Positive Health Online

There is in certain people's minds a defensive reaction to the whole idea of 'integration'. They see it as a 'take-over' of methods which, while often complementary, are also in many instances actually alternative to mainstream concepts and procedures. The suggestion is that by 'integrating' with orthodoxy these might be subsumed, tamed, emasculated even. In this way the 'danger' they pose to orthodoxy would be eliminated.

That is one quite widely held, some would say bizarrely egocentric, defensive, viewpoint. Others believe it to arguably represent a partially accurate perspective.

It is only necessary to carefully read the many fascinating, and sometimes mind-stretching ideas, which appear in the pages of this magazine to realise that not all of these methods are going to be welcomed with open arms by mainstream medical minds, let alone the accountants with their slide rules and calculators monitoring reimbursement issues (the force driving much integration on cost grounds alone).

Those methods and systems which are creeping into conventional settings are, to a large extent, approaches which are either very safe, without much potential for doing harm, reflexology and massage in hospice and stress management settings for example, or homoeopathy with its infinitesimal (and therefore comfortingly harmless) dose; and/or which have a good track record of reasonable safety and some research validation as to efficacy (osteopathy, chiropractic, acupuncture, homoeopathy and increasingly nutritional and herbal methods). The truth is that the financial minds governing much of health care provision in the USA, and increasingly in the UK, are concerned with the 'practical' features of complementary /alternative approaches, rather than their theoretical foundations.

They want to know certain things before considering any integration possibility, whether this relates to referring to, or working with providers of the method in question, or adopting it into mainstream settings, or reimbursing fees for its application.

Is there any research to validate use of method X? If not, is it at least safe? If it is not guaranteed to be safe, is the risk warranted in relation to possible benefit? What does it cost? In what way is it superior to current mainstream approaches (i.e. does it regularly produce results more efficiently than drugs or surgery, or achieve results with fewer side effects than drugs or surgery)?

In other words, neither orthodox medicine, nor the giant medical insurance companies, are interested in the beliefs which underpin, say naturopathy, or chiropractic, or acupuncture. They have little interest in philosophical debate as to the claimed self-healing potential of the body; or of the possible existence of 'vital energy'; or of the purportedly intimate link between bio-mechanical structural integrity and function; or of the likelihood that optimal nutrition may represent the single most important element in health provision, and that achievement of this requires orthomolecular nutrition strategies (i.e. supplementation) in the face of pollution and agricultural methods of food production; or of the suggested influences of subtle energy factors on health and disease or of… you get the picture.

What they are interested in, in relation to whether a method is or is not suitable for integration, relates more to 'bottom line' topics, i.e. can the method in question offer evidence of efficacy, safety and cost-effectiveness.

So is there a danger that methods which have evolved as a result of a different way of seeing the body, a different vision as to causes of ill health, will be adopted in a simplistic manner, devoid of their rich philosophical bedrock?

Does it matter that the rationale for the use of a particular homoeopathic remedy relates more to the idiosyncratic character-istics of the individual with the condition than the condition itself, when it can be shown that a significant number of people with that condition benefit from a particular remedy? Clearly the personality, likes, dislikes, and other characteristics of the person buying the product do not matter to the high street pharmacy selling low potency remedies over the counter for 'rheumatism' or 'allergy', etc. This triumph of commercialisation of a subtle healing approach epitomises the dangers of divorcing a method from its roots.

My own complicity in this is profound. I failed (and still fail) to fully comprehend the complexity of the roots of acupuncture when I trained in it, in the early sixties. A few years later, in order to cope with my confusion (an excellent reason for writing a book) I wrote a textbook on the use of acupuncture in treating pain. This was based on my attempt to graft the method-ology onto my existing belief system, at that time, founded on western physiological models. Nearly 25 years later the book is still in print (in the USA) and obviously therefore serves a need for others, who like myself, failed to fathom the mysteries of traditional Chinese medical thinking. But is the limited version of acupuncture which that book presents the real thing? Not at all. It does present an effective method of pain control, but that is a small part of what acupuncture should be about.

This may well serve as a metaphor for what could happen to other 'complementary' or 'alternative' methods of treatment as they are made to fit into the mould of orthodoxy. This may be the price they pay for integration.

Is there an alternative to this scenario? Absolutely! The alternative is that the methods need to be presented with their philosophical principles, as often as possible. Osteopathy is not just a matter of tweaking muscles and cracking joints (and neither is chiropractic); Medical herbalism is not just a matter of taking herb X for condition Y (instead of drug XXX for condition Y); Naturopathy is not just about getting enough sleep and exercise, and eating berries; Acupuncture is certainly not (or should not be) just about sticking needles into painful areas.

We need the baby and the bath water!

One image of integration is of a benign orthodoxy opening its arms and objectively evaluating what is presented.

Another is of a malign orthodoxy taking what 'works' and discarding the uncom-fortable 'truths' in which the methods are wrapped.

How do you see integration?