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Trivieri, Larry : Alternative Medicine
Larry Trivieri, Jr., is a recognized lay expert in the fields of holistic medicine and personal transformation. He was senior editor of the bestselling health book Alternative Medicine: The Definitive Guide, which has sold more than 600,000 copies, and coauthor of The Complete Self-Care Guide to Holistic Medicine. He is a contributing editor of Alternative Medicine magazine and writes for numerous other publications. Founded in 1978, THE AMERICAN HOLISTIC MEDICAL ASSOCIATION is a national organization of physicians and other licensed health care practitioners who share a body-mind-spirit approach to healing.
Chapter 1 The History and Philosophy of Holistic Medicine
As we enter the twenty-first century, a revolution in health care is slowly yet inexorably taking place all around the world. What distinguishes this revolution from similar momentous changes sweeping through other fields of human endeavor is the fact that it is being sparked not so much by leaders in the health care field, but by burgeoning numbers of laypeople who are seeking more effective solutions to their health and wellness needs. The reason for that search is simple: despite a century of remarkable diagnostic and therapeutic advances in the field of conventional, or allopathic, medicine, chronic illness continues to spread at an alarming rate and is proving increasingly impervious to drugs and surgery. Just as important, more and more patients are looking for health care approaches that address their specific and unique traits and needs, rather than simply treating their symptoms. But perhaps the primary factor that accounts for the growing shift away from allopathic care is the fact that many patients with chronic conditions, such as chronic pain, anxiety, arthritis, headache, gastrointestinal disorders, addictions, fatigue, and lack of energy, simply are not getting better using the remedies prescribed by their conventional physicians. As a result, surveys show that as many as two-thirds of North Americans now use some form of complementary and/or alternative medicine in their quest to find the type of health care they desire. The solutions they are searching for are broad-based and comprehensive and are increasingly being found in the emerging new field of holistic medicine.
According to the American Holistic Medical Association (AHMA), holistic medicine is defined as the art and science of healing that addresses the whole person--body, mind, and spirit--by integrating conventional and alternative therapies to prevent and treat disease, and to promote optimal health. AHMA members recognize that both conventional and alternative therapies have their place and combine both in order to offer their patients a full range of treatment options tailored to each patient's specific needs. At the same time, holistic physicians emphasize personal responsibility and educate their patients about how to take care of themselves at all levels of their being.
Robert S. Ivker, D.O., past president of the AHMA, describes holistic or optimal health as "the unlimited and unimpeded free flow of life force energy throughout your body, mind, and spirit." Each of us has the capacity to nurture and to heal ourselves, but most of us have yet to tap into this wellspring of loving life energy. Holistic physicians recognize this fact and help their patients learn how to tap into this life force while simultaneously treating their disease conditions. "The result," Dr. Ivker says, "is that their patients learn to safely and effectively treat any physical, mental, and spiritual conditions that may be impeding the flow of this vital energy in their lives, so that they not only start to get better, they also begin to thrive and experience more energy and joy in being alive. When this happens, there is a sense of harmony and balance in the physical, environmental, mental, emotional, spiritual, and social aspects of their lives." Holistic medicine also emphasizes treating the causes of disease, not just its symptoms. This, coupled with its minimal toxic side effects and generally lower costs, explains why so many Americans are now choosing holistic medical approaches.
THE PRINCIPLES OF HOLISTIC MEDICINE
Holistic medicine's comprehensive definition of health is at odds with our predominant health care system, which is based almost entirely upon the diagnosis and treatment of disease symptoms. While conventional medicine is unsurpassed in treating acute life-threatening illness and injuries, its reliance on pharmaceutical drugs and surgery has left it largely a failure in terms of handling chronic conditions. As a result, over 100 million Americans now suffer from some type of chronic illness, driving the cost of health care in the United States above $1 trillion per year. Further compounding the problem is the fact that most conventionally trained physicians are taught little, if anything, about maintaining and enhancing health, or even preventing disease. Even within the fields of alternative and complementary medicine the primary focus is still on relieving symptoms and treating disease. Although holistic physicians also address their patients' immediate physical discomfort by using both alternative and conventional therapies, most of their time is spent determining the multiple underlying causes of their patients' ailments and helping them to correct the imbalances in their lives that are responsible for them. Throughout this process optimal health remains the chief objective.
