Philosophy

Approaches to Healing

There are numerous complementary and alternative, or “CAM“, approaches to healing currently existing alongside the conventional, or “biomedical“, healthcare system in the United States. 

The most commonly practiced CAM healing systems include millennia-old East Asian medicines (Classical/Traditional Chinese, Japanese, and Korean medicines), Ayurveda, Unani (Persian traditional medicine), and various herbal and related traditional medicines originating from Africa, both North and South America, and Australia. 

More recent CAM approaches, often integrated with modern biomedical practice and increasingly referred to as “integrative medicines“, include Naturopathy, Osteopathy, Chiropractic, Functional medicine, homeopathy, and Anthroposophical medicine.

With all these choices, patients interested in complementary or integrative care are often at a loss as to which type of therapy to choose for their healthcare needs. It seems each of these myriad CAM healing traditions has a completely different paradigm or “world-view” (system of beliefs, accepted practices, terminology, and modalities) used to understand the natural world, the human being, health and disease.

In order to deeply comprehend CAM systems of healing, it is helpful to examine their paradigms in depth in order to tease out their common conceptual beliefs. Doing so, one gains the insight that nearly all CAM systems of healing share similar fundamental world-views and concepts, even though they might use different terminologies and originate from different cultures and historical eras.   

Further, by comparing and contrasting CAM paradigms with the core concepts of biomedicine, important insights emerge regarding the possibility of creating a more inclusive model of medicine, better able to address the complexities of modern chronic diseases.  

First, A Little Philosophy

Although it’s not always obvious, understanding the phenomena of the natural world, including human health and disease, requires more than the act of simple observation, or “naive” empiricism. 

In addition to the percepts or data gathered through our senses, we need concepts to filter our observations, make sense of them, find connections between data points, and to make predictions about future events using that data.  These concepts define our “way of knowing” the world. 

Once learned and adopted, these concepts become core beliefs, and usually remain unconscious to us. They are always running in the “background” of our minds while we go about our days observing the people and events around us, helping us to make sense of our experiences.  

Importantly however, while they do effectively filter the data around us, on the negative side, they also restrict our gaze to only certain aspects of the world, leaving other aspects and phenomena essentially invisible to us. 

Globally, the most widely accepted “way of knowing” the natural world originated in 16th-century Europe, and is widely known today as modern science. With its many branches, including the natural sciences of physics, chemistry, and biology, science (derived from the Latin scire, meaning “to know”) is defined as a systemic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe.  The methods and beliefs of science, applied to the human being, gave rise to modern biomedicine. 

Science is often associated with the scientific method: a way of testing and refining our hypotheses through the use of systemic observations and experiments. The scientific method replaced many earlier ways of gaining knowledge about the world, which were often biased by so-called “subjective” religious or philosophical beliefs, instead of being rooted in “objective” observations of nature. 

However, what is often overlooked is that in addition to the methods of science (known as epistemology), modern science is also steeped in a certain ontology or belief system about the fundamental nature of the universe, the physical world, and human beings.  

This ontology is often referred to as “metaphysical naturalism“, and consists of three core beliefs. These include physicalism-materialism (the belief that matter and physical energy is the basis of all phenomena), reductionism(belief that studying the smallest parts of a system can give us an understanding of the whole), and mechanism (belief that matter interacts through physical mechanisms, following the laws of physics and chemistry; in medicine, this is usually assumed to involve the rules of classical (as opposed to quantum) physics and chemistry).  

Technically speaking, to claim a hypothesis is “based in science” means only that it can be demonstrated to be true or not using the scientific method, through observation or experiment.  However, many go further and argue that only hypotheses that align with the ontology of modern science, metaphysical naturalism, have merit.  In everyday discussions about science, this is often what people mean when they say something is “scientific” or not. 

Therapies offered by CAM systems of medicine can be, and in many cases currently are being, tested using the scientific method in the laboratory or in clinical trials.  However, the belief systems of more traditional forms of healing differ significantly from metaphysical naturalism.  

