By Selima Iwilla Harleston Lust, Clinical Herbalist
Published: August 4, 2026 

I think a lot of us come into herbalism through our own health journey.

We turn our health around with plants. Maybe we get off pharmaceuticals. We finally feel better. And somewhere along the way, it's easy to start believing that because herbs changed our lives, they can change everyone else's in the exact same way.

Clinical practice has a way of humbling that belief.

It certainly humbled me.

I can think of a few moments over the years where I had to change—not just my mind, but my beliefs about healing—because it would have been dangerous, and in some cases completely irresponsible, to tell a client they could do this without their medications.

I remember someone walking into the shop straight from the hospital after being treated for diabetic ketoacidosis. She didn't want insulin. She wanted herbs.

I've had more than one person ask if herbs could heal their thyroid, only to tell me they had their thyroid removed years ago and weren't sure if they still needed their medication.

One time I was with someone whose blood pressure was reading at stroke levels. I remember thinking, How are you talking to me right now? How are you functioning? And how are you denying that you have hypertension?

You don’t forget moments like this.

They made me realize how little nuance there is in many wellness spaces. Medical professionals and herbal professionals each hold distinct areas of expertise, and there is often a significant gap between what each field understands and what the average person has been taught about their own body.

And it does not help any of us —not herbalists, not medical professionals, and not the public— to know so little about the full range of modalities and tools that can support our well-being.

Too often, the conversation about herbs and pharmaceuticals is framed as one or the other. Natural versus pharmaceutical. Good versus bad. Healing versus harm.

But real clinical practice is rarely that simple.

Those experiences taught me that believing deeply in plant medicine does not relieve me of the responsibility to recognize when herbs are not enough.

They taught me clinical humility.

Health Is a Spectrum

Health isn't simply healthy or unhealthy.

It's a spectrum.

On one end, you're in your vitality. You feel steady, resourced, and able to move through life with some ease and energy.

On the other end, you're exhausted, depleted, in serious pain, or living with a condition that's actively worsening.

You have to know where you are on that spectrum.

Because the closer you are to the extreme end of depletion—or the more medically urgent your condition—the more likely you'll need conventional medical treatment, including pharmaceuticals, to help you become stable.

And there's no shame in that because stability creates capacity.

Once you're stable, you have the energy and resilience to make additional changes that continue moving you toward health.

Sometimes Physiology Is Just Physiology

Some conditions simply cannot be supported without pharmaceuticals.

The folks with no thyroid? Come on.

You'll need thyroid hormone replacement for the rest of your life.

If you don't have the organ, there are no foods or herbs that are going to supply the hormone it once produced.

Herbs can absolutely support you in other ways, but they cannot replace an organ that no longer exists.

Sometimes the answer is simply physiology.

Capacity is Key

But I actually think it's deeper than, Can I heal with or without medication?

A better question is: What is my current capacity for change?

Every aspect of your life contributes to the status of your health.

If you've got a lot going on, then there's a lot that needs to change.

And you can't change everything at once.

Maybe the medication gets you stable enough to start looking for work.

Maybe it helps you leave the relationship that's been making you sick.

Maybe it gives you enough energy to be more present with your children.

Maybe it creates enough stability to begin therapy.

Maybe it helps you cook healthier meals.

I say this all the time: small changes make a big impact over time.

It doesn't matter where we start the healing journey.

It matters that we continue because every positive change you make supports your health.

Healing Is a Set of Skills

Most people never think about it this way, but healing is a set of learnable skills that most of us were never taught.

Yes, there are practical skills:

Cooking.

Moving your body.

Resting.

Communicating your needs.

Setting boundaries.

But I think the most important skill is learning to witness and examine your own thoughts.

To notice the conversations happening between you and you.

Are they supportive? Unhinged? Or are they constantly reinforcing fear, shame, hopelessness, and self-criticism?

Because if your internal dialogue is working against you, it doesn't matter how much tea you drink, how many super greens you eat, or how many times you go to the gym.

The disharmony of that misalignment will continue showing up in your body.

Your Worthiness Ceiling

I don't think what determines whether someone can sustain change is willpower.

I think it's worthiness. 

More specifically, I think many of us eventually reach what I call our worthiness ceiling.

If you struggle to stay consistent with the habits that support your health, your growth, or your goals, it might not be because you're lazy or undisciplined.

It might be because you've reached the edge of what currently feels safe.

You've spent so much time living with stress, dysregulation, pain, or survival that feeling better actually feels unfamiliar.

When life begins getting easier, the wheels start to shake.

You unconsciously find reasons to stop doing the very things that were helping you thrive.

Not because you consciously believe you don't deserve to feel good.

But because your nervous system has become accustomed to something else.

Healing asks you to become familiar with a completely different way of living.

And that takes practice.

The next time you notice yourself approaching your worthiness ceiling, pause.

Remind yourself:

"I deserve to feel good."

"I can adjust to ease."

"Life can get better for me."

Then keep going.

Don't negotiate your way out of the practices that support your well-being.

If you've been making time for them, you can keep making time for them.

You are worthy of prioritizing yourself.

You are worthy of your growth.

You are safe.

I still hope the woman who came into the shop after being hospitalized with diabetic ketoacidosis is okay.

I could not safely support her with herbs alone, so she chose to work with someone else.

Acknowledging my limitations was part of practicing responsible herbalism.

My responsibility is not to convince people to choose herbs over medicine. It is not to tell them what they want to hear when I know it may not be true.

My responsibility is to help people make the next wise decision that moves them toward life and health.

Sometimes that is an herbal blend.

Sometimes it is finally taking the medication you have been avoiding.

Sometimes it is therapy.

Sometimes it is surgery.

Sometimes it is all of those things together.

Clinical practice has taught me that healing is not about proving your commitment to one modality.

It is about responding honestly to what your body needs in this season.

And that kind of discernment may be one of the greatest healing skills we can learn.

Before You Go...

I have one more piece of exciting news to share.

The Confident Family Herbalist is now available for preorder on Amazon and Barnes & Noble.

This book is the one I wish I'd had when I first started learning herbalism. It's practical, evidence-informed, and rooted in the belief that herbs are powerful—but so is knowing when they are enough, when they work beautifully alongside conventional medicine, and when it's time to seek additional care.

I wrote it to help you build confidence, not certainty. To help you make thoughtful decisions instead of fearful ones. And to become the kind of herbalist who understands not only what plants can do, but also how to use them responsibly.

If you've been meaning to add it to your herbal library, I'd be honored if you preordered a copy.

You can now preorder wherever you prefer to buy books, including Amazon and Barnes & Noble. And you can still get 20% off plus free shipping when you support the publisher directly. Code: CFH20.

Thank you for cheering me on through every chapter, every revision, and every season of bringing this book into the world. I truly can't wait for it to be in your hands.

With joy,
Selima

This article is for educational purposes only. It is not medical advice, and it is not a substitute for care from your doctor, midwife, pharmacist, or other qualified provider. Herbs can interact with medications and are not right for every body or every circumstance. Talk with your healthcare provider before starting any herb, especially if you are pregnant or breastfeeding, giving herbs to a child, managing a health condition, or taking prescribed medication. If you are experiencing a medical emergency, call emergency services.