Informing holistic physicians' approach to health care are twelve principles of holistic medicine that have been established by the board of trustees of the American Holistic Medical Association. Each of these principles is outlined below.
1. Holistic physicians embrace a variety of safe, effective diagnostic and treatment options. These include education for lifestyle changes and self-care; complementary diagnostic and treatment approaches; and conventional drugs and surgery. In diagnosing and treating disease, optimal outcomes are most often achieved by combining the best of both conventional and complementary medicine and teaching patients how to live a holistic lifestyle. The need for the synthesis of these options is reflected in the recent draft document for establishing curriculum guidelines for teaching complementary and integrative medical principles and applications to physicians in specialty training in family practice residencies. The committee of the Society of Teachers of Family Medicine, which developed these guidelines, believes this step to be essential for the 470 family practice training programs in the United States.
2. Searching for the underlying causes of disease is preferable to treating symptoms alone. This second principle of holistic medicine is bolstered by a 1987 study published in the Journal of the American Medical Association (JAMA), in which researchers found that 40 percent of a large group of hypertensive patients maintained a normal blood pressure without drugs after losing an average of five pounds in body weight, reducing their sodium intake, and limiting alcohol consumption to one drink per day. Robert Anderson, M.D., is a founding member of the AHMA and president of its sister organization, the American Board of Holistic Medicine, the first organization to certify physicians in its practice. Dr. Anderson has observed that pursuing the answer to why patients have high blood pressure has resulted in 75 to 80 percent of patients being able to go off their medications, while the remaining 20 percent were able to reduce their dosage levels. "By losing weight, reducing sodium and alcohol intake, adopting a modest exercise program, paying attention to their attitude, and engaging in a regular program of deep relaxation or meditation, most patients can maintain a normal blood pressure without drugs," Dr. Anderson says. "Similar results can often also be achieved for most patients suffering with other forms of chronic illness. Moreover, many patients would prefer making such lifestyle changes rather than taking medications. The cost savings alone would make many consider this worthwhile, and surely it is the responsibility of the medical profession to look at these simplest solutions first."
3. Holistic physicians expend as much effort in establishing what kind of patient has a disease as they do in establishing what kind of disease a patient has. This hundred-year-old dictum from one of the revered fathers of American medicine, William Osler, M.D., emphasizes the multiple factors underlying the incidence and development of many diseases. In a group of women diagnosed with breast cancer, for instance, a recent study showed that the risk of recurrence of their cancer is nine times greater in women who are under high levels of stress compared to those whose stress levels are low. Failure to recognize the importance of stress and deal with it adequately greatly reduces the likelihood of a favorable outcome.
Further supporting this third principle is the fact that the internal healing capacity of the patient is the key to the presence or absence of disease. This basic medical truth was recognized in the late nineteenth century by Dr. Claude Bernard, the father of modern physiology, who pointed out that exposure to most bacteria, viruses, and toxins resulted in illness in only a portion of the population. Patient resistance to illness was, in his opinion, the consideration of first importance. A modern example of Bernard's tenet can be found in cases of tuberculosis. Recent research has revealed how lifestyle affects intrinsic resistance and immunity, and how it changes outcomes. Among the major lifestyle factors are attention to nutritional consumption, physical exercise, smoking, substance abuse, deeply held beliefs and attitudes, and protecting against accidents and trauma.
4. Prevention is preferable to treatment and is usually more cost-effective. The most cost-effective approach evokes the patient's own innate healing capacities. The conventional physicians' standard response to a diagnosis of chronic illness involves the prescribing of drugs. In cases of elevated blood pressure, these drugs include diuretics, beta-blockers, or angiotensin-converting-enzyme-inhibitors. While such drugs can often result in symptom relief, they do not alter the underlying causes of hypertension. But when unmanaged stress is recognized as a major contributing factor, a brief course in biofeedback/relaxation training greatly enhances a patient's ability to handle stress, reducing or normalizing blood pressure in the process. For patients who develop this skill, the benefits include improved immunity, faster reaction time, better hearing and pain tolerance, and a decrease in headaches, migraines, insomnia, ulcers, adrenaline, cortisone, cholesterol, and muscle tension. Similar results occur when both doctor and patient pay attention to diet and nutrition, since it takes five to seven times the normal amount of nutrition to build and repair as it does to maintain proper physiological function.
