1. Complementary and Alternative Health23
Complementary and Alternative Health

2. 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?

3. 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?

4. 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

5. 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

6. 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

7. 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

8. 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

9. 10 Most Common CAM Therapies among Adults
FIGURE 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, December 10, 2008

10. 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 from

11. 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

12. 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

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

14. 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

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

16. 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 from

17. 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 from

18. 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”

19. 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

20. 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).

21. 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).

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

23. 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

24. 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).

25. 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).

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

27. 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.

28. 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

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

30. 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

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

32. 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

33. 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.

34. 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).

35. 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).

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

37. 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

38. 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

39. 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

40. 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