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WHAT THE HELL IS WELLNESS?

Many years ago, long before Belle Gibson was credited as the creator of the world’s first health, wellness, and lifestyle app, a lanky young doctor named John W. Travis went for a walk in Baltimore. He had just graduated from medical school and had moved there to complete a residency at Johns Hopkins University. Bored with much of the curriculum, he frequently visited the campus bookshop.

On this spring day, in 1972, he rummaged through the unloved paperbacks piled on a clearance table and fished out a book, High Level Wellness, marked down to $2.

‘Wellness,’ John mused, and leafed through the opening pages. He paid the shop assistant and took the book home. ‘I didn’t like the word at first,’ he recalls, ‘but I really liked the ideas. It turned out to be the best two bucks I ever spent.’

John Travis was totally gripped. High Level Wellness was a collection of transcribed radio talks by Halbert Dunn, the founder and chief of the US National Office of Vital Statistics from the 1930s to 1960, and an assistant surgeon-general. Dunn’s concept of ‘high-level wellness’ was about promoting the positive aspects of health — the aspects that went beyond simply avoiding getting sick. It made sense to the young doctor. Wellness was the opposite of illness. And just as there were many degrees of illness, there were also many degrees of wellness.

Just because you are not sick or showing any overt symptoms, and you could get a check-up and obtain a clean bill of health, explains John, ‘that doesn’t mean you are well’. You might still be bored, depressed, anxious, or unhappy. All of this can set the stage for physical and mental illness. Stress, for instance, is often linked to the onset of disease. And negative emotional states can increase smoking, drinking, and overeating. Way ahead of its time, High Level Wellness taught that wellness was a continuing pursuit that had a holistic approach: one of mind, body, and spirit. And also other key factors, like the environmental, social, emotional, intellectual.

‘There was another whole dimension besides treating illness,’ he says, ‘another whole dimension that medicine wasn’t addressing.’

By 1975, John wanted to get out of Baltimore. He decided to head west and return to Mill Valley, California, where he had lived during his internship. There, he met a man named Don Ardell, the head of the Bay Area Health Planning Agency, who, it turned out, had also read Dunn’s work and considered him a visionary.

John rented a suite of offices in a renovated building surrounded by redwood trees on the edge of the downtown district, and opened the world’s first-ever wellness centre — the Wellness Resource Center. He began the centre with a part-time practitioner and a shared secretary. Meanwhile, Don Ardell was gaining national attention touring the country speaking about wellness to hospitals and health-planning agencies. The small centre grew to employ about a dozen practitioners and support staff.

There was no diagnosing here, no treating, no prescribing. They didn’t take insurance. It wasn’t that sort of centre. What they did provide for people who came in was a battery of lifestyle questionnaires, followed by a two-hour ‘wellness assessment’. Clients were then given feedback and offered a series of wellness proposals: stress reduction, nutritional counselling, fitness counselling, or a ‘lifestyle evolution’ group, a form of group therapy that emphasised positives. ‘We counselled them,’ John says, ‘and we had people coming back for multiple sessions.’

While Dunn’s wellness philosophy was a set of ideas without much practical application, wrote sociologist James William Miller many years later, John translated the core ideas into a concrete program. ‘It involved learning relaxation strategies, self-examination, communication training, coaching to encourage creativity, improved nutrition and fitness, visualisation techniques, and the like.’

‘The idea was to help clients to know themselves better, so they could take better care of themselves.’

In the following years, John Travis was featured in magazines and prime-time TV interviews. He wrote and self-published The Wellness Workbook, which was later picked up by a national publisher and eventually sold a quarter of a million copies. Hundreds of letters began flooding into their centre; people were hungry to find out more; nurses were asking how they could bring up such novel ideas with their doctors.

‘In those early days, this wasn’t something people had ever heard about … we had to spell the word out over the phone: ‘W-E-L-L-N-E-S-S’,’ John recalls. ‘But it caught on … and I had no idea where it was going to go.’

He didn’t know it yet, but wellness was on the cusp of a tremendous transformation, soon to become a ubiquitous and big-money global economy. Before long, hospital wellness centres sprang up across the US, and then across the globe. Health practitioners started co-opting the word. Wellness treatment spas came into fashion. And so did workplace wellness programs. It even entered the lexicons of the world’s largest insurance companies.