A physician who exemplifies the fourth principle of holistic medicine is Dean Ornish, M.D., who demonstrated that coronary artery disease can be reversed by instituting a combination of lifestyle changes. Two years after his pioneering research was published in Lancet in 1990, the Mutual of Omaha Insurance Company decided to cover the cost of his reeducation and training program for heart patients. Although expensive, it was a fraction of the cost of coronary artery surgery for just one patient out of an entire class of patients who followed Dr. Ornish's program.
5. Illness is viewed as a manifestation of a dysfunction of the whole person, not as an isolated event. Nonconventional healing systems in various parts of the world have recognized the importance of the whole person to a much greater extent than Western allopathic medicine. Traditional Chinese medicine, or instance, has for five thousand years recognized the importance of a balance of movement (a variety of martial arts), diet, herbal remedies, and the unimpeded flow of qi, or life force energy, as being essential for optimal health. The concept of the whole person has also been a core belief in Ayurveda, the traditional medicine of India and South Asia, or several thousand years.
The advantage of treating the whole person instead of an isolated disease is illustrated by comparing conventional and holistic approaches to treating cataracts, a common condition among elderly people in the United States. "Lens implant surgery is the largest single-issue medical expenditure for Medicare, and is the common approach undertaken by conventional physicians," Dr. Anderson explains. "Yet a cataract is much more than a disease of the eye. It is a manifestation of elevated free radical activity which has been developing in the body of the patient or many years due, at least in part, to decreased antioxidant levels." By incorporating better nutrition, exercise, smoking cessation, avoidance of extreme bright sunlight, and antioxidant supplementation into the treatment protocols of their patients, holistic physicians are able to reduce the risk of cataracts by as much as 70 percent.
6. A major determining factor in the healing process is the quality of the relationship established between physician and patient, in which the patient is encouraged to take responsibility for his or her health. The relationship between patient and physician is one of the most powerful influences on the eventual outcome of a medical disease or psychological condition. A high-quality relationship inspires willingness, confidence, and enthusiasm, and a sense of trust and satisfaction, all of which enhance healing. In a trusting relationship, a patient knows that the physician deeply cares and will focus his or her best effort on determining the cause of, and best treatment for, the patient's condition.
Participation in decision making, working cooperatively with one's physician and members of the health care team, and being highly informed about what is happening, all contribute to a heightened sense of autonomy on the part of the patient. Long-term studies in Europe have demonstrated much lower incidences of heart disease and cancer, for instance, in autonomous persons compared to more dependent people who allow their beliefs and attitudes to be determined by external actors. Members of the much healthier autonomous group espoused the belief that health is an "inside job," and were therefore more willing to do whatever was necessary to ensure their well-being.
7. The ideal physician-patient relationship considers the needs, desires, awareness, and insight of the patient, as well as those of the physician. "The beliefs, experience, and education of the patient will influence his or her desires and degrees of awareness regarding medical choices, and also influence his or her physician," says Dr. Anderson. "If the physician and patient both believe in a given approach, it will be much more effective. This is an important point to consider, given that in many clinical situations a wide variety of choices are frequently present.
8. Physicians significantly influence patients by their example. A cartoon hanging on the wall of Dr. Anderson s waiting room shows a three-hundred-pound, cigar-smoking physician tilted back in his chair, asking a shivering, half-clad skinny patient across the desk, "Are you eating properly and getting plenty of exercise?" This ridiculous comparison has tickled thousands of his patients over the years. "In all walks of life, what we do speaks more loudly than what we say," Dr. Anderson points out. "Therefore, physicians need to be aware of the influence their actions can have on their patients, both positively and negatively, bearing in mind Hippocrates' injunction 'Physician, heal thyself.' At the same time, patients would do well to ask themselves if their health care providers are living the healthy lifestyle they expouse. If they're not, it may be time for the patient to consider seeking someone else to guide them in their health care needs."
