Stage 1: Prevent Illness

(Or better yet, maximize health capability) including through self-care, wellness, and human services support (if needed) to counter social and holistic determinants of health

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Traditional, Integrative, Holistic

The first stage is prevention—the work of building a foundation strong enough that the illness cascade either never starts or never starts again. It answered the question: which sicknesses are people like me most prone to developing?

Prevention was the stage I didn’t know I was in until I’d already left it. Looking back, I could always find the stretch where the vulnerabilities were present and the stressors were piling up—the window where a thoughtful intervention could have interrupted the sequence before it reached compensation. For anyone not yet in crisis, the goal is enough self-knowledge to mitigate inherited vulnerabilities and keep active stressors below the tipping point. For anyone in crisis, it is keeping that crisis from knocking over more dominoes. For anyone in recovery, it is a return—taking everything the journey taught me and using it to protect what I’d recovered and build something sturdier than before.

Prevention is not passive. It is the ongoing practice of understanding my inherited vulnerabilities across all seven domains so I can support them indirectly or strengthen them directly, and then making lifestyle choices that kept my stressor load under the threshold where compensations form.

Stage 2: Contain the Crisis

Including with pharmaceutical, technological, or surgical intervention (if needed) and social support

Best aligned care sectors: Healthcare
Best aligned care models: Western

For many of us, we don’t know we’re on an 8+4 Complex Illness Healing Journey™ until we’re already in crisis—a collapse in functioning, a cascade of worsening symptoms, a system-wide breakdown that makes the old life impossible to continue. That was my entry point. When the journey begins here, the work is not cure; it is containment. This stage answered the question: what must I do right now to stop the bleeding?

A crisis happens when inherited vulnerabilities, aggravated by active stressors, force temporary functional compensations. Left alone long enough, those compensations harden into permanent dysfunctional programs that surface as the symptoms of complex illness.

My goal in this stage was to stabilize enough of those programs to halt the deterioration and create the conditions for Stage 3 (Activate Healing Program) to become possible. For me that meant naming which of my symptoms was making things worse, and trying to devise emergency strategies to mitigate them. The nervous system and the cognitive bandwidth that deeper work requires simply weren’t available to me in the middle of acute collapse, and trying to force them only cost me time, precious energy, and hope deferred.

Stage 3: Activate Healing Program

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Holistic, Integrative, Traditional

Before any of the deeper work could begin, one condition had to be met: my body had to believe it was safe enough and spacious enough to heal. This stage answered the question: what kind of environment did I need in order to get better?

My nervous system runs on a basic triage rule—survival before repair. A body stuck in permanent emergency mode, flooded with cortisol and adrenaline and given no margin to rest, will not spend resources on the slow, high-effort work of healing. It can’t. It’s too busy staying alive. Activating my healing program meant building enough safety, slowness, and margin into my life that my system shifted—first tentatively, then more fully—out of survival and into repair. That shift was spiritual, psychological, and physiological at once. Spiritually and psychologically, it took a willingness to let my status quo be disrupted: to let the symptoms surface, the grief move, the truth come out, in pursuit of something better. Physiologically, it took a real drop in the pace and pressure of my days.

I activated my own program mostly by accident—leaving a high-pressure consulting career, moving to Texas, starting a graduate program that demanded enormous self-reflection, and putting distance between myself and my heaviest psychological stressors. My body’s healing program finally switched on because it had been handed enough margin to do so, and the first thing it did was surface every symptom it had been suppressing for years. That was disorienting and frightening. It was also the beginning of everything. I don’t share it as a template—only as one example of what activation can look like: messy, unplanned, often disguised as crisis before it reveals itself as healing.

Activation can arrive a hundred different ways, and mine came dressed as catastrophe. What held constant was the non-negotiable core of this stage: I had to slow down enough to let my body speak to me through its symptoms. That meant breaking my agreement with the taskmaster inside who insisted, I need to earn my own income! I need to be productive! I need to adult! The slowdown was more like a screeching halt, but it wasn’t permanent—just enough that my body stopped spending every resource on getting through the day and started spending some on getting better.

