In the Vitalist Herbalist Practitioner Program, I talk about “root determinants,” which are the big-picture, general things that we do each and every day that determine our relative state of health (or lack of it). These are important things to know when working with clients, but sometimes they’re overlooked by practitioners because they’re considered basic and rudimentary and because there are so many other things to cover in a client intake.
So how do you do an intake in a way that makes sense . . . and so that you’re not sitting there with a person all day long trying to get all the information that you need? How much time is generally recommended for a proper intake that accounts for the five root determinants of health? That’s what I’m going to discuss here in this week’s blog post.
The Five Root Determinants of Health
First, I want to talk about some foundations about the five root determinants of health. These are the things that determine our relative state of health or lack of health at a very general level. Like many things I do, I correlate these with the five elements of Earth, Water, Air, Fire, and Ether or wind.
The Earth element represents the root determinant of health, which is mainly focused on our diet. The foods that we consume every day are important in terms of determining whether we’re healthy or not. This can include eating too much, or eating too little, eating healthily, or unhealthily. Nutrient deficiencies are a huge part of many health issues these days because our soils don’t contain the minerals and vitamins as they used too, so we see things like food intolerances now, leaky gut syndrome, allergies, and so on. Artificial food products and non-organic foods can also affect our health. Another Earth element signature here is the basic foundations of our home and our structure and shelter. It’s hard to be healthy if we don’t have an adequate shelter to protect us, as well as having a healthy home, in terms of not having a bunch of mold or other harmful things.
Now for the Water element – this represents our hydration, and not just hydration of water but also hydration of oils. Having proper water and oil intake in the body is critical to a person’s health, as we are humans made from 80% water. This Water element not only includes our hydration but also includes our emotional health—how we process, handle, and manage our emotional reality.
The Air element includes breath and breathing, including analyzing shallow breathing, deep breathing, and the overall state of our respiratory system altogether. We also look at the health of our mind, our psychological well-being, and whether our mind tends to focus on negative things, whether we perpetuate negative thought patterns, or whether we think positively and have an inspired, uplifted, and healthy, creative mind. This is a very important aspect of our health. You can eat the most amazing diet, be well hydrated, but if you’re thinking negative thoughts all the time, you are not going to feel very vital. The health of the mind is very important.
The second aspect of health with the Air element is sleep and the way it rejuvenates our whole body, including our nervous system. People who don’t get adequate amounts of sleep suffer from health issues and fatigue can be very challenging for people. So be sure not to overlook sleep when you’re working with people.
The Fire element represents exercise as exercise stimulates the heart rate and blood flow. This is why when you do vigorous exercise, you feel hot, and start to perspire. This is the activation of our inner Fire element and exercise is important for our health, strength, and vitality on a number of different levels. Exercise is imperative not only for our physical health but also for our mental and emotional health. I can’t tell you how many people feel so much better emotionally when they just get moving. With pent-up emotion, especially things like irritability and anger or frustration, or even depression, sometimes you’ve got to move it out. You’ve got to get that blood moving and move through it.
Last is the Ether element, which is attending to our spiritual health. I like to think of this as our purpose, having some sort of calling, having some sort of purpose in this life that gives our life meaning. That can take a number of different forms. For some people, their purpose is the work that they do. For others, their purpose is to raise children or to grow a beautiful garden. For some people, their purpose is to be a loving spouse or partner. There are many ways that purpose can manifest, but it’s about having something in our life that gives us a deeper sense of meaning and connection beyond ourselves. This is a critically important aspect of our health.
You can exercise every day, you can have great mental health, you can have great hydration and emotional health, you can eat amazing, but a life without purpose just feels like something’s missing. It’s hard to feel truly alive, fulfilled, healthy, and happy on all levels if we don’t have that greater sense of purpose.
So that’s a quick recap of the five root determinants of our health. These are obviously very general and basic. We all know to drink more water. We’ve all heard things like “You’ve got to sleep well. You’ve got to eat. You’ve got to exercise. You’ve got to drink water.” These are all no-brainers. But because they are no-brainers, it is easy for us to forget about them. So when we’re working with a client, we’ve got to treat the cramping, or the bloating, or the headaches, we can’t forget to ask, “Are you hydrated? Are you getting enough sleep?” and take a deeper look into these simple areas of everyday life.
How Long Does a Proper Intake Last?
Proper intake is on a spectrum. It depends on what someone is coming to you for. Sometimes people come to you and their primary complaint is a physical health concern. Sometimes people come to you and they have more of a psychological, emotional health concern. Sometimes people come to an herbalist and they’re looking for guidance, they’re looking for a greater sense of connection and purpose.
The important thing to remember is to always address the primary complaint, which is usually the main focus of that first initial consultation. But it’s always good to get background information and get to know any major surgeries, accidents, family history, inherited family stuff, or issues they’ve had in their past. Get a big, broad scope. But for the initial work with a client, you want to make sure that zoom in on their primary complaint, which can be difficult sometimes!
Sometimes those primary complaints will lead to the root determinants of health, and some of those issues will require a whole separate session. For example, when I do a session with a client about diet and nutrition, that’s usually an entire hour-long session with them where I’m diving deep on what their dietary habits are like, what kind of foods they eat, what their patterns and habits around food are, what time of day they eat, and not spending a whole tun of time on other areas of their health or life.
The length of a consultation depends on the person and the situation and on what the primary complaint is. It also depends on what the goals are for the client. It can be awkward if someone comes to you with headaches and you end up spending a whole bunch of time talking about a fight they had with a friend last week or maybe a foot fungus they’ve had since they were a child. It’s important to stay focused and not stray away from what the purpose of the meeting was… which can be challenging! Because there will be other things that need attention but will need further follow up sessions to attend all your client’s health concerns.
Focus on the Client and Long-Term Health
So, I like to think of these five root determinants of health on a larger time span of your work with the client. They come to you with their primary complaint, and you work with them through it. Maybe you address different attributes of these determinants of health. Maybe you find out they’re not sleeping very much, or you find out they need to correct their diet a little more, and those things start getting fine-tuned as you spend time working on these complaints with your client. And maybe eventually those primary complaints start to clear up, and they reach a new level of health, a new level of vitality, a new level of energy, great! So that’s when you can start exploring some of these other dynamics. Perhaps now that their physical health is cleared up a little more, they now have the energy and the vitality to focus more on their emotional health, their psychological health maybe even their spiritual side of things. This is where I see true holistic healing really takes place. Because you and the client are able to work through all the aspects of health.
A good way to think through these five determinants is that they’re building blocks. They might be important to consider for the primary complaint. Other times they might be just fine-tunings that help clients dial in and refine how they live their life every day to reach a greater level of health.
From my approach to herbal medicine, that’s what I want for the people that I’m helping. I don’t just want them to not have headaches anymore. I want them to feel good. I want them to feel healthy. I want them to feel alive, and I want them to have good energy and to wake up in the morning feeling rejuvenated and feeling like their mind is clear and their heart is open and strong. I want them to feel like they’re working toward a goal or a dream or an aspiration that gives them a greater sense of purpose in their life and a feeling of fulfillment. I believe herbal medicine can help us with all of those stages of our healing work that we all have to do in this life as human beings.
So the short answer I suppose is that there is no set amount of time for an intake interview, and it will differ from person to person. But I encourage you to be flexible and pay attention to the person sitting in front of you. Become acutely aware of what their needs are and how you can best help them.