9. Illness, pain, and the dying process can be learning opportunities for both patients and physicians. Dr. Anderson recalls the great shock of disbelief he experienced the first time a cancer patient in declining health said to him, "I'm glad I got my cancer." The patient was slowly losing her battle with breast cancer, yet as a result of her ordeal she had discovered some valuable life lessons. She had learned to appreciate every moment of her days: the incredible beauty of nature as she slowed her pace to pay attention; the wonder of moments of intimacy with her husband; her finite but previously unrecognized inner resources in dealing with the pain and fatigue of the cancer; the joy of plumbing the mysteries and meaning of life itself; and the ability to use her experience in helping others in similar circumstances. "She taught me that the quality of life in our brief span of life is perhaps our most important consideration," Dr. Anderson says. "After my experience with her, at least half a dozen other cancer patients have shared with me the same sentiments. All have learned things about themselves that overshadowed even their desire to prolong their lives." When both patients and physicians are able to recognize the healing potential inherent in pain, disease, and dying, miraculous resolutions in their lives can occur. And if death proves inevitable, it usually comes more peacefully and with greater acceptance on the part of everyone involved. On the other hand, sometimes the recognition of the gifts and lessons involved during the disease process can mobilize our innate healing abilities, even to the point of spontaneous remission.
10. Holistic physicians encourage their patients to evoke the healing power of love, hope, humor, and enthusiasm, and to release the toxic consequences of hostility, shame, greed, depression, and prolonged fear, anger, and grief. Extensive research documents the detrimental effects of hostility, depression, and anxiety in chronic disease conditions such as heart disease, cancer, stroke, and autoimmune diseases like rheumatoid arthritis, to name just a few. One study, for example, found that among a group of patients undergoing angioplasty for threatening coronary artery disease, the risk for restenosis (the recurrent closing down of the artery) was 250 percent greater in patients found to have high levels of hostility, compared to patients with low hostility levels. Another study of two thousand male employees of Western Electric, all of whom were initially free of heart disease, found that the rate of coronary heart disease over a ten-year period was 32 percent greater among those whose psychological tests showed great hostility. A third study found that when volunteers were asked to recall the last time they became extremely angry, measurements of their hearts' pumping ability decreased 12 percent in only fifteen minutes. Such studies clearly reveal that negative emotions and attitudes are toxic to the physical, mental, and emotional function of us all.
On the positive side, the therapeutic benefits of humor and laughter have also been repeatedly shown. One study, for instance, showed that volunteers who viewed humorous videotapes strengthened their immune systems within thirty minutes. According to Dr. Anderson, children laugh an average of four hundred times a day; adults only fifteen times a day. "No doubt that is one reason that adults are far more prone to chronic illness than children are," he says.
11. Unconditional love is life's most powerful medicine. Holistic physicians strive to adopt an attitude of unconditional love for patients, themselves, and other practitioners. "Unconditional love, released through the act of forgiveness, is the most important tool or self-empowerment, development of positive attitudes, and optimism, all of which contribute to better therapeutic outcomes," Dr. Anderson says. A growing number of studies demonstrate the healing power of love and intimacy.
12. Optimal health is much more than the absence of sickness. It is the conscious pursuit of the highest qualities of the physical, environmental, mental, emotional, spiritual, and social aspects of the human experience. The principal emphasis of Western medicine has been intervention in disease processes, primarily through the use of drugs or surgery. Holistic medicine adds a twofold question to this conventional approach: What has caused the patient's condition to develop, and what can be done to help him or her reverse that cause? In addition, what fundamental changes can the patient undertake to limit further degeneration, reverse the degenerative process, cure the disease, and pursue optimal health with the highest-quality physical, environmental, mental, emotional, spiritual, and social experience of life itself?
