Articles

Introduction

This discussion is written from the perspective of my professional experience as a complementary therapy practitioner (more specifically, Essential Oil Therapist), lecturer and author of related books, and  generally describes my awareness of the issues involved.

Background

Integrated medicine is a broad term that umbrellas a spectrum of healing modalities, ranging from the ethereal realms of Reiki and distant ‘healing’,  to the physical manipulation of chiropractic and osteopathy, acupuncture and the practical intervention of diet control and naturopathy, and also includes aspects of biomedicine, psycho-therapy and emergency care.  Complementary medicine views clients (patients) in holistic context as individuals comprising body, mind and spirit.  Complementary medicine modalities focuses on nurturing balance and equilibrium, health and healing within the body, mind and spirit: treatment, or support, focuses on restoring physical, psycho-emotional, and spiritual harmony, dis-ease and/or dysfunction is addressed within holistic context, rather than the one-disease or dysfunction one-treatment approach of biomedicine.   Integrative medicine melds aspects of conventional (allopathic) healthcare with complementary medicine or therapy practices (including, for example, yoga, movement and mobility, exercise, acupuncture, meditation and breath-work, diet and nutrition) to create a holistic approach to health care.

Complementary medicine modalities are naturally underpinned by holism and are, and have always been, practiced as integrated specialities that may be overlaid at one and the same time. For example, an acupuncturist, depending on their underpinning premise, may use oral herbal remedies as well as stimulating (either using very fine needles or moxa) specific meridian points as a collective measure to achieve the rebalance of chi (the flow of energy throughout the meridian system with in the body).  A client receiving allopathic treatment from their GP for, say, mild depression and/or anxiety, may be advised to also receive, say, essential oil therapy and/or attend mindfulness or yoga classes to aid their relaxation, and/or counselling sessions to assist in re-framing their psycho-emotional response or attitude. Or, an individual may elect to use, of their own volition, say, aromatherapy massage, to deal with their insomnia and/or headaches and/or eczema, synchronously with dietary intervention following an allergy/food intolerance test. Bach Flower Remedies apparently influence subtle physical, mental and emotional energetic resonance within the body and are applied to harmonise or rebalance mood and emotional attitude, and may safely be used by virtually anyone in isolation or concurrently with allopathic medication and/or other complementary therapies. And so on.  A person may select one modality or method according to their condition and/or personality, for example, homeopathy, acupuncture or chiropractic, to work on the underlying fundamental precursor, as well as the symptoms, of their condition or dis-ease.  I observe from my own practice that complementary medicine and/or therapies are also frequently utilised as a preventative measure, to support and maintain wellness, to ‘manage’ the effects of stress and to navigate challenging life events.

“Vibrational healing methods represent new ways of dealing with illness. Practitioners of subtle-energy medicine attempt to correct dysfunction in the human organism by manipulating invisible yet integral levels of human structure and function. Healing at the level of human subtle-energy anatomy is predicated upon New Physics understanding that all matter is, in fact, a manifestation of energy.”   Gerber (2001)

Acknowledgement and acceptance of subtle (as well as obvious) energetic resonance underpins most complementary medicine modalities (especially, for example, acupuncture, homeopathy, and healing). Unfortunately, it is the apparent vagueness, illusive, or non-tangible aspect of this energetic aspect of complementary medicine that allopathic practitioners appear to have difficulty accepting.  Separating the body into component parts and examining a single condition against and single remedy is not reflective of ‘real world’ scenarios which involve multiple dynamics with numerous influencing variables that are difficult to disentangle.   The same applies when evaluating subtle energetic elements for efficacy; there are multiple variables at play that are difficult to disentangle

Complementary medicine practices are increasingly popular in the West (indeed, over 70% of the worlds population, particularly in developing countries where most people do not have access to bio-medicines, rely on traditional healing modalities and herbal remedies).  Explanation for this phenomenon is levelled at public disenchantment with allopathic drugs, their toxicity and side effects; especially those prescribed for long-term chronic or auto-immune conditions.  The shift towards public interest in complementary medicine might also be explained as a consequence of spontaneous enlightened perception or awareness, which, acting as a precursor, or catalyst, has naturally directed attraction towards modalities complementary to the remit of holism and sense of spirituality (meditation and mindfulness practice, for example), and the acknowledgment of the seamless interconnection of body, mind, and soul  and the existence of vibrational energy fields.