Nearly all CAM paradigms are based in ideas that are nearly the polar opposite of the concepts of modern biomedicine, which makes for any sort of deep integration with the biomedical model challenging.  They “see” different aspects of reality that are missed by the biomedical paradigm, and vice versa.

For instance, most CAM paradigms hold that consciousness-mind-information, not matter-energy, forms the basis of the universe. Consciousness or mind is “super-sensible” (above the level of the usual senses) and guides the formation of matter. Matter in this view can be likened to a “frozen thought”. They view human beings as a multi-dimensional beings consisting of several layers or “fields” of consciousness or “information”. 

Further, CAM systems of healing hold that these layers of consciousness contain information patterns or “wholes” that have independent realities not reducible to the physical parts of our bodies, a principle known as holism. Thus, the human sense of self or “I” is not something that can be found in the cells, molecules, and genes of the body. Instead, the “I” exists independently of those parts and organizes them into a coherent whole.

Finally, CAM systems of healing argue the physical mechanisms, especially the mechanisms envisioned by medical scientists (such as the local physical interactions of protein and DNA/RNA molecules), are inadequate to explain the complexity of interactions taking place within living organisms.  Instead, long-range and coherent non-energetic informational processes, which have quantum-like properties, guide and direct the activities occurring within the human being.

Ironically, the belief system of modern science and medicine, based in materialism, reductionism, and mechanism, is itself a hypothesis and can’t be “proven” using the scientific method.  Those who argue that the metaphysical belief system of modern science and medicine is the best and only interpretation of reality and the natural world are promoting scientism, not science. Scientism is the belief that the ontology or worldview of modern science is the only valid descriptor of nature and the universe.  

CAM paradigms can be used to make measurable predictions about health and disease, which can be tested through the scientific method. They can ultimately meet the criteria of being “scientific”. However, they are mostly based in an entirely different ontology about the nature of reality and the human being.

This schism in world-views between modern biomedicine and CAM systems of healing has contributed to considerable confusion and has led to often only superficial levels of integration between these various approaches to healing.

It is my belief that the common “consciousness-based” ontology of CAM systems of healing can be expanded to include the “materialistic” ontology of biomedicine, thereby paving the road towards a truly integrative and more effective system of modern healing.  

Biomedicine

Most are widely familiar with the core beliefs and practices of modern medicine. 

The biomedical paradigm began to form during the European Renaissance in the 1500’s, and was largely established by the latter part of the 1800’s. The scientific method, cell and germ theory, the sciences of physiology and biochemistry (and in the 20th century molecular biology and genetics), modern surgical techniques and anesthesia, and modern pharmacology, all contributed to the foundation of the biomedical paradigm. 

If examined closely, several core beliefs characterize the biomedical paradigm: 

Materialism-Physicalism

The first core belief of biomedicine is that the human being is primarily a material-physical being, constructed from atoms and physical energies.

This is an extension of the belief of metaphysical naturalism that matter and physical energy, which includes atoms together with the four forces of nature) gravity, electromagnetism, and the strong and weak nuclear forces), forms the basis of reality.

In living organisms, cells are viewed as the fundamental units of life. All aspects of a human being are believed to emerge (in yet unexplained ways) from the activities found within cells.

These activities assumed to emerge from our cells include our life activities (metabolism, repair, growth, breathing, assimilation, reproduction, etc.), our consciousness activities(sensations, memories, instincts, emotions, conditioned thoughts), and our higher consciousness activities (related to our values, capacity for creativity/insight, self-introspection, and sense of self or “I”).

Thus, our physical form, life, consciousness, and self-consciousness are all assumed to arise from the complex interactions of molecules and genes occurring within the trillions of cells comprising our bodies. 

Importantly, although there is much interest in how molecular biology and genetics are related to life activities, few stop to think that materialism doesn’t adequately account for all aspects of the human being. Some are beginning to argue that consciousness, not matter, forms the basis of the universe, and the the human being is perhaps a being of consciousness first, and a being of matter secondly.  