"In nearly every instance in which an individual commits to a significant change in diet, exercise, or other health practice, there is an incremental improvement in their state of health, even at an advanced age," Dr. Anderson reports. Illustrating his point is the case of one of his patients, a sixty-four-year-old woman who developed widespread ovarian cancer. Surgery removed the bulk of the tumor, but significant amounts of the cancer remained. She refused chemotherapy. Respecting her choices, Dr. Anderson responded to her request that he help her to get well. Together they developed a comprehensive strategy to enhance her immunity, evoke her determination and will, improve all aspects of her lifestyle, and enhance her spiritual life, including forgiving a large number of people. One of her life's greatest pleasures was attending opera. As part of her recovery, she saved her money to fulfill a lifelong dream and was able to hear some of the greatest stars of opera perform for three nights at La Scala in Milan, Italy. Later, surgery showed her cancer to be totally gone. She eventually died of unrelated causes after eight years of enjoyable, satisfying life, having accomplished what she wanted to do in this lifetime, while overcoming an aggressive cancer that could have taken her life a year after its discovery.
The underlying concepts of holistic medicine are not new. In actuality, they represent a return to medical principles that have shaped our understanding of health and illness for thousands of years in both Eastern and Western cultures. In the East, the idea that each of us is a being of body, mind, and spirit has played an integral role in shaping the traditions of Chinese and Ayurvedic medicine, both of which are thousands of years old. In the West, the idea that health is directly related to a state of harmonious balance, both within oneself and with the outer world, also extends back thousands of years, and was a major tenet in the teachings of Hippocrates, the father of Western medicine.
Disease, from the perspective of both the Eastern and Western medical traditions, was recognized as a consequence of disharmony, or living "out of tune" with the natural order of things. Among the conditions that both cultures recognized as being crucial to health were a healthy diet, proper hygiene, exercise, a calm mental and emotional state, home and work environments conducive to well-being, and a recognition of a natural life force, or spirit, that pervades and sustains all life. Similar tenets can also be found in the healing traditions of ancient Africans, Native Americans, and other indigenous cultures. Teaching patients how to live in harmony with themselves and their environment by emphasizing each of the areas above was the primary goal of the healers and physicians within these cultures. Over time, however, they lost sight of much of what they had learned in these areas, especially after the discoveries of Pasteur and the advent of "germ theory." Since then, modern medicine has becoming increasingly one-sided in its focus, seeking out ever more powerful drugs to treat bacteria, viruses, fungi, and other microorganisms, while focusing on body parts and specialization to the point where the individual being treated is altogether forgotten.
Recognition of this fact led world-renowned neurosurgeon C. Norman Shealy, M.D., Ph.D., to found the American Holistic Medical Association in 1978, in order to provide a "common community" for physicians committed to treating the "whole person" according to the philosophy of holistic medicine. Since its inception, the AHMA has emphasized the principle that "drugs and surgery are often the treatment of necessity and of choice in acute illness, and often inadequate in significant healing for those with chronic illness." In order to better serve their patients, AHMA members also emphasize nutrition, exercise, various bodywork therapies, energy medicine, mind/body medicine, "and, above all, an emphasis on spirituality." In so doing, they are leading the way toward a new system o health care that combines the best of both modern allopathic medicine and the far older or more holistic medical systems around the world.
BODY, MIND, AND SOUL: A MULTILEVEL APPROACH TO WELLNESS
According to Dr. Ivker, true holistic health can be achieved only when there is harmony and balance in body, mind, and spirit.
Each of these three levels of health contain two components. Being healthy in body means not only being physically healthy, but also creating a healthy environment, both at home and where you work. Mental health comprises the quality of our thoughts and emotions, and also our attitudes and beliefs about ourselves. And being healthy in spirit means being connected both spiritually and socially to the flow of life force energy. A weakness in any one of these areas will eventually lead to a decline in all areas, and ultimately result in disease. As holistic physicians, our primary job is to help our patients recognize this fact and guide them towards healing whichever areas of their lives are out of balance. As a specialist in the holistic treatment of sinusitis and other respiratory conditions, for instance, I've found that many of my patients have problems with unresolved anger. Helping them learn how to express their anger safely and appropriately can make a big difference with their sinus problems, and often is the key factor in curing their condition.
