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Vitality or life energy: the heart of wellness.

This month's discussion of wellness will emphasize the notion of our health energies: i.e., vital energy, life force, Chi or Qi, elan vital, or vitality.

Why? It is because many nurses and others experience feelings of persistent tiredness rather than vigor both professionally and personally. "I am tired, so tired." "At the end of everyday I am in a state of exhaustion." "I really need more energy." "I wake up tired." These are the words expressed by countless nurses in America today. Coupled with these statements are complaints from these same nurses about depression, anxiety, inability to concentrate, difficulty with sleep, burn-out, and the overwhelming sense of "being drained." The holistic aspects of personhood--the body, the soul, and the spirit--are encompassed in these tired reflections.

A qualitative study (Ekstedt M and Fagerberg I, 2005) explored the lived experiences of the time preceding burn-out. The researchers queried 8 professional workers (5 women, 3 men, ages 30-56) with a high burn-out score and reported that the meaning of burn-out is understood as being trapped between a self-nourishment drive for invigorating challenges on the one hand and driving responsibilities and demands on the other. When these drives are balanced, all is well. However, when these professionals neglected essential needs, they reported symptoms of energy drain, feelings of guilt, threatened self-image, and bodily manifestations (head aches, muscle pain).

So, what is your health energy state as we move into Spring? Are you at risk for burn-out? Are you already there?

Fatigue has been described as an unpleasant, subjective symptom with a multi-dimensionality rendering it difficult to define and to measure. One nursing study defines fatigue as persisting distress and decreased functional status related to a decrease in energy (Pickard-Holley, 1991). Fatigue may be viewed as an experience opposite to positive life energy or vitality. It has been argued that fatigue is a symptom of an alteration in human life force energy (Paterson, Canam, Joachim, Thorne, 2003). So where is our energy?

Health energy, conceptualized by Western thought as vitality, may be characterized as liveliness or an abundant physical and mental energy usually combined with a wholehearted and joyous approach to situations and activities. Vitality, a positive subjective feeling of aliveness and well-being, has been hypothesized to "reflect organismic well-being and thus should co-vary with both psychological and somatic factors that impact the energy available to the self" (Ryan and Frederick, 1997, p. 530). The dictionary (Merriam-Webster, 2002, p. 1317) defines it as: "1. the peculiarity distinguishing the living from the non-living; the capacity to live and develop and 2. power of enduring; lively, an animated character." Eastern healing modalities, such as Traditional Chinese Medicine (TCM) where meridian theory/acupuncture are rooted, call this vitality or life energy, Qi or Chi. Qi fills the whole cosmos; it is seen as the origin of all life and things which are infused with this invisible life resource. Qi is often characterized as "the one essential thing" and is central to health and healing (Jahnke R, 2002 and Kaptchuk T, 2000).

Human energy can be conceptualized as power or potential power (Becker, 1985). How does this relate to the energy of the human spirit that enables health and well-being? Do we feed our life force (Qi) in the same manner that we feed our body? What role does the human will and the mind play in this life force? How can nurses and others intervene in the area of energy medicine when we do not have the language to understand life force (Qi) in the context of American culture? It seems valuable to examine the balance of life force energy by querying those who are "well" in addition to those who are ill. Attention to vitality and balance in our life force gives opportunity for formulating effective preventive choices and actions that have not been discovered.

Nursing has investigated notions of energy as it relates to health and wellness (Kreiger D, 1979 and Rodgers M, 1990) and many advocate hands-on therapies such as healing touch. Psychology once only concerned with psychopathology has turned towards preventative investigations into vitality as a construct in human wellness (Cowen E, 1991) as it relates to subjective well-being and human potential (Ryan R and Deci, 2001), and happiness (Ryan R, Huta V, and Deci E, 2008).

So what approaches might we consider to restore and sustain vitality? Reiki, healing touch, therapeutic touch, many types of physical movement, any type of massage/ body work, and a diversity of spiritual meditative practices offer approaches to invigorating our inner energies for well-being and healing. Qigong, Tai Chi, and yoga are also modalities that address your whole-person energies. These offer more than the usual "fuel in the tank" and "calorie burning or low carb/low trans fat" diet and exercise programs that most of us fail to enjoy. Check them out! What else might you consider as you seek to maintain and nourish your vitality? When was the last time you did something that you truly enjoyed and left you with that "peaceful, easy feeling" of subjective vitality?

As caring professionals do we all take for granted our health, vitality, Qi, or elan vital? We often keep going until fatigue or other acute symptoms engulf us. Think about the old proverb "you don't miss the water until the well runs dry" or Joni Mitchell's song about, "Don't it always seem to go, that you don't know what you've got 'till it's gone?" (Mitchell, 1969). You are no longer unaware! My challenge to you, dear reader, is to consider what you can do to foster your own healing energy. This boils down to investments in self care--yes, back to personal leadership again! If we don't maintain our vitality, who will? Please, don't burn yourself out!

Web links:

Stress reduction strategies: http://ya-hink-web1.healthink.com/vitality/vod/ShowArticle.asp?ID=15

Walking for fitness: http://ya-hink-web1.healthink.com/vitality/vod/ShowArticle.asp?ID=21

The Healing Touch http://www.ncbi.nlm.nih.gov/sites/

Selected References

Ekstedt, M. & Fagerberg, I. (2005). Lived experiences of the time preceding burnout. Journal of Advanced Nursing, 49(1), 59-67.

Jahnke, R. (2002). The healing promise of Qi: Creating extraordinary wellness through Qigong and Tai Chi. Chicago, IL: Contemporary Books.

Kreiger, D. (1979). The therapeutic touch: How to use your hands to help or to heal. New York, NY: Prentice Hall Press.

Ryan, R., & Deci, E. (2001). On happiness and human potentials. Annual Review of Psychology, 52, 141-166.

Ryan, R., & Frederick, C. (1997). On energy, personality and health: Subjective vitality as a dynamic reflection of well-being. Journal of Personality, 65(3), 529-565.

Ryan, R., Huta, V., & Deci, E. (2008). Living well: A self determination theory. Journal of Happiness Studies, 9, 139-170.

The Center for American Nurses, established in 2003, offers tools, services, and strategies designed to make nurses their own best advocate in their practice environments. Through research, education, and advocacy, the Center offers resources to more than 44,000 nurses, visit www.centerforamericannurses.org.

Susan Vorce Crocker, PhD, RN
COPYRIGHT 2008 Vermont State Nurses Association, Inc.
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Author:Crocker, Susan Vorce
Publication:Vermont Nurse Connection
Geographic Code:1USA
Date:May 1, 2008
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