Back in the day when I worked primarily with the mentally ill, substance abuse and homeless populations, I was introduced to the practice of Harm Reduction.  At the time this approach focused on reducing the negative consequences and risky behavior of substance abuse. For example, clean needles were given to known heroin addicts to prevent the spread of HIV, AIDS and Hepatitis through sharing of used needles.  

    The National Healthcare For The Homeless Council put out a fact sheet in April 2010 called Harm Reduction: Preparing People for Change. https://www.nhchc.org/wp-content/uploads/2011/09/harmreductionFS_Apr10.pdf  

It explains the Harm Reduction philosophy which includes embracing respect, trust and a non-judgemental stance… and helps clients take responsibility for their behavior while helping them make positive changes.  

    I have used the Harm Reduction approach in my private practice and in classes to help patients and students make healthier choices for themselves in difficult areas of concern.  Besides the obvious illegal drugs, like heroin you can include alcohol, smoking and other legal drugs.

Many of my patients decided to abstain from their substance of choice, while others chose a harm reduction approach.  For example, after exploring her relationship with smoking, one of my patients decided she would reduce her habit to one cigarette a day.  All of her parts agreed and she easily kept her commitment to one cigarette per day for over one year. She needed a minor surgical procedure and the doctor told her to refrain from smoking two weeks before the surgery. After which, she decided to abstain from smoking permanently.  

Another common area in which harm reduction has helped me and many of my patients is with food choices.  If there are some foods that you feel are bad for your health but some part(s) of you are not going to quit for whatever reason(s), a harm reduction approach can help.  For me, ice cream was probably my favorite food for the first half of my life. Sugar and dairy did not always agree with my body but my heart and mind often overruled my food choices.  Although I had been doing Asian martial arts and meditation for years my eating habits lagged behind. It was not until 1987 that I was introduced to Chinese herbs as nutritional supplements and to stevia as a healthy sugar substitute that I began to take control of my food choices.  It was a slow process of harm reduction techniques over a period of years. It usually takes mainstream about 20 years to catch up to what many health pioneers were preaching about long ago. Through T’ai Chi Ch’uan and the healing modalities I studied, I was surrounded by more health conscious people and began to make more positive food choices and reduced the negative choices.  Now that mainstream has caught up in many ways and a variety of healthier foods are more readily available, harm reduction has become an easier and more fun process. I remember getting excited back in the day to visit friends in the Bay Area. I’d always want to go to Berkeley to get stuff from Whole Foods and Trader Joe’s.

Take a moment, imagine a time before the internet, before big health food chain super markets were on the east coast.  Even in NYC you had to go out of your way to get organic foods or use your landline to call a company that would ship to you.  Now local supermarkets often have an organic or healthier choice section. I was just telling one of my patients about dark chocolate sweetened with stevia which made his day.  I think you get the picture of how you can apply harm reduction to food choices.

You can apply it to other behaviors that may seem extreme or are not serving you.  One of my patients was concerned about a hobby he had in which he spent thousands of dollars often on the same items.  After looking in his closet, he realized he had bought the same thing sometimes five different times. We explored what was satisfying about the hobby which had a strong kinesthetic and visual connection that gave him a sense of pleasure and peace.  Once he got to the root of how the hobby was serving him, he was able to make less expensive, more targeted choices of what he purchased without sacrificing the pleasure and peace. Did you know that my father and Hippocrates are from the same island of Kos, Greece?  The beginning of the Hippocratic Oath which doctors still recite today is, first do no harm. Whether you are a doctor or just health conscious at the very least help yourself by reducing the harm.