How to Become an Agent of One's Own Healing Processes: Self-Management for Chronically Ill Patients in Integrative Health Care

‘Knowing that the most important strategy for fostering health is to engage patients in better lifestyle choices, we seek to develop our skills to activate patients to be self-responsible, to strengthen their resilience, and become captains of their own healing processes’ – this passage was part of the Berlin Agreement of April 2017 authored by the Presidents of the World Congress on Integrative Medicine and Health 2017 in Berlin, Brinkhaus et al. [1], and the other members of the International Organizing Committee. This was one of the first times that fostering of patient competencies was emphasized explicitly within the discourse of integrative health care. Usually, integrative medicine and health focus on medical concepts, professional competencies, and patient-therapist interaction, but the Berlin Agreement formulated the need to enable patients to take over the responsibility for their own health. This statement can be seen in the context of the important paradigm change from understanding a patient as somebody who must be treated to somebody who can develop own skills to mobilize health-related resources. But how can we support people with chronic diseases in developing these skills, to become ‘agents’ instead of staying ‘patients’? When I – coping with a type-1 diabetes mellitus since 40 years – happened to suffer from depression, standard interventions did not help me. My depression was increased by the prognosis of potential fatal pathogenic developments. Nor could I arrange myself with the empathic but helpless reaction of complementary medicine doctors. What was helpful for me was to behave and to be treated as an agent of my own condition. From my viewpoint, this included relevant diagnostic data and medical support in looking for an appropriate treatment option and making my decision to choose unconventional therapeutic interventions, biographic introspection, and finding a new meaning by using spiritual resources. Based on these experiences and knowing the research on patients’ needs in relation to self-management (SM) [2, 3], the question arose to what extent patients can expect health care professionals to provide support, information, and skills development, which are needed to transform patients’ attitudes towards their health care and for them to gain control over their lives. After all, patients with chronic diseases have Published online: August 15, 2017