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just a journal of chapter 20 and 21. it can be between 300 to 400 words. both intext citation and a reference page. The title of the book is INVITATION TO HOLISTIC HEALTH. Author is Charlotte Eliopoulos, publiction date is febuary 6, 2017
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CHAPTER
20
Navigating the Use of
Complementary and Alternative
Therapies
OBJECTIVES
This chapter should enable you to
• List three factors that have stimulated Americans’ interest in complementary therapies
• Discuss at least three philosophical differences between holistic and conventional approaches
• Describe the role of self-awareness in health and healing
• List at least five questions that should be asked to guide the decision to use a complementary therapy
• Describe the five major categories of complementary therapies
Complementary therapies have been used for centuries throughout the world; however, it has
been primarily since the 1990s that their use has soared in the United States. It was during that
decade that the landmark study by David Eisenberg and his colleagues, published in the
prestigious New England Journal of Medicine, revealed that one third of Americans were using
alternative therapies—a figure that has continued to grow since that study (Eisenberg, 1998). By
the turn of the century, Americans were spending over $27 billion annually for complementary
and alternative therapies, most of which was out of pocket. The National Health Interview
Survey (NHIS), which included a comprehensive survey of complementary health approaches
use by Americans, showed that 34% of American adults use complementary and alternative
therapies with dietary supplements (nonvitamin, nonmineral), deep-breathing exercises, yoga,
Tai Chi, and Qigong; and chiropractic or osteopathic manipulation being the most popular
approaches (Clarke, Black, Sussman, Barnes, & Nahin, 2015). About 25% of all out-of-pocket
spending for pain management is for complementary approaches (Nahin, Stussman, &
Herman, 2015). To say this has caught the medical community’s attention would be an
understatement!
Many factors have contributed to the growing use of complementary therapies. The interest in
preventive health has stimulated individuals to explore practices and products that they can use
independently, and many complementary therapies, such as meditation and dietary
modifications, fit the bill. Growing reports of adverse drug reactions and other complications
from conventional medical care have led people to explore natural means to manage illness. The
personalized attention provided by practitioners of complementary therapies offers people a
superior experience to the abbreviated and often impersonal office visits and hospital stays.
Furthermore, research proving the benefits of complementary therapies is growing by the day.
The heightened attention to complementary therapies also has created much confusion regarding
the safety of using many of these therapies. Questions such as these emerge: Why and when is it
appropriate to use these therapies? Are these therapies consistent with my health beliefs? Are
these therapies consistent with my spiritual beliefs? How do I choose a practitioner or a therapy?
Above all, are these therapies right for me?
Mystery and what seems to be a strange language surround many complementary treatments.
Even the terminology used to describe these types of therapies is confusing. These therapies
were first called (and continue to be called) alternative therapies. This term does not fit for many
because it creates an either/or choice situation. Because it is felt by many that these therapies can
be used in conjunction with Western medical treatments, the word complementary conveyed a
clearer meaning. Clarifying even more the joint use of several methods of treatment at the same
time, use of the term integrative has evolved. Integrative medicine now commonly is used to
describe a model of holistic care that combines conventional Western medical treatment with
complementary and alternative therapies.
Terms such as holistic and natural are frequently used to describe complementary
therapies. Allopathic is a word that describes Western conventional medicine. Some feel that
using the term traditional medicine to describe today’s practice of medicine is incorrect. It is felt
by many that traditional indicates the use of a treatment since the beginning of time and,
therefore, conventionalbetter describes the present use of Western medical treatments.
KEY POINT
The evolution of terms used in describing complementary therapies is most evident in the changed name of the division of the N
established as the Office of Alternative Therapies, in 1998, it became the National Center for Complementary and Alternative M
name was changed to the National Center for Complementary and Integrative Health. Along with the name changes has been an
History
Many complementary therapies originated from ancient and non-Western healing traditions,
many of which have their roots in spiritually based health-care systems. These systems use such
measures as prayer, meditation, drumming, storytelling, and mythology to help people in their
search for wholeness by allowing them to experience sacred moments in their lives. Spirituality
is not in itself religion, but it underlies and enhances all world religions. It is also seen as a drive
to become a complete, balanced individual. Most ancient and non-Western cultures express
healing as being in balance and harmony.
