Identity Crisis

Those medical practitioners who fall outside of the mainstream have an identity problem of sorts. First of all, do we practice "alternative" or "complementary" medicine, and how are these different? Second, are we "holistic" in our approach or "integrative" and does this matter? Maybe some of us do not wish to have any of these labels applied to us. For some, any of these labels may bring with them pejorative connotations, suggesting that these treatments are in some way less valid or more "out there." For others, they may be a banner of humanism or progressive thinking.

Whatever we call ourselves or others call us, it is important to be clear about what we mean by our different monikers. For me, "alternative" implies a different choice, a kind of "either-or" relationship with conventional medicine. It implies a different way of thinking, a different approach, and a different model of healing. Contrast seems to be the key concept.

"Complementary" implies a dovetailing or consanguinity between differing approaches. The type of healing in "complementary" medicine may come from an unconventional tradition, but it at least compatible if not synergistic with conventional approaches. A happy mutuality seems to be the key concept here.

What one calls oneself, therefore, in my mind, is a statement about one's feeling about conventional medicine. The more hostile one is to it the more likely one is to want to identify oneself as a practitioner of "alternative" medicine. The more one wants to be embraced and accepted by conventional medical specialists or those who favor conventional approaches, the more likely one is to view oneself as a practitioner of "complementary" medicine.

The converse also may apply: conventionally oriented individuals who regard unconventional treatments with suspicion or disdain would probably prefer to label them "alternative" medicines. Those who are more open and welcoming to multiple perspectives on healing would want them referred to as "complementary."

Holistic and integrative have similar meanings, but there are separate connotations for me. One who uses the term "holistic" tends to differentiate oneself from conventional treatments, which are viewed as dualistic, Cartesian, and intrinsically more limited in healing potential. Holism implies an attitude that embraces mind, body, spirit, family, community, culture, and environment together. It holds itself up as a contrast to the conventional model, where a perspective on the larger context of healing is deemed to be absent. The term "integrative" comes close to "complementary" in emphasising the joining together in a kind of melting pot of different healing approaches. Compatibility, rather than difference is emphasised.

These terms are meant to identify discreet phenomena, but life is not always so neat and tidy. At its best holistic healing truly advances an ecumenical view of health and helps to avoid the narrow views that lead to personal, public or familial disasters. It promotes the health of the individual within the realms of the emotional, spiritual, and interpersonal, and takes into account the wider context of the society, culture and environment. At its worst, holism merely is an advertising tool for promoting a certain modality endorsed by the practitioner to the gullible few. Allopathic medicine, similarly, at its best can make use of the "biopsychosocial" model, which though taught in medical school, is all too often ignored. The biopsychosocial model, which might be the conventional version of holism, attempts to broaden the perspective of the practitioner in a way similar to that of holism, but, unlike holism, it does not feel the need to differentiate itself from conventional treatment.

Integrative medicine at its best, brings together disparate approaches to produce better outcomes for patients. At its worst, it leads to disagreements and lack of cohesion in the treatment team, with people sometimes working at cross-purposes. So to advocate holistic or integrated is not enough. What is your underlying agenda in promoting it, cooperation or cooption?

Hahnemann gave birth to homeopathy in a spirit of conflagration. Homeopathy was in many ways a declaration of war against allopathy. Integrative or complementary are terms Hahnemann would have for the most part reviled, I believe, because he felt that the fundamental approach of allopathy was flawed. Yet in spite of these deep differences between the Hahnemannian approach to healing and the "old school" or allopathy, Hahnemann did allow for certain occasions when allopathic healing would be appropriate. Thus even such a firebrand as Hahnemann was forced to permit some "integration" of allopathy into his system. There is a tendency among many homeopaths to be critical of the allopathic approach, to emphasise its weaknesses, and long history of obvious misjudgments -- obvious, at least, when viewed from hindsight. Yet if we are true followers of Hahnemann we must allow for some role for allopathic treatment. How much can be debated, but the monomaniacal pursuit of homeopathic healing to the exclusion of all other types, including allopathy is clearly at odds with what Hahnemann himself said and with the homeopathic tradition. I emphasize here the capacity for integration, whereas others might rightly wish to emphasize the differences between homeopathy and allopathy. I would say that the difference in emphasis springs largely from personal feelings. It is intrinsically subjective. There remains an identity crisis of sorts within the ranks of homeopaths, and it would probably behoove homeopaths in terms of our relationship with other healing modalities to spend more time clarifying our role. Are we complementary or not? Are we against all non-holistic approaches, or are we able to work with them? Are we with allopathy or are we against it? Are we truly holistic, or are we advancing this approach as a form of self-promotion?

Who are you, and what are you, homeopaths?