Reductionism 

Reductionism refers to the belief that understanding the activities of the smallest parts of a system, such as the molecules, genes, and cells of the human body, is both necessary and sufficient for understanding the “whole”. 

Using a “bottom-up” approach, it is widely believed that having detailed knowledge of the molecular-genetic machinery of our cells will ultimately reveal the mysteries of disease and how it can be treated.  

It is also thought that reducing the complex activities our of being to these molecular parts will someday explain why our organs, for instance, take the shapes that they do, how life activities arise from the interactions these parts, and how consciousness arises from neurons. 

Reductionism also leads to the view that parts, such as organs and joints, can be removed or replaced without much change in the overall nature of the human being. 

However, although great progress has been made on some of these fronts, some are beginning to question whether reductionism is adequate to understand the “whole” of the human being, and argue that processes such as life and consciousness, although dependent on the underlying parts, cannot be explained from them.  This is similar to how understanding the alphabet and having a detailed knowledge of words isn’t enough to help you understand a book: the meaning is not found in the words, sentences, or paragraphs, but instead “exists” on a higher level. 

Mechanism

The parts (cells, genes, molecules) interact through known physiochemical mechanisms, especially those based in the laws of classical physics and chemistry. There are no mystical “vital” forces or mysterious “energies” in the body. The human being is basically a machine, albeit an extremely complex machine. 

Interestingly, the emerging field of quantum biology is challenging this belief, and is yielding evidence more in alignment with the views of organicism. It is being discovered that classical physics and chemistry alone are inadequate to explain some cellular and tissue processes, and that non-classical quantum-like explanations better fit various phenomena that occur, for instance, in photosynthesis, animal migration along magnetic field lines, and human olfaction.

Pathogenic Model of Disease
 
Biomedicine views diseases as distinct entities arising within the body’s cells (cell theory of disease), and seeks to address the mechanisms leading to disease, known as pathogenesis. 

Various physical factors, such as microbes, toxins, radiation, genetic defects, and nutrient deficiencies, trigger disease-causing mechanisms within our cells (such as inflammation, tumor formation, and tissue breakdown), which need to be addressed. 

This is done using largely suppressive or “anti-” therapies (anti-inflammatories, antipyretics, antihypertensives, etc.). These agents are targeted to block the primary disease causing mechanisms, thereby alleviating illness.  However, as more evidence accumulates, it is being discovered that targeting single, or even multiple, mechanisms of disease fails to “outsmart” the disease activity, and secondary and tertiary mechanisms are often up-regulated, thereby reducing the efficacy of therapies.  

The entire emphasis of the biomedical model, then, is focused on the elimination of disease, rather than the restoration of health.
 
 

Complementary and Alternative Medicines (CAM)

As mentioned previously, CAM approaches to healing are grounded in core beliefs about the nature of reality that are nearly polar opposite to the beliefs of modern science and medicine. 

They can be briefly summarized as follows: 

Multi-dimensional nature of the human being
 
CAM approaches view human beings as consisting of multiple layers of organization, each layer or dimension having its own set of rules describing the network of relationships and activities within that layer. Each layer can be thought of as a “field of consciousness”, having its own inherent rules, memory patterns, and purpose.  
 
Often likened to subtle “bodies”, CAM approaches often conceive of these layers of organization as originating from super-sensible dimensions of reality, independent of but working through our physical organization. 
These layers include the: 
 
  • Living organization, which governs our inner activities of metabolism, assimilation, growth, tissue repair, nutrition, and reproduction. These life activities constantly regenerate and restore the body to health. They are largely directed by the various hormones, growth factors, and proteins dissolved in our body fluids, both inside and outside the cells of our tissues and organs. 
  • Consciousness organization, which integrates our sensations, emotions, and conditioned thoughts, and instincts, historically referred to as our “soul”. These activities unfold largely through the activities of the nervous system, both through the brain and spinal cord, but also through the autonomic nervous systems. The autonomic nervous system includes both the “rest-and-digest” activities of the parasympathetic nervous system (carried largely by the vagus nerve), and the “fight-or-flight” response of the sympathetic nervous system. Emotional patterns of disturbance can be deeply ingrained in the various parts of the nervous system, which can adversely affect organ and glandular function. 

