättnad då de får en diagnos för att deras symptom då får en förklaring. I en bok jag läst betonar författaren att en diagnos från början är en absolut förutsättning för att kunna ge en människa adekvat hjälp. Vad säger du om detta?

Peter: Det är ofta bra att ställa en arbetsdiagnos, d.v.s. skapa en hypotes om vad som kan ligga till grund för de aktuella problemen. Men den är inte inristad i sten. Den kan helt naturligt ändras allteftersom man gör framsteg.

Vivi: På vad bygger du det du kallar en arbetsdiagnos?

Peter: Jag bygger den på ditt sätt att bete dig. Det som enligt min erfarenhet ger bäst resultat är när jag begränsar mig till att diagnostisera beteenden och de tillstånd dessa genererar men inte människor i sig.

Vivi: Men människor i sig kan väl ha något fel?

Peter: Nej, vi människor kan enligt mitt sätt att se inte vara sjuka. Beteenden, tillstånd och kroppen kan vara icke-fungerande men inte du, d.v.s. människan bakom dessa, du som skapar dem. Vi kan t.ex. producera negativa tankar som kan skapa negativa beteenden och mentala och fysiska ohälsotillstånd. Men sådana går att förändra.

Vivi: Det finns väl heller ingen skarp gräns mellan hälsa och ohälsa. Övergångarna mellan dem är flytande.

Peter: Ja, de kan ses som poler på en sammanhängande linje och du kan befinna dig var som helst på linjen på olika avstånd från dess ytterlägen. Men återigen, hälsa respektive ohälsa är inte kopplade till oss som människor utan till de beteenden och mentala och fysiska tillstånd vi skapar.

Vivi: Och du säger att beteenden och tillstånd går att förändra.

Peter: Ja. Och eftersom det är så håller inte diagnoser över tid förutsatt att du får den hjälp du behöver. Efterhand som du förändrar ditt tänkande till det bättre i den grad det behövs förändras även dina beteenden och de tillstånd du befinner dig i.

Vivi: Behöver man alltid gå via tänkandet?

Peter: Nej, du kan även gå via andra beteenden som man gör i beteendeterapi och tillstånd som man gör i hypnos. Man kan också förändra olika beteendemönster och tillstånd genom att öka kroppens rörlighet som man gör t.ex. i feldenkraismetoden.

Vivi: Du kan kanske placera mina beteenden någonstans på den sammanhängande linjen med positiv respektive negativ pol.

Peter: Ja, det viktiga är att dina beteenden är tillräckligt funktionella, d.v.s. ändamålsenliga i den situation och i det sammanhang du befinner dig i.

Vivi: Jag tycker din inställning till människors möjlighet att förändra känns hoppfull. Det är så lätt man hamnar i grubbel över vad man egentligen har för ”fel”.

1 Eve A. Wood: There´s always help: There´s always hope. CA: Hay House, Inc. 2006.
2 Se Aaron Antonowsky: Hälsans mysterium. Stockholm: Natur och Kultur 2004. Förf. anser att dikotomin hälsa-ohälsa borde ersättas med ett s.k. salutogeniskt perspektiv, d.v.s. att man ser hälsa-ohälsa som ett kontinuum och att man bör undersöka ”var varje person vid en viss tidpunkt befinner sig på detta kontinuum” (s. 24).
3 Moshe Feldenkrais: Awareness through movement: Health exercises for personal growth. (reprinted) Penguin Books 1988.

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