What this stage looked like changed with each season of my life. When I was single, it meant moving back in with my parents so I could save my limited disability income for the care I was paying for out of pocket. When I caught myself postponing my whole life until I’d found my future husband, I realized I had to start healing then, before adding anyone else to the mix—the alternative was finding my partner and then losing the relationship to an illness I’d never addressed. I chose to invest in myself first, and my husband still thanks me for it. As a house-parent of young children, it meant arranging childcare a few hours a week for journaling, prayer, crying, walking, soaking in the tub, tremoring, and therapy—trading childcare, negotiating with my spouse, working a small remote job to pay a sitter, whatever it took, because the alternative was caring for everyone but myself and dying early. As a working parent putting in sixty-hour weeks, it meant downshifting to forty and giving ten of the recovered hours to my healing and ten back to my family. When I had to earn less to do it, I did—the alternative was to die rich and early, and leave my family poorer for it.

Once I’d made the time and space, I started two-way journaling. I wrote about old hurts, current symptoms, anything that felt important. I asked myself and my Higher Power: how healthy is each of my seven domains? Where are the hidden wounds? How is the state of one domain affecting the others? Where do I begin? Then we dreamed together about what fully healthy looked like for me—so I’d have a destination to aim at and a reason to keep going through the hard seasons.

Stage 4: Promote Health

Including improvements in sleep, nutrition, toxin load, movement, light/outdoor time, spiritual connection, self-talk, social interaction, and stress management

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Traditional, Integrative, Holistic

Once my healing program was active and the acute crisis had stabilized, the long, steady work of promoting my overall health through lifestyle optimization. This stage answered the question: how could I give my body the best chance to be healthy? The core work was reducing active stressors and mitigating inherited vulnerabilities across all seven domains through daily choices I could make on my own, without outside intervention.

It was a disciplined reconfiguring of how I lived—the spiritual practices I kept, the thoughts I cultivated, the sleep I protected, the air I breathed, the food I ate, the water I drank, the products my skin absorbed, the place I lived and the home I kept, the cookware I used, the clothes I wore, the medications I took, the sun I took in, the resources I grew, the family I built, the friends I kept, the affection I gave and received, the neighborhood I rooted in, the purpose I chased, and the mark I wanted to leave. It was the work of pulling out as many of the inputs that kept my system chronically aggravated as I could find, and replacing them with the inputs my body was actually built for. I later discovered that there is an area of medical practice called Lifestyle Medicine that covers these bases.

This stage mirrored Stage 1 (Prevent Illness), but I was doing it after a crisis instead of before one, so early on the weight fell harder on reducing active stressors. The other difference was that I was now doing this work knowing exactly what my system looked like when it was overwhelmed. That knowledge turned out to be one of the most useful things complex illness ever gave me, because symptoms tell a story—and once I was willing to receive that story, it pointed me straight toward the work that was actually mine to do.

Stage 5: Cure Root Cause

Including addressing trauma, genetic, epigenetic, event-triggered, and social contributors to illness

Best aligned care sectors: Healthcare
Best aligned care models: Traditional, Integrative, Holistic

This was the investigative heart of the journey, and the stage that spoke most directly to the question every sick person carries: how did I—precisely—get sick? The work here stopped being general. It was no longer a statistical game of hedging my bets on what works for “normal” people. It became a precision game in which I had to find my own root cause: the specific mix of my inherited vulnerabilities and my active stressors that drove the functional compensations that cascaded into the dysfunctional programs that showed up as my particular crisis. And as I hunted for that root cause, I kept asking the second question: what would curing this specific cause actually require?

(Why? Because population statistics works by averaging observations across a sample, which tells me how often people grouped with me tend to get sick—or tend to respond to a treatment. What it can’t tell me is where I, specifically, will land. A bell curve says I’m most likely to sit near the average and least likely to sit out at the edges, but “most likely” is a fact about the group, not a verdict on me. The underlying problem is which group I even belong to: reclassify me—for example, out of the “white women in their 30s” group to “female combat veterans” to “minority children of post-communist immigrants” and the odds move with me. So the numbers might be a starting estimate for my case, but never a prediction of it—which is exactly why I had to stop playing the statistical game and start playing the precision game.)

This work needed enough stability to do the investigating, which is why it came after Stage 2 (Contain the Crisis), Stage 3 (Activate Healing Program), and Stage 4 (Promote Health) rather than before them. It also took honesty, courage, and usually skilled guides, because root causes are almost never comfortable to look at head-on or alone. They’re the things I’d spent years compensating for precisely because looking at them directly felt unbearable.

Each of these discoveries was a big shock to my system, but these root causes were worth finding, because a functional compensation or a dysfunctional program addressed before its root cause simply comes back. (e.g. This is why we have cancer remission, yo-yo dieting, and generational cycles of abuse. The pattern is everywhere.)

