2.3.2 Responsibility for the causes of ill health
Doyal and Pennell (1979) write from the perspective of political economy and argue that there is a continual state of conflict hidden within health experiences and health care relationships. Society produces ill health through an unrelenting drive towards profit and a failure to put the health and wellbeing of individuals first. Work and everyday social life are bound up with taking risks. Many workers experience stress and some occupations involve the risk of physical injury. Social class groupings, affluence or poverty, gender, age and ethnicity can all impact on the likelihood or not of an individual becoming ill. Some occupations are associated with diseases, such as miners and industrial workers (white finger), hairdressers (eczema) and typists (carpal tunnel syndrome). From the perspective of political economy, the development of more ‘caring’, and allegedly equal, therapeutic relationships in orthodox health care settings is little more than an attempt to gloss over the inequalities that lead to ill health in the first place. For all the talk about patients’ rights, and the shared responsibility between doctor and patient, it is the patient who carries the risk and burden of industrial and work-related stress, illness and disease. Orthodox medicine has arguably done little to address these underlying causes of illness. While a small proportion of doctors will take on an advocacy role for their patients, the politics of ill health remain outside the surgery door.
Should CAM therapists be expected to be more overtly political? Poverty, social deprivation and overwork are key stressors for people in modern society. Much CAM business involves helping individuals whose health has been adversely affected by these types of problem. Critics of CAM, such as journalist and social commentator Rosalind Coward (1990), argue that CAM practitioners do not really deal with the social causes and aspects of ill health. Thus, while a hypnotherapist is happy to help a client learn to deal with stress at work (and charge the going rate for this service), hypnotherapists are not marching to Parliament en masse to complain about poor workplaces, heavy workload, bullying and interpersonal aggression, which can lead to people seeking help for stress-related problems. In other words, CAM does not attribute much importance to the political context of illness. Instead it compounds the view that the individual is responsible for dealing with their damaged health.
It can be argued that CAM practitioners perpetuate an unhealthy obsession with perfect health. Because practitioners offer to treat people's minds, bodies and spirits, the quest for perfect health may, for some, become a relentless preoccupation. When treatment is extended beyond illness to wellbeing, people may feel they could always do more to enhance their health. This might reflect a more general concern with control over their life which people in western industrialised societies are encouraged to feel they should have.