Wellness turned into a hugely popular, high-end, and fashionable pursuit, especially among society’s rich and glamorous. In 2015, the wellness tourism sector was said to have generated $563 billion in revenue, and is growing by 7 per cent a year, making it the fastest-growing form of travel worldwide. According to research group SRI International, which was commissioned by the Global Spa and Wellness Summit to quantify the value of wellness tourism in 2013, more than one in six ‘travel dollars’ that year was spent on these kinds of holidays.

Part boot camp, part yoga retreat, the so-called ‘wellness vacation’ has exploded into vogue, and models and movie stars are setting the trend. Shunning the more traditional good-book-and-poolside-mojito style of getaway, the rich and famous are opting for vacations at luxury seaside wellness retreats, signing onto strict programs that are devoted to bettering body and mind. In April 2016, Australian actor Rebel Wilson was featured in New York magazine after posting a photo of herself on Instagram, sweating, one arm raised victoriously. She was at the end of a gruelling mountain hike in Malibu, California, where she had just done an intensive four-day ‘wellness program’. The program was called Ranch 4.0, at the Four Seasons Hotel, and each day consists of a gentle wake-up with Tibetan chimes, restorative yoga, eight hours of exercise, and a 1,400-calorie organic plant-based diet.

Among other star-studded ‘Ranch’ alumni are A-list actors Selma Blair and Mandy Moore, who have similarly taken to Instagram with mountaintop selfies in their active wear. Not only confined to the Ranch in California, idyllic wellness retreats are flourishing across the world. Kylie Minogue and Naomi Campbell have spent holidays at the SHA Wellness Clinic, on the Spanish coast, just outside of Valencia. Russian leader Vladimir Putin was widely rumoured to have stayed here, too, on an anti-ageing and weight-loss detox diet of grains, beans, vegetables, and a daily cup of miso soup. In the Caribbean, Morgan Freeman and Emma Bunton have both reportedly travelled to BodyHoliday, a wellness-focused resort in a secluded cove on the island of St Lucia. And every year, Kate Moss goes to the LifeCo Detox and Wellness Centre in Turkey.

In 2015, according to the Global Wellness Institute, wellness trips accounted for 6.5 per cent of all tourism trips, but represented 15.6 per cent of total tourism expenditures. This, it says, is because wellness travellers come with cash to blow, spending much more money on each trip than ordinary ‘non-wellness travellers’.

‘Words become buzzwords,’ writes Anna Kirkland in the Journal of Health Politics, Policy and Law, because they capture something salient about a moment in time.

In the case of ‘wellness,’ she says, more of us are living longer and avoiding many of the illnesses and accidents that cut short our ancestors’ lives. And, in turn, the era of purely combating diseases has given way to a new ambition: living well. The guiding philosophy of wellness, at its core, is a deeply appealing one. In our work-obsessed lives, where smartphones and technology ensure we are forever plugged in, wellness encourages us to reflect, to reconnect with ourselves and take time to focus on our physical and mental wellbeing. Sounds good, right? But, in typical buzzword fashion, Kirkland says, wellness has come to mean ‘different things to different stakeholders’. And some of those meanings are more unsettling than others.

These days, John Travis is exactly where you’d expect to find him: leaning back in a faded canvas deck chair, shirtless, eating cereal, in a place called Skinners Shoot, in the Byron Bay hinterland, in northern New South Wales. Home for him, for half the year, is a rusting blue-and-white caravan parked next to a banana tree in a commune with 12 other people. ‘An unintentional community,’ he calls it. When we met him for the first time, on a Skype video call with a two-second delay, John was kicking back on his little deck in the bush.

The combination of slow internet and piercing sun through the leaves of the poinciana tree overhead make it hard to see his face, so he shuffles around. He throws on an old purple-checkered shirt, which he leaves unbuttoned.

Even through the pixilated connection, John beams. He looks much younger than his 74 years, and radiates good health. He is grey-bearded, bald, but lean, with bright skin, clear eyes, and a toothy smile.

He chuckles, and shakes his head. ‘You know, I almost gave up on the word completely.’

