Integrative Medicine: A Useful Framework
May 30, 2019 01:40AM
Ask 10 practitioners to define “integrative medicine” and you’ll likely get 10 unique answers. So we decided to put a stake in the ground and adopt a framework for the topic. Not only will it help guide our development of editorial content, but it also will give us greater context for everything we do in the future.
Fortunately, we don’t have to do this alone. We’re adopting a model articulated by Dr. Bonnie McLean in her book Integrative Medicine: The Return of the Soul to Healthcare. We have distilled it down to share with you. The only thing we’ve added is the label “five principles of integrative medicine” to some of the key factors she discusses.
We feel honored and privileged to have worked with McLean to make this presentation as concise and accurate as possible. With deep appreciation we say, “Thank you for being wonderful!”
Why Integrative Medicine?Let's start at the beginning: Why is integrative medicine essential to our well-being?
For all the power, glory and success of conventional Western allopathic medicine, it falls well short of solving a broad range of health issues, most notably chronic diseases, which are responsible for seven of 10 deaths each year, according to McLean. “Treating people with chronic diseases accounts for 86 percent of our nation’s health care costs,” she continues.
Allopathic medicine is at its best when it treats acute conditions: When surgery and antibiotics are absolutely necessary, there are no substitutes. But as most integrative medicine practitioners agree, when it comes to chronic disease, conventional medicine most often treats the symptoms but not the underlying causes. And thus, the patient’s condition can worsen over time.
Plato said it well: “The cure of many diseases is unknown to many physicians … because they are ignorant of the whole. For the part can never be well unless the whole is well.”
The first principle of integrative medicine, then, is that it is holistic in nature.
The View from The EstablishmentFor background, McLean discusses the perspective of the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health as it defines integrative medicine. She writes:
Integrative health combines mainstream medical therapies with CAM (complementary and alternative medicine) therapies that are backed with high-quality scientific evidence of safety and effectiveness. “Complementary” means that a non-mainstream practice is used together with conventional medicine. Alternative medicine means a non-mainstream practice is used in place of conventional medicine.
NCCIH goes on to explain that most complementary health approaches fall into one of two subgroups: 1) natural products such as herbs and supplements, and 2) mind and body practices such as yoga, meditation and qi gong. Other mind and body practices include chiropractic, acupuncture, massage, hypnosis and imagery.
The Body Can Heal ItselfMcLean considers Hippocrates to be the founder of integrative medicine “because he taught the principles of both conventional and holistic medicine.” One of his central beliefs was that the body can heal itself.
With this perspective, Hippocrates echoed what practitioners from the East long before him believed. Ancient practices from China and India “are based on the concept that the body is a self-healing entity. Illness is caused by an imbalance in the body or mind. If our bodies and minds can be brought back into balance, they can self-heal,” McLean points out.
From this understanding, we infer the second and third principles of integrative medicine: The body can heal itself. And illness is a function of imbalance.
McLean spends some time explaining the ideas in Taoist philosophy “because they help explain the basis of Chinese medicine, such as the concept that life, including our bodies, is dynamic and constantly changing. Chinese medicine treats each patient as a unique individual whose body—and life—is constantly adjusting and rebalancing.”
That’s principle No. 4: Each patient is unique.
Anyone who has had an extended, hours-long initial exam with a chiropractor, acupuncturist, naturopath or homeopath will have experienced the principle of “each patient is unique.” Contrast this with conventional medicine’s tendency to place patients in categories, labeled with the names of diseases and conditions rather than the names of the patients.
Principle No. 5: Embracing change.
The fifth principle of integrative medicine is also reflected in Ayurveda, India’s sister science to yoga and one of the world’s oldest healing systems. Ayurvedic prescriptions change not only with the changes in the body but also with nature’s rhythms, the shift from night to day and the rhythm of the seasons.
