1.10 Concepts of healing: philosophies underpinning CAM practice
Activity 5: Health beliefs in CAM
Read the following accounts by individual CAM practitioners of four different modalities. These are personal perspectives, which may vary from other people's in their disciplines. As you read the accounts note:
the positive and negative implications for lay users
different approaches to healing among the four CAM modalities.
Currently osteopathy has no agreed definition. It is a hands-on approach to various health problems which manifest themselves through the neuro-musculo-skeletal system (the moving parts of the body and the associated nerves and blood vessels). This approach embraces a holistic system of diagnosis and treatment involving palpation and manual intervention, complemented by health education. It recognises the primacy of the therapeutic relationship and is based on the philosophy and principles first enunciated by Andrew Taylor Still in 1874:
Displaced joints may obstruct the free flow of blood – ‘the rule of the artery is absolute’.
All diseases are mere effects, the cause being partial or complete failure of the nerves to conduct the fluids of life properly.
The body tends to be self-regulating and self-healing.
All body structures and processes are interdependent.
Therefore, rational treatment is based on the above principles and directs proceedings rather than attempting to effect change directly. Still's therapeutic maxim was to ‘find it, fix it and leave it alone’ (that is, to diagnose the disorder, treat it, and leave the rest to the spontaneous forces of nature), in recognition of his understanding of the body as an internally organising system.
Acupuncture is part of a comprehensive system of health care called ‘oriental medicine’. This has a clinical history of at least 2000 years to the present day. Indeed, it is all based on the concept of qi, or ‘vital energy’, a concept that every living organism has energy running through and around it, which enables physical movement, emotional balance and spiritual connection, provided it is in balance and can flow smoothly. This model is based on natural laws and has connections with Taoism. These laws are: the eight principles of yin/yang, deficiency/excess, cold/hot and interior/exterior; the five elements (earth, air, fire, water and wood) and their associations; the causes of disease – internal or external, miscellaneous and secondary; and a different diagnostic language to identify the energetics of each individual patient. Many patients do not want treatment for one complaint, but rather for an apparently disconnected set of complaints or because they do not feel well. Acupuncturists can make connections of the mind, body and spirit for patients and enable them to start making sense of their perceived and experienced ‘dis-ease’. Practitioners use a research method of investigation based on looking, asking, feeling and listening (sizhen), leading to diagnosis (bazheng, or eight rules), then testing the hypothesis in treatment (ben and biao, or root and branch) and evaluation. In its simplest terms, acupuncture stimulates the body's own healing response and helps restore its natural tendency to balance and harmony by inserting, and manipulating in a variety of ways, fine needles into specific points along the channels of energy (meridians). Centuries of observation, analysis and empirical use have resulted in an extensively catalogued location and function of all the points. There are believed to be low-level electrical resistances at these points, but how acupuncture works is still not known. Western thought insists on the search for an explanation in scientific terms; eastern thought does not.
Western medical herbalists are trained in orthodox medical science and use the same technical language as the orthodox medical professions. Although they may use the same labels in terms of pathology, their aim is to support normal physiology and help the ways in which the body heals itself, rather than to treat a named disease. Sometimes users are encouraged to see symptoms such as tiredness or fever as being part of their healing rather than just an aspect of their problem. Herbal medication is seen as having three modes of action:
a biochemical pharmacological action
a micronutritional effect (plant remedies contain a range of trace nutrients that are often missing from a modern diet)
an energetic action.
For any particular required pharmacological action there are several possible herbal remedies. The herbalist has a subjective appreciation of the character of each of them and tries to match the correct remedy to the client's needs.
The philosophy of reiki is that everything in the Universe is made of energy, which vibrates at different rates and frequencies on a continuum from the dense, slow vibrations of physical matter to the fast vibrations of spiritual energy, consciousness or light. The human body is made of energy which is dense enough to become physical matter, so it can be seen and touched, but people also have a field of spiritual energy called an aura, which surrounds and interpenetrates the physical body. Life-force energy (qi or chi) flows within the physical body through energy centres called chakras and energy pathways called meridians, as well as flowing around the body in the aura. Reiki is a spiritual energy vibrating at a very high rate, which helps to break through blockages, flowing through all the affected parts of the aura, charging them with positive energy and raising the vibratory level of the whole energy field. It clears and balances the chakras and straightens the energy pathways, allowing the life force to flow in a healthy and natural way around the whole body. This strengthens and accelerates the body's natural ability to heal itself, and opens the mind, emotions and spirit to an acceptance and understanding of the factors that led to ‘dis-ease’ in both the physical and the energy bodies.
For some practitioners, CAM is more than simply about treating disease: an accusation levelled at the biomedical model in its purest form. Individualised user-centred treatment is central to their philosophies. CAM therapists explore and treat underlying causes, not merely control symptoms. CAM therapies sometimes use phenomena that are outside the biomedical understanding of health and disease. For many practitioners, building strong therapeutic relationships is crucial. This includes practitioners’ attempts to bridge their own philosophy or cosmology to that of the user, so as to provide an account of illness that resonates for that user. CAM promulgates the view that users promote their own healing, and that the therapist is a conduit for healing energy. While the philosophy of holistic health concerns the user's mind, body and spirit, the treatment is individually targeted.
This extract introduced four (of many) models of health. Although they were presented as discrete entities, in practice there is considerable blurring of the boundaries between them. Many features of alternative health models are now being incorporated into mainstream medicine and vice versa. For example, a study comparing osteopathic practitioners and doctors in the UK notes that the holistic approach is less confined to osteopathic physicians, especially in speciality hospital care, and is, perhaps, even becoming a trend in the approach to care used in allopathic medicine (Johnson and Kurtz, 2002). As CAM and orthodox medicine continue to integrate, there will probably be further overlap and evolution of health models, reflecting the plurality of ways of knowing about health and dealing with illness.