Wellness, John says, has devolved, stripped of much of its original meaning. It’s commonplace now to hear the word used to peddle products of all descriptions, which have a tenuous link at best with personal health and wellbeing. Go into just about any pharmacy, or supermarket, or sports event, or even turn on the television, and you’ll probably see the name Swisse Wellness, Australia’s most popular vitamin and supplements manufacturer. Its name used to be Swisse Vitamins, until, around 2015, it was taken over by listed Hong Kong-based company Biostime International Holdings, and someone had the idea to drop the namesake of its core product and tap into something much bigger. Among the $1.6 billion company’s celebrity ambassadors have been Hollywood actress Nicole Kidman and cricketer Ricky Ponting, both of whom have featured on commercials with the tagline, ‘You’ll feel better on Swisse’, despite a federal watchdog finding in 2012 that there was no evidence most people got any benefit from taking many of its products.

Wellness stores today offer body scrubs and facials, and department-store chains now devote entire sections to wellness products. In 2017, Saks Fifth Avenue’s flagship store in Manhattan renamed its second floor ‘The Wellery’. Covering 1,500 square metres, The Wellery provides exercise classes, brow bars, vegan non-toxic manicures, cellulite treatment, salt-detoxification booths, and, in its clothing range, it stocks golf wear and activewear.

Workplace wellness programs are another of wellness’s best-known adaptations today. Half of all US employers with 50 staff or more are estimated to have one in place. But its definition here, too, is largely pared back, often focusing on things such as body-mass indexes, cholesterol checks, blood pressure, and perhaps some yoga, but overlooking many of wellness’s core aspects outside of physical health.

John spent 30 years fighting to get Halbert Dunn’s ideas out into the world, and now ‘there’s a wellness centre on every street corner’, bearing scant resemblance to its original philosophy. It once frustrated him, seeing ‘wellness’ being thrown around and used as a marketing buzzword in a cheap bid to garner attention. The last time he typed ‘wellness’ into Google, the No. 1 hit that came back was some sort of all-natural dog-food brand.

But that’s not what upsets him the most about the devolution of the term. John seems much more distressed by another way that wellness has come to be used: the medicalisation of wellness; the notion that wellness can be used to treat health problems.

‘Wellness is about learning and it’s about growing,’ John explains. ‘It’s not about fixing things.’ Wellness could just as easily be founded in psychology or sociology as it could be in healthcare, he says.

Few cancer specialists dispute the idea that many therapies falling under today’s big umbrella of wellness can have a positive effect on patients. When used in tandem with chemotherapy, radiation therapy, and surgery, things such as yoga, massage, meditation, acupuncture, aromatherapy, and relaxation techniques constitute what cancer doctors now refer to as ‘complementary’ therapies. The Cancer Council advises patients that such therapies can help them manage the symptoms of the disease and the side effects of treatment, as well as relieve stress and anxiety. The famous singer, actor, and cancer-awareness advocate Olivia Newton-John, in 2012, permitted Melbourne’s Austin Hospital to use her name in its new $189 million cancer wing on two conditions: first, that it incorporate the word wellness and, second, that it offer wellness therapies to ease physical, emotional, and spiritual pain. (When, in 2017, Newton-John revealed that her breast cancer had returned, she said she would complete a course of radiation treatment in conjunction with ‘natural wellness therapies’.)

Then, however, there are the more extreme, more cultish, and far more disturbing manifestations of wellness theories in cancer treatment: where wellness becomes a synonym for alternative medicine; where it becomes about curing the disease. Once confined to the fringes of the wellness movement, the advent of social media has propelled this most controversial aspect into a world of its own. A world of pseudoscience, fad diets, juice cleanses, and miracle cures. A world of popular wellness warriors, like Jess Ainscough and her heir apparent, Belle Gibson.

For Ainscough and Gibson, and wellness warriors like them, their interpretation of the word wellness goes beyond the down-to-earth values, and attention to mind and body and spirit and environment. Wellness, for them, often means distrusting conventional medicine and believing in unproven treatments such as extreme dieting, colonic irrigation, or high doses of vitamins and antioxidants instead. You might also hear these sorts of people claiming that cancer battles boil down to having the right attitude or willpower to survive. At best, according to experts at the Cancer Council, these theories can be misleading and expensive, and provide false hope. At worst, they encourage vulnerable people to withdraw from treatments that give them the best chance of survival.

