Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021
Alternative Medicine: What is it and Does it Work?
The great tragedy of science — the slaying of a beautiful hypothesis by an ugly fact. (T.H. Huxley, Collected Essays)
But besides real diseases we are subject to many that are only imaginary for which physicians have invented imaginary cures. (Jonathan Swift, Gulliver’s Travels)
Complementary and alternative medicine (CAM) has gained wide recognition and CAM is now big business. There are common themes in the philosophies of CAM. Aakster (1986) argued that they differ from orthodox medicine in five ways:
Health: Whereas conventional medicine sees health as an absence of disease, alternative medicine frequently mentions a balance of opposing forces (both external and internal).
Disease: Conventional medical professionals see disease as a specific, locally defined deviation in organ or tissue structure. CAM practitioners stress body-wide signs, such as body language indicating disruptive forces and/or restorative processes.
Diagnosis: Regular medicine stresses morphological classification based on location and aetiology, while alternative interpretations often consider problems of functionality to be diagnostically useful.
Therapy: Conventional medicine often claims to destroy, demolish or suppress the sickening forces, while alternative therapies often aim to strengthen the vitalizing, health-promoting forces. CAM therapists seem particularly hostile to chemical therapies and surgery.
The Patient: In much conventional medicine the patient is the passive recipient of external solutions, while in CAM the patient is an active participant in regaining health.
Aakster described three main models of medical thinking: The pharmaceutical model is a demonstrable deviation of function or structure than can be diagnosed by careful observation. The causes of disease are mainly germ-like and the application of therapeutic technology is all-important. The integrational model resulted from technicians attempting to reintegrate the body. This approach is not afraid of allowing for psychological and social causes to be specified in the aetiology of illness. The third model has been labelled holistic and does not distinguish between soma, psyche and social. It stresses total therapy and holds up the idea of a natural way of living.
The popular interest in CAM has been matched by a relatively sudden and dramatic increase in research into the two central questions in this area:
1 Does it work? Is there good evidence from double-blind, placebo-controlled, randomized studies that the therapy ’cures illness’ as it says it does? That is, is there any indisputable scientific evidence that documented findings of success are due to anything more than a placebo effect? Properly designed and executed studies are complex, very expensive and similar to the research effort to determine the efficacy of psychotherapy. The answer to the question is that either very little or no good evidence is available for the efficacy of most CAM, with the possible exception of herbalism.
2 Why choose it? If the evidence is limited, equivocal and indeed often points to lack of efficacy, the central question must be why do patients choose at their own expense to visit a CAM practitioner? What do they get from the treatment? Why do they persist? This is where there have been many psychological studies. They concern the often mixed motives that patients have in shopping for health treatments.
There is some evidence that frequent CAM users are more health conscious and believe more strongly that they can influence their own state of health, both by lifestyle and through maintaining a psychological equilibrium. CAM patients appear to have less faith in ’provider control’, that is in the ability of medicine (specifically orthodox doctors) to resolve problems of ill health. The principal reason for individuals beginning any CAM treatment appears to be that they regard it as more natural and effective, and it allows a more active role for them.
The second reason is the failure of orthodox medicine to provide relief for specific (usually chronic) complaints. The adverse effects of orthodox medicine, and a more positive patient—practitioner relationship are also important for many patients. There is little to support the widely held view that CAM-seeking patients are especially gullible or naive, or have unusual (neurotic) personalities or (bizarre) value or belief systems.
Results from various studies reported by Furnham and colleagues show:
• People shop for health.
• People want a cure without side effects or pain.
• CAM patients have chronic illnesses or conditions they have difficulty living with.
• CAM patients are disappointed by the traditional orthodox consultation.
• CAM patients want to learn more about self-care (fitness, wellness and prevention).
• CAM patients believe in the ’holistic’ message.
WHO SEEKS CAM?
It would be foolhardy to talk about ’typical’ patients as CAM rejoices in differences, individuality and the uniqueness of people’s lives. However, there are patterns and a higher probability that particular types of people are likely to seek out, use and benefit from CAM.
Demography: CAM patients are more likely to be: women rather than men; aged 30—40 rather than older or younger; middle rather than working class; well-educated; and urban rather than rural.
Medical History: First, patients seeking CAM have chronic problems rather than acute. Secondly, their health problems are often non-specific or have a psychological component. Thirdly, many patients have a ’thick file’ in the sense that their interest in health issues has led them to seek out various remedies from many different sources.
Beliefs, Attitudes and Values: Many patients seem to be sympathetic with green issues, ideas and understanding. These include environmentalism, one-world-ism and anti-materialism. Pro-CAM beliefs may also include issues of inequality, alienation and social exclusion. CAM patients also seem to be interested in general consumer affairs and may even belong to bodies that lobby in favour of a certain position. CAM patients appear to be particularly interested in the ’life of the mind’. They certainly believe the maxim of ’a healthy mind in a healthy body’. CAM patients are, because of their own medical condition, likely to be very empathic to the plight of others, and hostile to the ’uncaring’ attitude of certain specialists (e.g. surgeons).
Aakster, C. (1986). Concepts in alternative medicine. Social Science and Medicine, 22, 265—73.
Eisenberg, D., Davis, R., Ettner, S., Appel, A., Wilkey, A., Van Rompay, M., Kessler, R. (1998). Trends in alternative medicine use in the national survey. Journal of the American Medical Association, 11, 1569—1575.
Furnham, A. (2005). Complementary and alternative medicine: Shopping for health in post-modern times. In P. White (Ed). Biopsychosocial Medicine. Oxford: OUP, pp.151— 71.