Over the last few years of my practice, I have come across a common thread with many of my patients that I would like to bring to light out of the darkness of the confines of my office. It is that of thinking in strict endpoints, opposites, and absolutes. For common examples, let me use the following: Black or White; Right or Wrong; All or Nothing; Yes or No; and my favorite Good or Bad. This is what is known as a dichotomy in thought. A dichotomy is by definition "a division into two especially mutually exclusive or contradictory groups or entities" and "something with seemingly contradictory qualities". According to Merriam-Webster, related words are also antinomy; conundrum; enigma; mystery; mystification; puzzle; puzzlement; and riddle. Two funny notes on looking up this word on the Merriam Webster website: The initial example is "false dichotomy" and the word that it rhymes with "lobotomy". A medical definition is "bifurcation" or a division or forking into branches…and branches…and branches. So, you ask, how is this harmful to my health. Humor me for a moment.

Black or White: Actually, we all know that between black and white there is 50 shades of grey. Also, we know that what actually black is an absence of all reflected light waves because they are absorbed. White is actually all of the colors of the light spectrum reflected to us making a whole. There are various shades of red, orange, yellow, blue, indigo, and violet. In art, white is the absence of colors used, and black is all of the colors used. Grey is a muddled mess between when some of the colors are used, and there are warm grays and cool grays depending on which colors were chosen.

Right or Wrong: where we definitely have our own compass as to what is right or what is wrong, depending on the subject matter, the shades of grey are wide indeed. There are moral definitions, religious definitions, etc. If anyone has every written an essay for school, you write on a particular subject matter using a variety of sources of knowing, and your grade is at the hand of the teacher, school, and educational institution that makes the rules of your classroom.

All or nothing: Just like the color spectrum, there is a perception of all or nothing, but reality is neither all nor nothing. You can give all or nothing of yourself, but even in your perception of your all or your nothing, it is still not all or nothing because you thought about it putting out of the nothing category immediately.

Good or Bad: This is the big one. It is right up there with right or wrong. It is a judgment of the self, the action, and the object, whatever you are speaking of when we use the common language of good or bad. It is rare in life that anyone or anything is pure good and pure bad. Often, the eye of the judgment on that person, place, or thing is from that person’s cultural background, their religion, their education, etc.

Many scientific teachings in medicine are made easier to understand by creating endpoints, opposites, etc as reference points. Each system, science, and learner is asked to imagine these endpoints as true in order to understand the concept of any one teaching. Examples are like the light example above. Both white and black are concepts, and the reality of those concepts is much more intricate and defined in different studies differently, like art, physics, and religion (light and dark). A medical example may be like the following: Anxiety and Depression; Good cholesterol and Bad cholesterol; Procancerous and Anticancerous; Pre-menopausal and Post-menopausal; etc.

Due to our need to understand opposing forces and endpoints, this nomenclature or naming is translated into medical jargon that then is placed upon the body as if it were a true absolute instead of a false one.

Let me use cholesterol for example. The naming of cholesterol as good or bad is really relative to heart disease and atherosclerosis. Additionally, all cholesterols in the body have a purpose in the body and are rarely spoken about from doctor to patient. All cholesterol has many purposes including the suppleness of all cells in the body, the ability of the body to withstand cold and heat, the transport of lipids to and from various places in the body, and the making of all steroid hormones like Cortisol, Estrogen, Progesterone, and Testosterone. In terms of Atherosclerosis (see Dr. Sedmak’s article), there are many factors involved, and cholesterol overall is not the bad guy in this scenario.

This article is not an article about heart disease in the medical sense of the term. This is an article about a heart disease of a different kind. Dichotomies in medicine, though useful, are creating a cultural language that is internalized into the minds and bodies of people, and is creating another source of stress. It is the stress of being pulled into two, the stress of your self-diagnosis as good or bad, right or wrong. This stress is one of not seeing the connection between all systems in one’s life, in one’s body, and between one’s mind and one’s heart. Seeing our body as a puzzle is truly a more intricate and difficult problem than we realize. When someone is stressed, even if they are in control or seeming control of their stressors, compensation in the body, mind, and spirit (of which are not separate in our waking life) occurs. When one judges the stressors or the compensatory mechanisms to be good or bad, or black and white, there is something that is missed. That something is the very fabric of our lives, because we all function on organs that work with other organs, systems that work with other systems, people with other people, hearts and minds, body and minds, etc. to create something much richer in texture than any endpoint could ever satisfy. We are missing it and it is right here, right now. Plants, for instance, are no more good or bad than the sun is good or bad. People are in and of themselves a mosaic of time and space, experience and exploration. Health is about recognizing the greatness that each one of us possesses, utilizing those things in our environment that fulfill us and support our highest purpose, and doing so with a love for the simple things in life.

So the next time you want to know "is this good for that…is this good for me?" stop and take a breath and re-frame "is this supporting me in my greatness, my highest good, and my vitality?" It is a much different question, and will reveal to you a much different answer.