Sceptics of complementary medicine practices argue they pander to an individuals need for attention, therefore, self indulgence, and tend to attract those of a sensitive nature, especially ‘hypochondriacs’, the gullible and those desperate to find a ‘miraculous cure’ where conventional allopathic medicine has reached its limit.  The word ‘placebo’ is often cited in this context. Indeed, observing my own practice I notice that the majority of my clients are middle-class, mostly mature females, some males, who generally have access to a ‘disposable income’, therefore, are able to exercise a certain amount of freedom of choice of their health and wellbeing.  I am also aware that most of my clients are generally sensible, intelligent professionals (many of my clients, for example, work in health and social care, education, and management).  As a private, independent practitioner (sole trader), in order to cover costs, a minimal charge has to be applied, which consequently limits clientele to those who can afford to buy their treatments. This phenomenon is true for the majority of complementary medicine practitioners.  Even though some practitioners offer concessionary rates, potential clients in receipt of low or minimal incomes or state pensions or benefits, tend to have negligible disposable income, therefore, even cutting the cost of a treatment by half, still renders the therapy an unaffordable luxury to many.

Even so, while the above disparities and limitations exist, people (from a range of socio-economic backgrounds) appear increasingly inclined to take personal responsibility for their own health and personal well being; evidenced through increasing public interest in mindfulness and meditation practice, relaxation techniques, yoga, exercise, movement and mobility, diet and nutrition.  Indeed, self-help courses and advices abound – from crystal healing to yoga and meditation and mindfulness practice, to super food diets, to name a few.  Set within this trend, where there are extremes from nutritional advice to spiritual healing, complementary medicine modalities might be seen as a fad; therefore, it is convenient to perpetuate the notion of ‘pampering’.  Unfortunately, this attitude also detracts attention from their potential efficacy. In deed, funding for research and development is very limited (if non-existent) for modalities that fall outside of mainstream pharmaceutical or high-tech parameters.  Complementary medicine is accepted in palliative and ‘end of life’ care, where the focus is on the support and management of comfort, quality of life and emotional acceptance rather than on retrieval, cure or direct intervention.  Indeed, it is true that complementary medicine has an invaluable role within this sector of health care, whatever the perceived premise might be. However, returning to the issue of cost and funding, in this context, these treatments are often delivered ‘free of charge’ or for nominal token fees.

There is another concern; that is, the danger incurred from exploited ignorance and/or misguided naivety, a critical argument often presented by the sceptics of complementary medicine. It is true that, embracing the ethereal, these modalities appear to be entangled within the romantic notions of New Ageism, which in itself has cynically become a media driven commercial opportunity exploited for all its material worth. Although there seems a genuine and sincere trend towards holism and the spiritual dynamics involved in sustaining wellness and healing, this is often obscured by the shroud of hype and a leaning towards Mystic-Meg-type freakishness. Unfortunately, the consequential ironical trivialisation also serves to perpetuate dangerous misperceptions, which may seriously skew important decisions when choosing appropriate health care modalities.  In deed, although books and weekend courses abound in relation to an ever-increasing array of therapies and advices, this does not necessarily lead to well-informed enlightenment. Some contend that emotive, romantic claims regarding the therapeutic value or processes of certain therapies are made without real substantiation, are often anecdotal accounts and may, therefore, be misleading.  Another concern is that, in exploiting the commercial viability of the surge in interest in complementary medicine, appropriate professional training is compromised, with over emphasis for or reliance on ‘on-line’ learning (in some instances without any contact teaching or training) and/or short courses that allow rapid cost effective turn-around for the provider but which do not support depth of study or sufficient experiential guided training and learning.

Questions

Reflection on the above indicates a number of reasons that support the need for high quality outcome measures and rigorous research to assess the value and viability of interventions and treatment packages provided by complementary medicine modalities.  Fair unbiased research might then provide evidence to placate scepticism, eradicate naive ignorance and encourage appropriate application and integration within a universally accessible health care system.

For example, research might be aimed broadly at:

1. Identification of limitations
2. Identification of strengths
3. Validation of efficacy measured against a holistic outcome
4. Identification of the ‘right fit’: which health issue best suits which modality?

However, reflecting on my own practice, I also appreciate that some compromise is necessary.  For example, it is not possible to completely overlay the principles and philosophy of one approach on top of the other as integral parts of a whole without acknowledgement or validity. Acceptance and integration of attitudes and methods as diverse as those represented by reductionism and holism requires a shift of boundaries and mutually, amicably agreed consensus in terms of the achievement and viability of treatments, goals and outcomes.  A universal overarching consensus must also include health and wellness maintenance and personal sense of wellbeing. Eliciting evidence embraced within the holistic philosophy of complementary medicine might prove challenging to a reductionist mindset, as much as a reductionist stance is often perceived as inadequate for complementary medicine mindsets.