Dr. Ivker further describes each of these six components as follows:
In addition to the factors above, optimal health also depends on the healthy functioning of the body's interdependent systems. According to Joseph Pizzorno, N.D., founding president of Bastyr University and author of Total Wellness, chief among the body's intrinsic healing systems are the immune system (including the lymphatic system), the detoxification system, the inflammatory system, the metabolic system, the regulatory system, and the rejuvenation system. As Dr. Pizzorno points out, these systems "must work effectively for each of us to establish and maintain total wellness." In addition, only by understanding and correcting whatever imbalances may be present in these systems can we reestablish normal function and create lasting optimal health. As Dr. Pizzorno writes, "It is easy to prescribe a whole-foods diet, more exercise, less pollution, and less stress for everyone, but such generic prescriptions do not recognize the unique needs of each individual." Recognizing such individual needs and creating a wellness program to match them is the goal of holistic medicine.
In designing a wellness program for their patients, holistic physicians also recognize and honor the principle of homeostasis, which refers to the body's wondrous capacity to maintain and repair itself by supporting the equilibrium within the various body systems. When we are healthy, this homeostatic process occurs automatically so that if we cut ourselves, or example, the healing process begins immediately. But when our body systems are overtaxed or out of balance, this self-regulatory process becomes impeded. Restoring homeostatic function, therefore, is one of the primary goals of holistic physicians when treating disease, and is one of the ways that their approach to health care differs from their conventional counterparts.
When a person becomes ill, homeostasis manifests itself in the form of symptoms. Holistic physicians recognize that these symptoms are signs that the body is homeostatically trying to restore proper function. Instead of trying to suppress such symptoms through the use of drugs, holistic physicians seek to assist the body in ridding itself of whatever infectious agents may be present so that it can restore itself. Only in cases where the symptoms are life-threatening or tremendously painful will they consider interrupting this process. Otherwise, they monitor the situation and use whatever measures are most advisable and most appropriate for each patient in order to help the process run its course. This means making sure that the patient's needs are being met on all levels body, mind, and spirit. The resultant healing crisis may be uncomfortable, but when it is over, typically the patient will experience a new level of wellness. "Many times, too, patients will have a new understanding about themselves," Dr. Ivker points out, "since in our society it is often only when we are forced to rest that we take the time to reconnect with ourselves and discover what our inner guidance is trying to tell us."
Symptoms of the body's homeostatic response to disease include fever, inflammation, vomiting, and diarrhea, all of which will usually run their course within a few days without the need for outside intervention. All too often, however, both patient and physician will seek to arrest such symptoms prematurely. When this happens, many times the initial symptom will disappear, only to be replaced later with a different symptom that is more severe, as the body creates a stronger "message" in order to get our attention. But if such messages aren't heeded, the symptom picture can progressively worsen and ultimately become chronic.
THE PATH TO HEALTH
As the following chapters make clear, the field of holistic medicine encompasses a wide range of modalities and treatment options. From the holistic perspective, however, all such therapies are based on a philosophy informed by the following principles:
The road to health is a journey that each of us must travel according to who and what we are uniquely. It is also a road that must address our entire being--body, mind, and spirit--and assist our bodies' interdependent systems to function properly while honoring the principle of homeostasis. Because holistic medicine understands and respects these concepts, it continues to increase in popularity and offers the promise of most effectively treating our many chronic health conditions.
A Complete and Comprehensive Guide to Holistic Treatment
"Larry Trivieri beautifully illuminates the full spectrum of natural healing approaches, highlighting the unifying themes and distinctive features of health systems around the world and across the ages. This book is a valuable resource for individuals interested in their personal well being, as well as health professionals seeking to deepen their understanding of holistic medicine."
--David Simon, M.D., Medical Director, the Chopra Center for Well Being, Author, Vital Energy and Return to Wholeness
Submitted by Publisher, January, 2003
Foreword by Robert S. Ivker, D.O.
The History of Philosophy of Holistic Medicine.
The Holistic Self-Card Program.
THE MAJOR THERAPIES OF HOLISTIC MEDICINE.
Traditional Chinese Medicine and Acupuncture.
Additional Therapies of Holistic Medicine.
About the American Holistic Medical Association.
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