‘Drugs do not cure cancer,’ Ainscough once wrote. ‘They just don’t. Cancer is nothing more than your body telling you that something has got to give. It is the result of a breakdown in your body’s defenses after it has endured years of abuse in the form of a toxic diet, toxic mind and toxic environment. I feel so, so blessed to be wise to these facts.’

When it comes to Ainscough, and the new wave of so-called wellness bloggers who ply their miracle cures online, prominent naturopath Grace Gawler is scathing. ‘Sweet-faced, ill-informed young women,’ is how she describes them. ‘I’m sure — or at least, I hope — they have no idea of the influence and impact they are having on the lives of cancer patients.’ When she was a young woman herself, Gawler, too, was a part of the wellness movement, but this was before there was a strong counter-narrative to accepted science, back when it was about ‘merging the best of both worlds, complementary and conventional’.

When wellness was born out of the 1970s New Age revolution, and popularised by the likes of John Travis and Don Ardell, it was a ‘new path that promised health, wellbeing, longevity, and enlightenment’, Gawler explains. By the end of that decade, wellness had taken a noticeable turn. ‘Some stayed true to the real pursuit of wellness,’ she says, ‘but many saw the economic opportunity of blending wellness, treatment, and spirituality and selling it as a cure-all.’ In the 1980s, Gawler continues, unsubstantiated stories of miracle cancer healings brought about through diets, meditation, and positive thinking abounded. But it was perhaps not until the advent of the internet that wellness and the treatment of diseases became inextricably bound. ‘Access to the internet provided a conveyor belt of opinions, pseudoscience, fake news, and opportunity for anyone to peddle their cyber health-wares. Some had their 15 minutes of fame; some became folk heroes of the online cancer world.’

Gawler is the ex-wife of the controversial Australian cancer guru Ian Gawler, with whom she established a cancer support group in the early 1980s, founded in teachings about nutrition, meditation, and the power of the mind. Ian Gawler claimed to have cured himself of secondary bone cancer in the 1970s, and authored a popular book, You Can Cure Cancer. In more recent years, doubts have surrounded whether he ever had advanced cancer at all, with two eminent oncologists suggesting he in fact had tuberculosis. Ian, who still runs the popular natural-healing program he set up with Grace, disputes this hypothesis. Grace now runs an organisation on the Gold Coast offering ‘cancer navigation’ services to patients.

After four decades working with more than 18,000 cancer patients, Grace Gawler still believes in the benefits of complementary treatments, but is frank in her advice that wellness therapies cannot kill the disease. Grace, who has seen many cancer patients die prematurely because they put their trust in unproven ideas, now describes herself as someone who ‘shepherds’ patients back to conventional medicine. ‘Forty-two years into my career has shown me more misery, pain, and suffering from patients following unproven advice than I could have imagined,’ she says. ‘In the past, patients turned to alternatives when they had no viable medical options. Today, too many patients turn to alternatives, turning away from viable medical options, based on a whim and an ideology.’

For Gawler, the silver lining of the Belle Gibson saga is that it has helped lift the lid on the darkness that has gripped the wellness industry, which, she says, is ‘rotten to the core’. ‘It has lost a connection to the very humanistic values that in the beginning, made it so special,’ she says. ‘For our physical and psychological wellbeing, we need to take a long, hard look at the remedies.’

When the idea of wellness first shot to national attention, and John Travis appeared on the US’s 60 Minutes programme in November 1979, host Dan Rather, sitting across from him, asked a question about wellness that was on a lot of people’s minds: Is it meant to be a substitute practice of medicine?

‘Absolutely not,’ John returned frankly. ‘It is an adjunct to, and quite different to, the practise of medicine.’

Until just recently, John had never heard of Belle Gibson. But he has seen plenty of others like her, and seen them come and go: people who claim to be treating their varied diseases with wellness.

‘What she was doing is not what wellness is. Wellness is growth, and learning about yourself, and expanding your horizons,’ John says, easing back in his deck chair again.

‘But I’m afraid a lot of that falls on deaf ears.’