Equally, as pointed out previously, users of complementary medicine modalities often engage various methods of treatment concurrently, rendering the outcome of a single treatment modality an unreliable indication of singular efficacy. Quantifiable data may be retrieved from consultation details, but many complementary medicine modalities tend to treat each client as an individual, with longer client/therapist interaction time scales. Even if clients present with similar symptoms, methods of treatment are tailored and vary according to individual needs.  Many complementary medicine modalities also hold as valid client’s perceptions of their treatment, their personal sense of wellness, their attitude and their personal response to their dysfunction,  illness or dis-ease, seeing such dynamics as integral aspects of the underlying cause and/or ability to manage their recovery and/or energetic rebalance. What may be accredited a successful outcome by one mode of thinking might be measured as a failure or a limited success by another.

For example, eliciting the quantifiable details from consultation records, I am able to determine the gender, age and socio economic status of my clients, their common underlying presenting conditions, general wellness status and identification of their reasons for coming for treatment. However, subsequent to consultation, each client has a treatment plan specifically orientated to their individual requirement, and consequently, each client is given a different blend of essential oils, which they participate in selecting on an acceptance/rejection basis. In terms of measurement of outcomes, the variables are endless in this type of scenario; success or failure tends to be judged subjectively. But does this invalidate the outcome? Clients usually come of their own volition, knowing what they expect, and are informed of the limitations before treatments commence, therefore, the rate of success is highly increased (in aromatherapy) as their expectations are already geared up for it. But does this preconception bias the successfulness of treatment? Is this not merely positive collaboration between therapist and client to achieve a desired outcome? Equally significant, clients often choose therapy as a preventative measure, for its potential emotional balancing and immune stimulating qualities. Consequently, there needs to be a system of measurement which embraces what some might regard as the placebo effect, but which others regard as an inevitable mechanistic result triggered by energetic manipulation, sometimes produced at a very subtle level, whether manifesting on a mental/emotional level, or a physical level, but which ultimately leads to health improvement or an ability to positively manage the effects and consequences of a chronic condition, illness, or recovery in general.

Summary

• Complementary  medicine treatments may be applied singularly or applied (if appropriate) concurrently with allopathic treatments or other CAM methods.
• Complementary medicine treatments may be used as a preventative therapy.
• Complementary medicine treatments may be used to support wellness and a sense of wellbeing.
• The premise of most complementary medicine practices is underpinned by the acceptance of the principle that energy is an intrinsic part of all matter, and, therefore, may be influenced on subtle as well as gross, obvious, levels.
• Allopathic practitioners do not necessarily accept the ethereal element implicated in energetic medicine.
• The term placebo is often ascribed to complementary medicine outcomes.
• Trivialising complementary medicine as a fad distracts attention from its potential efficacy.
• New Ageism is entangled with some romantic notions and misperceptions of complementary medicine, which may serve to dangerously misguide choice regarding appropriate health care.
• Reliable and fair research may placate ignorant and misguided misperceptions and validate the role complementary medicine modalities may play in health and wellbeing, identifying and verifying appropriateness.
• The reductionist view of allopathic medicine and the holistic, energetic view of complementary medicine may not completely fit into each other’s ideological framework.
• Complementary medicine practice and philosophy presents many variables and unquantifiable results that do not necessarily negate the validity of an outcome.

Conclusion

As a practicing therapist, it is difficult for me not to display bias. If legitimate integration within a universal health care system is to be achieved then all possible views and angles must be explored and ultimately synthesised into a realistic, workable and universally accessible health care infrastructure, perhaps with equal emphasis on the validity of ‘wellness’ (and ‘feeling well’) and preventative measures of maintaining health and wellness as on ‘cure’ and intervention. Success of treatment should be measured within a broader context; all treatments should embrace and be measured against a holistic perspective.

Research Methods

Phenomenological

Methods

• Independent research
• Interviewed by researcher
• Client’s views of process and outcome
• Practitioner’s views of process and outcomes

Process outcome/bias

• Qualitative
• Some quantitative
• Single case studies
• Time consuming

Practitioner based

Method

• Researcher elicits information from clients and therapist regarding outcomes and procedures

Process outcome/bias

• Quantitative
• Qualitative
• Researchers interpretation
• Inference of questioning
• Time consuming

Practitioner as researcher

• Practitioner from single discipline
• Practitioners from various disciplines – Independent Researcher to collate collective outcomes

Process outcome/bias

• Quantitative
• Qualitative
• Case Studies
• Anecdotal
• Risk of bias

Independent researcher

• Both potential for non-bias and bias outcome depending on motivation of researcher(s) / funding body (Duerden, 2003; Jenkins et al, 1998; Clegg, 1997)

References

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