The Boundaries of Homeopathy

In an effort to expand my repertoire of treatment options, I recently began training in a type of bodywork known as "Bowenwork." Developed in the 1950's through the 1970's by the late Tom Bowen, an Australian sports trainer, Bowenwork attained such success in Australia that by the 1980's it was spreading world-wide. It's applications have expanded far beyond it's author's original intents, largely by virtue of empirically demonstrated results, to include, in addition to general musculo-skeletal injuries or illnesses, respiratory problems, kidney problems, some mental and emotional disturbances, and a variety of other general systemic illnesses. It's adherents report success rates of 80-90%, with virtually no adverse effects and relatively few sessions (3-5 on average) to complete the majority of treatments.



Sometimes known as the "homeopathy of bodywork," Bowenwork also uses minimal dose methods (less is generally more effective), it embraces the notion of healing through energetic processes, and also, it seems to have the same absurdist mode of action -- i.e., it is completely inexplicable. Bowen workers twang and pluck muscles, tendons, ligaments, and other physical structures in the body much like guitar strings. This plucking process, which are referred to as "moves" are for the most part extremely gentle and pain-free, although why they should have any salubrious effects is in no way apparant. Certain moves may elicit some discomfort, but the presence of pain is generally considered to be an indication that the practitioner has not used proper technique. Like homeopathy, treatments must be given time to have an effect, and too rapid repetition of a treatment can be counterproductive. My interest in Bowenwork was actually stimulated by other homeopaths, who have written or spoken favorably about Bowenwork (including Jeremy Sherr).

One of the things that has struck me about Bowenwork as I have been learning it is how tightly regulated it is in comparison with homeopathy. Certified instructors are the only ones permitted to teach, and they must undergo additional training to be certified. To be certified as a Bowen Practitioner, one must pass a practicum, and demonstrate proficiency in business matters as well. In short, the Bowen establishment want the purity of the technique to be preserved and they also want people to be successful in their practices, so that Bowenwork achieves the success its founders felt it deserved.

By contrast, homeopaths have no mandatory certification process, and pretty much anyone can study or teach it. There is a certain amount of infighting within the homeopathic community about which approaches are legitimate (this infighting actually began in the late 19th century, with the so called "highs" and "lows", who fought over the legitimacy of the high potency remedies vs. low potencies), who is most qualified to practice homeopathy, and which homeopathic organizations should represent homeopathy to the public and the scientific community. There is the National Center for Homeopathy (open to anyone), The American Institute of Homeopathy (open to M.D.s, D.O.s, dentists and certain other qualified practitioners with medical backgrounds) and the North American Society of Homeopaths (organized and run by naturopaths). There are several types of certification, and practitioners may have anywhere from zero to three certificates, depending on their ambitiousness. The value of these certifications seems largely nominal, as the non-homeopathic world does not tend to regard homeopathy as legitimate, and being certified in an illegitimate practice confers little or no more respect. These certifications are valued by homeopaths as personal acheivements and to some extent by the rest of the homeopathic community, although they are not regarded as necessities.

While there there appears to me to be a tendency in the allopathic community to label all treatments as on the one hand "medical" or "evidence based" or "legitimate" and on the other hand as "alternative" or "complementary" or "of questionable legitimacy", the truth about the varieties of treatment is far more complex. Some conventional treatments are of little value, even though evidence may support their validity. Some evidence is simply not very high quality. Other treatments, though lacking in large randomized controlled trials, are buttressed by testimonials, dramatic case findings and other empirical evidence. It is important that we as homeopaths define our boundaries a little better. Some lay treatment practitioners are far better at what they do than many board certified physicians, or other licensed health professionals. I myself have had several sports injuries which were helped by non-medical professionals, one a sports trainer, and the other a naturopath. I had been evaluated by several experienced and well trained orthopedists, had x-rays, bone scans and MRI's done all to no avail. These non-medical professionals fixed up the problems, which had become quite chronic, in short order.

Yet, I know that if I had advanced osteoarthritis, a complex fracture, or other severe pathology, I would have been in better hands with the orthopedists. It's not a question of who is better, but who is better for what problem. Homeopaths with medical backgrounds have an advantage in treating complex medical illness where there are medication issues to deal with in conjunction with the homeopathic treatment. This is not to say that those without medical backgrounds are unable to treat people with such illnesses. Rather, I wish to make the point only that overall, in such cases, those with a medical background are more likely to be well equipped to handle severe pathology, managing the allopathic and homeopathic treatments together. Those without a medical background may do fine treating these cases in some circumstances, but overall, they will more often be in their comfort zones in cases where such severe pathology and pre-existing medical treatment is not a significant issue. You don't need 12 letters after your name to prescribe Arnica for a bump or bruise. Conversely, having the 12 letters does not necessarily mean that your results will be better in the treatment of chronic illness, where constitutional remedies are likely to be most effective.

Homeopaths need to define the scope of their work better, and within the homeopathic community those of us with different backgrounds should define the scope of our work vis-a-vis other homeopaths better. Certification would be more useful if it gave some indication of where our strengths and weaknesses as healers lie, rather than simply some more letters of unknown significance to tack on after our names in the vain hope of impressing ourselves or others. The same would be true for physicians and other practitioners of alternative medicine. Being board certified in a medical specialty, from my experience, means being a good test-taker. There has been no evidence that I know of that being board certified is correlated with better care or more satisfied patients. Yet people often act as if this is the case. What foolishness!