Complementary and Alternative Health 23 Complementary and Alternative Health

Key Questions A friend said that acupuncture helped her relax by balancing the flow of energy in her body. Does energy really flow through our bodies—and what does it have to do with feeling good? I have been so stressed my doctor prescribed medication to help me calm down, but the medication has some side effects. What are some other options to taking powerful medicines?

Key Questions (cont’d.) I’ve become friends with an exchange student from China. He was explaining that, when his mother was sick, she was treated with herbs, massage, and energy therapies. What’s that all about, and if it works, why don’t we do it in the United States?

Objectives Explain the five categories of complementary and alternative medicine Describe complementary and alternative (integrative) healthcare practices that relate to stress management within each of the five categories Discuss the stress-related health benefits of complementary and alternative healthcare

Objectives (cont’d.) Differentiate between the various types and techniques of massage Contrast the typical Western medicine approach to health with alternative or integrative medical approaches to health and healing

Complementary and Alternative Health An estimated 60–90% of visits to healthcare professionals are for stress- related disorders Yet many people have found that our current healthcare system is not especially effective in helping them deal with stress

National Center for Complementary and Alternative Medicine Responsible for research on complementary and alternative health Defines complementary and alternative medicine (CAM) as a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine Boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted

Complementary vs. Alternative Medicine Complementary medicine: refers to using a non-mainstream approach together with conventional medicine Alternative medicine: uses a non- mainstream approach in place of conventional medicine Integrative medicine: describes practices that combines both conventional and CAM treatments for which there is evidence of safety and effectiveness

10 Most Common CAM Therapies among Adults FIGURE 23.1 10 Most Common CAM Therapies Among Adults Source: Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 10, 2008

FYI: The Cost of CAM In a 12-month period, U.S. adults spent $33.9 billion out-of-pocket on visits to complementary and alternative medicine (CAM) practitioners and purchases of CAM products, classes, and materials Source: “Americans Spent $33.9 Billion Out-of-Pocket on Complementary and Alternative Medicine” National Institutes of Health: National Center for Complementary and Alternative Medicine. Retrieved 4-3-2011 from http://nccam.nih.gov.

Alternative Medical Systems Built upon complete systems of theory and practice Evolved apart from and earlier than the conventional medical approach Examples include homeopathic medicine, naturopathic medicine, traditional Chinese medicine, and ayurveda

Mind/Body Interventions Mind/body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect the body Some techniques have become mainstream Cognitive behavioral therapy Interventions include meditation, prayer, mental healing, biofeedback, and therapies that use creative outlets such as art, music, and dance

Biologically-Based Therapies Involve use of substances found in nature, such as herbs, foods, and vitamins Examples include dietary supplements and herbal products

Energy Therapies Biofield therapies Bioelectromagnetic-based therapies Intended to affect energy fields that purportedly surround and penetrate the human body Examples include qi gong, reiki, and therapeutic touch Bioelectromagnetic-based therapies Involve the unconventional use of electromagnetic fields

Manipulative and Body-Based Methods Based on manipulation or movement of one or more body parts Examples include chiropractic and osteopathic manipulation and massage

Culture Connection: Culturally-Based Healing Arts Traditional East Asian medicine, Indian systems of healthcare, and Native American healing practices all incorporate the beliefs that: Wellness is a state of balance between the spiritual, physical, mental, and emotional “selves” An imbalance of forces within the body is the cause of illness Source: “Alternative Approaches to Mental Health Care” Athealth.com. Retrieved 5-9-11 from http://www.athealth.com.

Culture Connection: Culturally-Based Healing Arts (cont’d.) More common beliefs Herbal/natural remedies, combined with sound nutrition, exercise, and meditation/prayer, will correct this imbalance When you bring the body back into balance, it will work more effectively to heal itself of most of the maladies that occurred because of the imbalance Source: “Alternative Approaches to Mental Health Care” Athealth.com. Retrieved 5-9-11 from http://www.athealth.com.

Applications of Alternative Medical Systems Used by 80% of the world Traditional Chinese medicine Variety of carefully formulated techniques such as acupuncture, herbal medicine, massage, qi gong, and nutrition Ayurvedic medicine India’s traditional system of natural medicine, described as “knowledge of how to live”

Applications of Alternative Medical Systems (cont’d.) Naturopathic medicine Encompasses the diagnosis, treatment, and prevention of disease, as well as the promotion of health Makes recommendations on diet, exercise, and stress management Six principals: nature has the power to heal; treat the whole person; first do no harm; identify and treat the cause; prevention is as important a cure; doctors should be teachers

FYI: Traditional Chinese Medicine around the World Approximately one-fourth of the world’s population uses TCM, including some 12 million people who go to TCM practitioners in the United States Source: The Best Alternative Medicine: What Works? What Does Not?, by K. Pelletier (New York: Simon & Schuster, 2000).

Culture Connection: Patient Care Ayurvedic physicians are more interested in the patients they see than in their diseases Understanding what is causing stress in a person’s life is integral to health and healing Source: Quantum Healing: Exploring the Frontiers of Mind/Body Medicine, by D. Chopra (New York: Bantam Books, 1989).

