What Are the Four Quadrants and How Do They Apply to Chronic Illness?

1. Our personal individual interior experience.  We all have thoughts, dreams, beliefs, hopes, worries, and plans.  Our experience of these takes place inside us, in our minds or psyches.
2. Our physical bodies and behavior and the world around us.  Unlike thoughts and dreams, these aspects of life are things we can see and measure.  We have temperatures and blood pressures, ways of behaving, things that we interact with.  All of these take place in the physical world.
3. Our relationships – our internal collective experience.  We have friends, family, and other groups (religious, social, work-oriented) that we interact with.  We also interact with and are influenced by our culture as shown in movies, TV, books, ethnic norms, and so on.  All of these interactions take place in a “we” space.
4. Our systemic world – another collective experience but this time with the exterior systems of the world.   Examples are the political system, the economic system, the transportation system, the medical system.

Knowing about these four quadrants is important. Whatever problem we are trying to solve, we need to look at it in all of these dimensions. For example, if we have a problem with our significant other, both the other person’s and our own interiors will be active: thinking, imagining, fearing, hoping, and so on. We will share a physical (or in some cases virtual) space with things in it that may affect our ability to get along such as other people, clutter, behavioral habits, and so on. Whatever is going on with us is also influenced by our social world, our friends, family, cultural expectations for someone of our gender, age, and so on.  And finally, we will both be affected by the systems around us; for example, if work is stressful, we may come home too irritated to engage in a reasonable discussion. We will be much more successful in negotiating any issue if we take all of these areas into account.

You are probably already noticing how these quadrants may affect illness. Even a simple cold or flu will take place in all four quadrants: you will have physical symptoms (runny nose, cough, trouble sleeping, etc.), you will have interior feelings about it (oh no, I can’t have this now, I feel so miserable), you will have relationship considerations (am I infections, do I look awful to others) and you will have experiences that relate to the systems in your life (can I go to work, is it serious enough that I need to go to the doctor?).

A major illness actually requires you to take these quadrants into account.  If you don’t acknowledge your feelings about it, you can develop psychological issues that interfere with your health; if you don’t take care of your physical body, you may get even sicker; if you don’t deal with the changes that illness wreaks on your relationships, you may find problems arising in your social world; and if you don’t deal effectively with the insurance system or the hospital system, you will experience negative financial and physical effects.

The more you can see into these quadrants and the effects they are having on you, the more ability you will have to manage your illness.

The integral model offers many other ways to view and manage illness which are covered in the course series called The Koan of Illness:  An Integral Approach.  For more information about upcoming programs, click here. 

For a look at how Ken Wilber, who himself suffers from a serious chronic illness, uses these quadrants, click here.