Holistic Health Beliefs
Today the word holistic is being used freely, and yet many of the basic concepts that underlie its
true meaning are not understood or fully embraced by those using it. The most basic of these
concepts is the concept of wholeness. Many ancient healing traditions have as a belief that
wellness exists when there is balance of the physical, emotional, mental, and spiritual
components of our being. Your physical body has an innate physical tendency to work toward
equilibrium or homeostasis. It has a built-in potential to maintain physical health or optimal
function of all body systems and a complex natural ability to repair itself and overcome illness.
In the quest for balance emotionally, you strive to feel and express your entire range of human
emotions freely and appropriately. Mentally, you seek a sense of self-worth, accomplishment,
and positive self-identity. Spiritually, you seek a connectedness to others and to a higher
power or divine source. This balanced state is seen as wellness in a holistic approach to health
care. Illness is considered an imbalance of these components.
KEY POINT
Holistic health is the balance among your physical, emotional, mental, and spiritual components.
Healing is seen as an ongoing, lifelong process, and when viewed in a positive manner, it is seen
as a continual journey of self-discovery. All healing is self-healing, and conventional (Western)
medical treatments and complementary treatments help by creating an environment that supports
your attempt to balance the components of your being. Nevertheless, some philosophical
differences exist between the holistic and conventional (Western) medical approaches. These
include:
• The holistic approach to healing seeks the root cause of the problem (the source of the imbalance)
and tries to reestablish a balance of mind, body, and spirit, whereas conventional medical approaches
are more disease oriented and focus more on removing or managing signs and symptoms of physical
illness.
• In Western medical approaches, people have been conditioned to turn over the responsibility of
healing to the health-care provider; however, participation in one’s own healing process is a key
component of a holistic approach to health care. Being a passive recipient or expecting others to fix a
problem independent of your efforts is inconsistent with the holistic caring process. This belief in
seeking balance or healing is carried out in a partnership. You and your care provider have
complementary responsibilities. Learning how to partner is a very important concept that
conventional medicine, until recently, has not strongly emphasized.
• Another element of the holistic approach to health care is the requirement of self-care. The care and
nurturing of all aspects of oneself support a healthier balance and result in more productivity and a
fuller participation in the life experience. Western medicine tends to focus on diagnosing symptoms
and treating illnesses with minimal attention to teaching and supporting individuals in practices that
promote the health. Sound health practices form the foundation for wellness and healing.
• A holistic orientation to health recognizes the interconnectedness of the mind, body, and spirit. If any
aspect of yourself is not attended to and nurtured, it cannot function to its capacity; this will have a
detrimental effect on the other components of your health. Imbalances are identified and addressed
before they become disease processes. Although Western practitioners may appreciate the
relationship of body, mind, and spirit, they tend to focus on restoring and promoting normal function
of the aspect of the body that relates to their area of practice. For example, a cardiologist may
prescribe treatments to restore a normal heart rate but not explore the spiritual distress that is
burdening the patient.
Self-awareness then becomes paramount in this dance between balance and imbalance of the
mind, body, and spirit. This self-awareness is supported and/or learned through many of the
complementary therapies. Many of the therapies can precipitate an awareness of emotions as
well as a physical awareness. It may have been the physical complaint that directs a person to
seek the therapy, but the awareness of an emotional component may surface in the process.
Knowing this is of importance when seeking complementary therapies. This is also the reason
that these therapies are referred to as holistic; they involve all aspects of the person. Recognizing
and choosing to act on this self-awareness is part of the personal healing process.
REFLECTION
How do you react when you experience headaches, indigestion, and other symptoms? Do you quickly try to eliminate th
them in the future?
