Control: The problem and the solution for all sickness and ill-health
Homeostasis, that process of keeping things in balance, is a process that is essential for life itself. In fact, Jason Fung (2016) describes homeostasis as the defining characteristic of life on earth. There’s a good reason for this: Homeostasis is one example of the more general principle of control.
Control is exactly what it sounds like – keeping things the way they are supposed to be. One of the important aspects of control, however, is that the way things are supposed to be is always established by the behaving system whether that’s a single cell, a brand new baby, or a fully grown individual. As much as we might like to, no-one can decide for another person what the “right way” will be for them.
If people aren’t able to control or keep things the way they are supposed to be, sickness and ill-health will eventually, and inevitably, follow. Sometimes people will feel unwell almost immediately, sometimes it won’t happen until much later. But it will always happen. Control is so important it is essential for health and wellbeing. Control, in fact, is health.
Viruses, bacteria, and parasites can disrupt health on a microscopic scale and we’re all familiar with serious illnesses such as tuberculosis, malaria, rabies, and measles. We might not, however, be used to thinking of these things as control problems but that’s exactly what they are. These unwanted little critters disturb important bodily functions and processes and prevent control at physiological and biochemical levels.
What is perhaps even less well recognized is that compromised control at psychological and social levels leads to ill-health as surely as invading viruses will. Michael Marmot (2011, p. 512) has stated that, if people do not have the conditions that allow “them to live lives that they would choose to live, ill health is an inevitable result.” Words don’t come much stronger than “inevitable”.
An understanding of control explains why “inevitable” is not overstating the case at all. Preventing people from controlling the things that are important to them is preventing them from living as they are designed. In the same way that pouring diesel into a car that is designed to run on gasoline will lead to the car not functioning properly, when people are prevented from controlling, they are not able to function properly either.
Imagine if the place you were living in was always just a bit colder than you wanted it to be, and you had no ability to increase the temperature or put on additional clothing. Day after day you had to go about your business in temperatures that were uncomfortable. The situation might not even be horrendous or diabolically awful. The temperature doesn’t have to be a long way away from what you’d like it to be. But if it’s not right according to your own personal standards, and you have no way to make it right, it’s not difficult to see how this will result in ill-health sooner or later.
Recognizing the particular control processes that are compromised whenever someone experiences a state of sickness or ill-health will allow us to design more effective and efficient treatments. Designing societies where everyone is able to control the things that are important to them should be the goal of all our politicians and policymakers. When some people in a society or a community are routinely restricted or prevented from controlling, sickness and illness will occur and we will all be a little poorer as a result.
Understanding and enhancing control is the best chance we’ve got of building a world we’d all like to call home.
By: Timothy A Carey, Ph. D.