The FrameworkMcLean tells her readers that ancient Chinese medicine was divided into eight branches. The branches were arranged in hierarchical fashion with the mind at the top. At the bottom were the three branches that required intervention by practitioners. They were placed at the bottom because they were “the least empowering to the patient.”
One interesting note: Exercise, which along with diet sits one level up from the bottom level of intervention, is not defined as most Westerners would define it. McLean writes: “In ancient China, exercise meant qi gong, tai chi and other martial arts. The focus was not on trying to build muscles for appearance and strength of the external body. It was on building the internal body of organs and endocrine glands, as well as the energy body, for health and longevity.”
Borrowing directly from the Chinese model, McLean’s framework for integrative medicine has eight branches arrayed in a hierarchical pyramid with four levels.
At the top is The Self. Similar to the Chinese model, McLean’s refers to this as one’s Soul, or Essence. In ancient China, the medicinal practices were the study and practice of Taoism, which spoke to how to be a “good person,” and meditation.
At the second level are the environment and one’s mind and emotions. In the ancient Chinese model, the two branches are feng shui and astrology. While “feng shui meant living in a peaceful and harmonious environment,” McLean actually doesn’t elaborate on her meaning. Given the toxic environment in which most Americans live—our body politic; a culture based on acquisition and material wealth; the excessive and inescapable use of, and immersion in chemicals, drugs and environmental pollutants; and, for many of us, toxic relationships—a meaning of “environment” can be readily gleaned.
And while McLean’s branch of mind and emotions may suggest personal meditation and breathing practices as well as assisted work such as with life coaching and talk therapy, the Chinese model has astrology slotted in this position, which would seem to serve the same purpose. McLean writes, “Chinese astrology gave ways for people to better understand themselves and how they lived their lives.” Indeed, astrology can still easily fill this role for some, as can models that help explore one’s personality and psyche, such as the Enneagram and Ayurveda.
The branches at the third level of importance in McLean’s model of integrative medicine are the same as those of the Chinese model: diet and exercise. These, hopefully, are self-explanatory.
Finally, at the bottom level are self-care, natural medicine and allopathic medicine. As McLean does not elaborate upon self-care, it seems as if there is some overlap between that and natural medicine. For example, the taking of herbs and supplements or the use of Emotional Freedom Technique could be seen as belonging to both self-care and natural medicine. Perhaps more solidly in the self-care sphere are Ayurvedic practices such as tongue scraping, oil pulling, dry brushing and oil massage.
Natural Medicine: A Closer LookMcLean elaborates on the topic of natural medicine. She sees this branch as a continuum based on, in essence, quantum physics—the nature of reality. At one end of the continuum is energy healing and on the other end is physical medicine.
McLean describes the continuum this way:
At the energy healing end, we can find methods that use the hands, either touching the body or holding hands over it, such as with Reiki, Pranic Healing, Therapeutic Touch and Healing Touch. Because there are tools involved, I would put acupuncture, laser, light and color therapy, far infrared therapy, vibrational healing (tuning forks), and inferential therapy next on that end of the continuum. Next, I would place the mind and brain therapies such as hypnosis, biofeedback, imagery and energy psychology (for example EFT, Tapas, Emotion Code). I would put homeopathy, essential oils and flower essences next.
In the middle I would place yoga, tai chi and qi gong because they work on both the energy and physical body. Then I would put biological medicine, such as nutrition, supplements and herbs. At the physical medicine end, I would put the hands-on disciplines of chiropractic, craniosacral therapy, physical therapy, cupping, gua sha, and all the many forms of massage and body work.
Observation And ConclusionPerhaps the most surprising component of the model is what sits atop the pyramid: The Self. One might resist the notion that the state of one’s soul is the most important variable in one’s health. Since the model is rooted in Taoism, the question becomes: “How do one’s efforts in becoming a better, more loving and compassionate human being affect one’s health?”
In sum, it can’t be denied that all parts of our being are connected. Thus, we return to the first principle of integrative medicine: It is holistic. To repeat what Plato said, “The part can never be well unless the whole is well.”