Stage 6: Clear Compensations

Including releasing stored up emotional biochemicals, fascial casting, and chronic pain systems

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Traditional, Integrative, Holistic

Once root causes were identified and getting addressed, the work of this stage was the deliberate healing of the functional compensations that had grown up around them. This stage answered the question: how had I worked around the pressure in my life?

My compensations were habitual coping strategies—choices I’d made to dull the pain and keep going—which meant they could still fire even after the root cause was cured. That’s why they had to be named, understood, and released on their own, gradually, as the wound underneath them closed.

This was often the most demanding part of the journey—spiritually, psychologically, and physiologically—because compensations feel protective. They formed in the first place to meet a need that was real and significant. Letting them go meant trusting that the healing underneath was solid enough to make them unnecessary, and that trust did not arrive all at once. It built incrementally, as I gathered evidence that the wound beneath the compensation was genuinely closing.

Stage 7: Reset Programs

Including reprogramming nervous system, hormones, cellular metabolism, and other responses

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Traditional, Integrative, Holistic

This is the most visible part of the journey. When functional compensations go unaddressed and reach a tipping point, the system can no longer carry their weight and starts failing more broadly—and that broader failure is a dysfunctional program. This stage answered the question: how has my body built a new “normal”?

I learned to recognize dysfunctional programs by the symptoms they presented: the depression that wouldn’t lift, the fatigue that made an ordinary life impossible, the immune system attacking its own tissue, the gut in revolt, the insomnia, the relationships that kept breaking the same way, the nervous system that couldn’t find baseline. The Western care model sorts these symptom-clusters into diagnoses. I have found that symptom-based naming is less helpful than root-cause-based naming, so I rename these in my head when I’m pursuing healing from them.

Resetting a program required every upstream stage to come first. This is why aiming straight at the symptoms—with medication, technology, physical manipulation, or social support—never cured the illness for me; it only bought temporary relief. More often than not, what a care professional called Stage 7 (Reset Programs) work was really Support A (Manage Symptoms) work disguised under a more hopeful name. The reset only held once the root cause was cured and the compensations beneath it had been cleared.

Stage 8: Graduate to Self-Care

Best aligned care sectors: Wellness, Healthcare
Best aligned care models: Holistic

This was the whole point: to graduate to lower and lower levels of care until the only thing required to stay healthy and thriving in a given capability was my own self-care, through an optimized lifestyle that promoted my overall health. This stage answered the question: how could I do less to get more health?

In the Western care model, care levels are organized by intensity—from disease-expert hospital inpatient or outpatient (quaternary care) to regular hospital inpatient (tertiary care) down through specialty and outpatient services (secondary care) to the general practitioner (primary care). The system steps a patient down toward the least intensive setting that’s still appropriate. What it doesn’t formally include is a level below primary care; it bottoms out at the general practitioner, not at the patient managing their own health. Self-management gets discussed—the chronic care model’s “self-management support,” the World Health Organization’s “self-care interventions”—but Western care doesn’t treat self-care as a formal level, or as the destination of the journey. (It probably should.)

I’ve been through the 8+4 Complex Illness Healing Journey™ so many times now that I rarely need primary care, let alone anything above it. My whole being has learned to do fewer interventions from outside me to get more health within me. I now live in a near-constant state of activating my own healing program—routinely spotting the signs of an inherited vulnerability, an active stressor, a root cause, a functional compensation, or a dysfunctional program on my own. From there I research my options and build a personalized healing plan, soup to nuts: the behavior changes I need to make and the outside interventions I need to pursue.

To give you a comparison between early on in my journey and my current journey: in the first two years of my journey I overhauled my entire life and received eight different kinds of healing intervention to get on track; in the ten years since, I’ve run more than fifteen or twenty on my own. The interventions I do for myself today are more effective than what most care professionals could expect from doing the same thing for me because I know myself better than any of them. I’ll usually see a care professional once or twice to learn how they think and what they do, then carry it out myself in a more sustainable and affordable way. And I no longer feel that old sting of disappointment with a new care professional who doesn’t understand my care needs, because I’ve learned to discern the right provider, the right treatment, and the right time for me.

Self-care, then, is not just better lifestyle choices or remembering my vitamins. It means becoming my own primary healer, and calling on other care professionals only when I already know their services will work.