  • Self-Consciousness Organization, which is level of organization related to the activities of the higher mind and self-awareness. Historically, this level of organization has been associated with our “spirit” and sense of “I” and self-identity. Unlike the lower mind/consciousness organization, which often continues to react and play out the same ingrained patterns over and over again in over lives, the higher mind, through self-observation, can become aware of these patterns and has the capacity to shift them into new states, allowing for greater self-expression and freedom. 

Thus, unlike the view of biomedicine, CAM paradigms posit that a human being is more than just a collection of cells and molecules. Rather, we are multidimensional beings consisting of a physical body, a living body, a soul, and a spirit. In order for a true and deep healing to occur in individuals, all these layers must be addressed.

 

Holism

The various levels of organization (or “bodies”) that comprise our being are wholes onto themselves, each having a unique set of organizing principles not reducible to simpler layers. The biomedical paradigm, which emphasizes the physiochemical activities of cells, genes, and molecules, excels at understanding our physical organization, but largely neglects the networks of relationships forming the other more subtle dimensions of ourselves. Ultimately, the human being is more than just the sum of its parts.  The “wholes” of organized activities in our living and consciousness/self-consciousness bodies are realities in and of themselves, even though they are non-material and require more delicate modes of knowing in order to be perceived. They each have their own unique anatomy and physiology. 

 

Organicism

CAM approaches hold that our living organization is governed by a unique set of principles that emerge from the physiochemical processes at the level of our cells, genes, and molecules. These “emergent” properties of living systems have their own unique laws and are similar to the coherent and wave-like processes described in quantum mechanics. Although often associated with energy, they are beyond physical energies and are more informational or formative in nature, and constantly strive to bring “inorganic” matter to a living state, where metabolic, repair, growth, and reproductive activities can occur. Importantly, they impart rhythms to living matter, and thus work through time and not directly through the spatial element. 

 
 
Homeostasis-Terrain
 
All CAM medicines view the activities of the living organization as being intelligent and purposeful, if allowed to unfold in an orderly way. They posit that if the obstacles to healing are removed (such as poor diet and excess stress) and the organs and glands are properly supported (through the use of herbal medicines and micronutrients, for instance), the life activities will seek to restore inner physiological balance, thereby engendering health. 
 
These intelligent life activities were known as the Vis medicatrix naturae (“healing power of nature”) in the Ancient Greek system of medicine, and were conceived of as being carried by various “vital” or special living forces, known as the 4-humors. In a state of health, or eukrasia, the humors are balanced. In disease, the humors are imbalanced (dyskrasia), and require rebalancing.
 
Ancient Greek medicine, for instance, would have viewed inflammation and fever, for example, as processes used by the body to discharge toxins and microbes from the body. When these processes are somehow impeded, the conditions for disease may occur. The goal of therapy would be to support these processes (within limits) in order for a greater state of healing to be achieved. 
 
Most CAM medicines, also known as “humoral medicines”,  achieve this rebalancing through the use of herbs, nutrients, and physical means, such as acupuncture and therapeutic massage. However, by the early 1800’s in Europe and North America, the humors were increasingly viewed in a materialistic way, being seen as “fluids” that needed to be purged from the body. This led to the widespread and unfortunate practice of blood-letting, which certainly contributed to a great loss of life, and helped usher in the demise of humoral thinking in modern medicine.  
 
However, in the early 20th century, the physiologist Walter Cannon updated the concept of the Vis medicatrix, associating it with his concept of homeostasis.  Homeostasis refers to the state of steady, internal physical and chemical conditions that need to be maintained within living organisms, such as our body temperature and the balance of all the various electrolytes and constituents in our blood and body fluids. However, instead of invoking humors and vital forces, Cannon provided a mechanical interpretation of how these processes occur through the activities of our nervous and endocrine (hormone) systems.
 