Acute and Chronic Illness
Pharmacological and technological advancements have equipped conventional medicine to
handle acute conditions effectively and efficiently. Heart attacks can be halted, shattered bones
mended, and infections eliminated. Unfortunately, as medical technology has increased, the
caring components of medical care seem to have shrunk. Hospital stays and office visits are
shorter; health-care providers seldom have ample time to learn about the whole person or to
teach and empower the person for self-care. For these reasons, conventional medicine is less
successful at managing chronic conditions than at treating acute illnesses.
Persons with chronic conditions are increasingly integrating complementary therapies into their
medical care. They find that complementary practitioners invest more time in getting to
understand their clients, encourage an active provider–client partnership, empower clients for
self-care, promote healthy lifestyle practices, and tend to see the whole person rather than merely
treat the symptoms.
KEY POINT
Nearly half of all health-care expenditures are for chronic conditions.
Self-Awareness: Body Wisdom
The journey toward self-awareness, like anything else, begins with the first step, and a beginning
point is physical body awareness. Physical body awareness appears to be a foreign concept in
Western society today, as most people have been taught to deny, ignore, or push through early
signs the body may express. Self-awareness is a major developmental pearl that provides key
information that influences choices in making informed decisions when choosing a therapy that
is most appropriate and/or safe at any given point in time.
KEY POINT
Self-awareness enables one to make informed decisions.
As body awareness develops, awareness of feelings and thoughts follows. This knowledge and
understanding leads to inward focusing. Inward focus and awareness protect and guide in many
ways. Most of us have been directly taught by our parents, teachers, and others how to get
around our weaknesses and imbalances. We tend to ignore body messages until they scream so
loudly that we finally are incapacitated and forced to stop and take notice.
Befriending and listening to the body is a lifelong process that continues to be refined as more
attention is paid to it. Paying attention leads to learning the body’s wisdom versus overriding it.
Learning how to recognize this wisdom increases personal knowledge, and with this knowledge
comes personal power—power to be in greater control of knowing the best choice to help the
body regain or move toward balanced health.
Self-awareness feeds into self-responsibility in a holistic approach to maintaining wellness.
Rather than following the pattern of expecting others to provide information of what is best, selfawareness provides the ingredient of self-involvement in illness prevention. This journey of
exploration and self-discovery can be fascinating and removes the image of the body as
foreign territory. This voyage begins with small steps and requires notation of results obtained.
This tuning into the body, instead of tuning out, allows the body to be worked with in a
cooperative way.
Self-awareness better equips a person in making an initial choice of which complementary
therapy to experience and provides information after receiving the therapy. Paying attention to
the physical, mental, and emotional responses after receiving a treatment is invaluable in making
future treatment decisions. Were the reasons for choosing a particular therapy satisfied? In what
way? For how long? What new information was obtained about the body and the mind? This
information allows for the choice to continue an old pattern of ignoring the messages received, or
paying attention, learning, and deciding to make new informed choices.
KEY POINT
Paying attention to their physical, mental, and emotional responses helps people to determine what is best for their health rather
The continued evolution of this self-awareness can become very powerful and self-empowering.
Becoming more involved allows for greater participation in decision making in health care or
wellness choices. This gentler, friendlier approach to body–mind maintenance allows for less
faultfinding with the body, less rushing ahead without willpower, and less blindness to personal
weaknesses. Self-awareness and self-acceptance are major components that propel a person on
the journey toward a more balanced mind, body, and spirit and establish a more personal feeling
of control of life in general.