Applications of Mind/Body Interventions Clear connection exists between mind/body interventions and stress management Biofeedback Electromyogram Temperature biofeedback Galvanic skin response Electroencephalogram

Applications of Mind/Body Interventions (cont’d.) Biofeedback for stress reduction Gives you the power to use your thoughts to control your body, often to help with a health condition or physical performance Frequently come with games or activities that turn the process of relaxing into an interesting adventure or a fun challenge: FreezeFramer, Journey to the Wild Divine

FYI: Take an Herb and Call Me in the Morning In Germany, 70% of physicians prescribe herbal remedies, many of which are paid for by government health insurance Source: The Best Alternative Medicine: What Works? What Does Not?, K. Pelletier (New York: Simon & Schuster, 2000).

FYI: Acupuncture in Action Acupuncture has been used at the Mayo Clinic since the 1970s When performed properly by trained practitioners using sterile needles, acupuncture has proved to be a safe and effective therapy Review of acupuncture by the World Health Organization found it was an effective treatment for 28 conditions Source: Mayo Clinic Book of Alternative Medicine (2nd ed.), by B. Bauer (New York: Time Inc., 2010).

Applications of Biologically-Based Therapies Among American consumers, herbs are popular as a means to help the body adapt to physical and emotional stressors

Research Highlight: Calming Kava Kava is recommended for treating nervous anxiety, stress, and restlessness In clinical trial, kava is superior to placebo Kava has none of the tolerance problems or potential addictive qualities associated with other antianxiety medications More research needed on long-term use Sources: Mosby’s Complementary and Alternative Medicine: A Research-Based Approach (3rd ed.), by L. Freeman (St. Louis: Mosby, 2009); The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines, by M. Blumenthal (Boston: Integrative Medicine, 1998); “Kava-Kava Extract WS 1490 versus Placebo in Anxiety Disorders: A Randomized Placebo-controlled 25-week Outpatient Trial,” by H. Volz and M. Kieser, Pharmacopsychiatry, 30(1) (1997): 1–5.

Applications of Energy Therapies Involve the use of energy fields including meridians (invisible channels of energy that flow in the body) or energy fields outside the body Reflexology Based on the Asian theory that meridian lines or pathways carry energy throughout the body See Figure 23.2

Reflexology: Approximate Locations of Reflex Areas FIGURE 23.2 Reflexology: Approximate Locations of Reflex Areas.

Applications of Energy Therapies (cont’d.) Four related energy therapies intended to open the flow of chi, restore balance, and support the natural healing of the body Acupuncture Acupressure Emotional freedom technique Shiatsu

Applications of Energy Therapies (cont’d.) Other energy therapies with relevance to stress management Qi gong Tai chi Therapeutic touch Reiki

Applications – Manipulative and Body- Based Therapies Touch has both physical and emotional benefits Important for managing stress and improving health Typical benefits of therapeutic massage Physical Mental Emotional Other

FYI: Tai Chi: Meditation in Motion Harvard Medical School review of 26 studies of tai chi 85% of trials reported that tai chi lowered blood pressure Source: "Take Up the Ancient Exercise Tai Chi," by C. Rubin, U.S. News and World Report, December 2010, page 24.

Research Highlight: The Touch Factor Investigators at Ohio State University studied the effects of a diet high in fat and cholesterol in rabbits, specifically as it affected the process of atherosclerosis Certain group of the test rabbits demonstrated atherosclerotic changes that were 60% less than that of the overall group Fed and cared for by one of the investigators who, during the course of the experiment, regularly took them from their cages and petted, stroked, and talked to them Source: “Social Environment as a Factor in Diet-induced Atherosclerosis,” by R. M. Nerem, M. J. Levesque, and J. F. Cornhill, Science, 208 (1980): 1475–1476, as quoted in L. Dossey, Space, Time and Medicine (Boston: Shambhala Publications, 1982).

Research Highlight: The Touch Factor Systematic, controlled studies designed Rabbits that received affection once again demonstrated a 60% lower incidence of atherosclerosis Source: “Social Environment as a Factor in Diet-induced Atherosclerosis,” by R. M. Nerem, M. J. Levesque, and J. F. Cornhill, Science, 208 (1980): 1475–1476, as quoted in L. Dossey, Space, Time and Medicine (Boston: Shambhala Publications, 1982).

Applications – Types of Massage Swedish massage Deep tissue massage Myotherapy Craniosacral therapy Sports massage Chair massage Hot stone massage

Applications – Self-Massage Incorporates the use of oils Morning is the recommended time for massage, before bathing or showering Massage is administered from the head to the feet

Conclusion All five categories of CAM therapies clearly relate to stress management The effectiveness of some of the alternative approaches to health and healing has not been proven through rigorous scientific study You must take responsibility to investigate what is acceptable, safe, and effective for you

Lab 23.1: Contrasting Health Systems Research and respond to the following Explain how stress management and prevention is typically approached in the traditional Western medicine health system Based on the six basic principles of naturopathic medicine found in this chapter, explain how stress management and prevention would be approached in naturopathic medicine

Lab 23.1: Contrasting Health Systems Discuss your perception of the strengths and weaknesses of how stress would be addressed from both the Western medicine and naturopathic medicine perspectives Cite your sources