Support A: Manage Symptoms

Including with pharmaceutical, technological, or surgical intervention (if needed), wellness services, and social support

Best aligned care sectors: Wellness, Healthcare, Human Services
Best aligned care models: Western, Traditional, Integrative, Holistic

Symptom management ran alongside every stage of my journey. Its job is not to cure—it is quality of life and crisis containment. This support answered the question: how could I feel better while I was doing the harder work?

Good symptom management lowered the physical and psychological drag of illness enough that I actually had the capacity for the deeper work in the eight stages. It also kept me from stacking new compensations on top of unsupported symptoms, which is its own road back into crisis. Needing symptom management didn’t mean I wasn’t healing. It meant I was healing inside a body that still hurt—which, honestly, is the only condition most healing ever happens in.

So symptom management was anything that eased the experience of a symptom without curing the root cause, clearing a compensation, or resetting a program. None of it touched the root cause, but all of it made life bearable until I could find and fix the cause myself.

Support B: Meet Social Needs

Best aligned care sectors: Healthcare, Human Services
Best aligned care models: Traditional, Holistic (and, increasingly, Western through the Social Determinants of Health)

Social support ran alongside every stage, too—and its job was connection and carrying capacity, not cure. This support answered the question: who was walking with me on my healing journey?

What good social support did was spread the weight of illness across more than one set of shoulders, so I had something left for the eight stages. It also held off the isolation that quietly worsens every other symptom and sets up the kind of crisis a person ends up facing alone. Leaning on people was not weakness or dependence; it was me healing the way social creatures are built to heal.

In practice, social support was anything that gave me connection, a hand, or a witness to what I was carrying—without curing the root cause, clearing a compensation, or resetting a program. None of it reached the root cause, but it kept the journey survivable until I got there.

Support C: Augment Basic Needs

Augmenting basic needs includes food, water, clothing, and shelter. These needs must be met before anyone feels safe enough to activate their healing program.

Best aligned care sectors: Human Services
Best aligned care models: Western, Traditional

Healing is impossible without the basics of human life. This support was the external scaffolding underneath everything else—food, housing, income, safety. It answered the question: what help did I need just to survive today?

Just as for a lot of us with complex illness, the capital health I had before getting sick collapsed under the weight of my getting and staying sick. This support was about reaching for the financial, community, and government resources that let me meet basic needs when illness had wrecked my capacity to meet them alone—disability support, community aid, crisis grants, housing assistance, vocational rehabilitation (academia and entrepreneurship included), or the plain physical help of people who loved me.

Getting housed, fed, and cared for didn’t cure a root cause, clear a compensation, or reset a program—but it kept me from sliding into homelessness and everything that comes with it.

There was no shame in needing this. It is a biological fact that hurting people eventually can’t care for themselves; that is exactly why we are social creatures, built to be picked up when we fall. The trap is staying here—getting basic needs met by others without ever moving through the eight stages—until dependence on others calcifies into what some have called toxic charity.

Support D: Accommodate to Abilities

Best aligned care sectors: Human Services
Best aligned care models: Western, Holistic

Complex illness shows up as symptoms—some temporary, some permanent—that may need accommodating until they’re cured. This support was about restructuring my life, environment, relationships, work, and goals so I could thrive inside my actual capacity instead of waiting for full recovery to start living. Accommodating to my abilities was never resignation; it was wisdom. It asked: given my current capacity, how can I build a life that plays to my strengths?

The answers kept changing as I healed. Accommodations I couldn’t live without in Stage 2 (Contain the Crisis) were unnecessary by later stages. Over the years they included: help with transportation, modifying my house for fatigue, using screen-readers to read to me, having a job with a hyperflexible or part-time schedule, finding low-stress work with a safe workplace culture, longer rest periods, remote worksites, on-site childcare, and the everyday use of earplugs, dark glasses, or medical equipment (including blood glucose monitors and nervous system regulation devices) on the job. The most effective accommodations for me weren’t the ones that only worked around a limitation—they were the ones that accounted for my limitations and my strengths at the same time.

When I had to build a business that fit both my limitations and my strengths, I got to design a role that was part creative and part technical, part indoors and part outdoors, part social and part solitary, part physical and part sedentary, part flexible and part scheduled. That became the hyperflexible, remote management model I still offer my Benes Companies teammates today. This is also why I wish that promoting entrepreneurship for people with disabilities was a norm in our society.