TIP FOR PRACTITIONERS
Clients need to understand that an alternative or complementary therapy may not alone be adequate for addressing their health n
individual’s health and/or manage a disease is essential. It may be that a blend of alterative and complementary therapies with c
Selecting a Therapy
Some common categories of complementary and alternative therapies are as follows:
• Natural products, including herbs, aromatherapy, vitamins, minerals, probiotics, other supplements
• Mind and body therapies: These include many diverse practices that are either performed or taught by
a trained practitioner. Yoga, meditation, massage therapy, and chiropractic and osteopathic
manipulation are the most popularly used therapies in this group according to the National Center on
Complementary and Integrative Health. Other therapies in this category include relaxation
techniques, biofeedback, guided imagery, hypnotherapy, healing touch, Qiqong, yoga, Tai Chi, and
movement therapies such as the Trager psychophysical integration, Feldenkrais method, Alexander
technique, Pilates, and Rolfing Structural Integration.
• Alternative systems of healing, including traditional Chinese medicine, acupuncture, homeopathy,
Ayurveda, and naturopathy
Specifics about these therapies can be found in other chapters in this text.
KEY POINT
If a person desires to use complementary or alternative therapies, he or she must be committed to being an active participant in
Deciding to use a complementary/alternative therapy (CAT) requires much consideration and
forethought. In order for a CAT to be safe and appropriate, many questions need to be asked.
A major consideration is how to work effectively with a primary health-care provider. Is
conventional medical care required to monitor a particular medical condition? If so, developing a
partnership with the conventional health-care provider is crucial. Cooperation by the provider
and the person seeking CAT is essential. For proper assessment of treatment effects, if
combining conventional medicine and CAT, the conventional health-care provider needs to be
informed. Clear baseline assessment information of current symptoms or concerns is needed. The
person must be prepared to keep a diary of information to assist in evaluating CAT results.
Decisions need to be made regarding the safety of combined therapies or the impact of
postponing conventional medical care while using CAT. Agreements need to be reached
regarding follow-up visits with the Western medical care provider, if necessary, during or after
receiving CAT. Some suggestions for using CAT safely are listed in Exhibit 20-1.
EXHIBIT 20-1 SUGGESTIONS FOR SAFELY USING COMPLEMENTARY AND ALTERNATIVE THER
• Know your reason for choosing a CAT. Is it out of frustration with experiences of Western conventional medicine? Seeing published res
that have aroused your curiosity?
• Use CAT in collaboration with a qualified physician if you have a serious medical illness.
• Understand and establish your goals in using CAT.
• Beware of mixing and matching conventional and CATs on your own.
• Do your homework and gather information; do not rely merely on testimonies of persons who have used a therapy.
• Avoid the more is better fallacy.
• If something sounds too good to be true, it generally is.
• Keep an open mind, and use the best of conventional medicine and CAT to achieve an integrative approach.
• Ask questions of practitioners before selecting their therapy, such as the following:
◆ What is the therapy?
◆ How does it work?
◆ Is there research supporting the therapy’s claims?
◆ What health conditions respond best to this CAT?
◆ When is it best to use it/not use it?
◆ What should I expect?
◆ Will it interact with or affect any medication or other conventional treatment that I am using?
◆ What are the possible harmful effects?
◆ What is the cost and length of a session?
◆ How long must I use the therapy/receive treatment?
• What information and resources are available to help me learn about this CAT?
• Do you need to be licensed or certified to practice this CAT? If so, are you?
• What professional organizations can be contacted to get information about practitioners of this CAT?
Choosing a Practitioner
Deciding which therapy to receive is part of the process, but deciding which provider will deliver
that therapy requires just as much serious thought and investigation. There are some important
steps in selecting a treatment specialist.
First, people need to be urged to take their time. They should gather names of practitioners by
contacting professional organizations, asking for recommendations from people they respect, and
checking local directories. After a few practitioners are identified, their websites can be visited or
they can be called and asked questions regarding education, experience, and
credentials/certification. Some therapies require degrees, whereas others require training with
specific criteria. People need to beware of any pressure or claims about cures. Brochures can be
requested, as can the names of some of the practitioners’ clients who can be contacted for
references. State licensing boards can provide information about standards that practitioners need
to meet.
After reviewing the information, people need to assess their own co …
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