Since then, the role of the immune system and the connection with the psyche have been incorporated into our knowledge of homeostasis, leading to the modern field of study known as “psycho-neuro-endocrine-immunology”.  
 
So, interestingly, although biomedicine recognizes the importance of homeostasis, improving homeostasis, especially through nutrition and lifestyle changes, is often not viewed as a primary goal of medicine. Rather the emphasis is placed on eliminating disease, and targeting pathogenesis (the mechanical origins of disease). 
 
 
Salutogenesis
 
CAM paradigms argue that the goal of medicine should be to increase the resilience and capacity of human beings to resist the various factors that lead to illness. Medicine should focus on supporting the Vis medicatrix and the factors engendering health, as opposed to focusing only on the mechanisms of disease. Increasingly, conceptual models of medicine that aim  to restore normal physiology and address psycho-social determinants of health are being referred to as “Salutogenic”, to distinguish them from the “pathogenic-disease” model of biomedicine. 
 
Coined by the medical sociologist Aaron Antonovsky (1923-1994) in the 1970’s, the term “Salutogenesis” (Latin salus = health + Greek genesis = origin) was originally used to describe the relationship between health, stress, and coping. However, the term can be used to describe CAM approaches to healing in general. Salutogenic medicines envision a continuum between health and disease, and ask what can be done to move a person towards the pole of health, as opposed to simply eliminating disease. 
 
 
Macrocosm and Microcosm
 
Although we often experience ourselves as separate from the world, a key principle of organicism is that the earth and cosmos are living and conscious beings. Further, human beings contain a compressed image of the enlivened and ensouled cosmos within them–they are a microcosm of the outer macrocosm of the universe–and contain within them all the myriad activities present in the mineral, plant, and animal realms. Thus, when illness occurs in a particular dimension of our being, the very remedies needed to address these maladies can be found in the various kingdoms of nature. Prepared in the right ways, remedies prepared from plants and minerals/metals can deliver specific healing information to the various levels of our being, restoring a healthy terrain.
 
 
Ultimately, Salutogenic-Terrain systems of medicine seek to empower the human being to lead a more joyful, vibrant, and purpose-driven existence. They seek to support the conditions leading to health by addressing the multiple dimensions of body, soul, and spirit. 
 
 

Integrative Medicine

In the end, the pathogenic-cellular and Salutogenic-terrain models of medicine both have their role, and both complement one another.  

When it comes to understanding and treating the actual mechanisms of disease at the cellular-molecular level, as well as arresting life-threatening acute disease, the paradigm of biomedicine reveals its strengths. 

It has revolutionized the treatment of acute and infectious disease, lead to profound advances in trauma and surgical care, has inspired technologies that illuminate the interior of our bodies to an unprecedented level of detail, and has produced increasingly targeted medications that more precisely quell the mechanisms of disease.
 
However, in the approach to chronic disease, the biomedical paradigm is often felt to be lacking.  With its emphasis on lower-level mechanisms, the more subtle regulatory networks that maintain life and health are largely neglected by biomedical approaches. While it can effectively suppress symptoms and may be life-saving, there is concern that the pathogenic-cellular model of medicine does not ultimately support health and greater wellbeing. 
 
Here, the CAM and Salutogenic-Terrain paradigm shows its strength by supporting the multidimensional layers of the human being, including the living and consciousness bodies, each with their unique laws and principles. With their emphasis on the “health” pole of the health-disease continuum, Salutogenic medicines foster wellness, inner resilience, and vitality. 
 
In my practice, I seek to combine these seemingly disparate healing paradigms into a more complete and integrative system of medicine, capable of addressing the most challenging chronic health conditions.  Knowing when and where each has its place in a treatment regiment is crucial. 
 
I look forward to being your guide in this emerging realm of truly integrative medicine.