Complementary and Alternative Therapies

The mainstream of health care practices in the modern world is based on allopathic methods of treatment.

Allopathic practitioners use medical and surgical methods to treat disease and injury by finding what is “wrong” and “fixing” it. Allopathic medicine is based on observation, scientific research, and objective explanations. Physicians (MDs), nurses, psychologists, and therapists receive years of special training before they are allowed to practice.

Complementary medicine includes practices and treatments that agree or “work with” allopathic therapies, used along with common medical treatments. Massage, for example, may ease pain and relax an injured body part. Complementary medicine practitioners may or may not be formally educated but usually undergo some type of formal training. Many medical practices are culturally based.

Alternative medicine refers to practices and treatments that are used instead of conventional (allopathic) medicine. To illustrate: some people with cancer use special herbs or follow a certain diet to treat the problem.

Integrative medicine attempts to blend the most effective practices and treatments from both conventional and alternative treatment systems. Emphasis is on the interrelationships among body, mind, and spirit.

The word “holism” is derived from the Greek word holos, meaning “whole.” Holism today views a person as more than just the sum of his or her parts. The concept of holism helps to blend many aspects of mental health care. The primary goal of holistic mental health care providers is to “help clients develop strategies to achieve harmony within themselves and with others, nature, and the world” (Rawlins, Williams, and Beck, 1993). This statement reflects the holistic concept of care. We are no longer content simply to treat the illness; we are learning to treat the whole person (Fig. 6.1).

An illustration of upper half of human figure shows self-responsibility marked at head; human dimensions including physical, sociocultural, emotional, intellectual, and spiritual, marked at the torso; and adaptation to stress and relationship with environment marked at both the sides of head.

Ayurveda is a healing system that was developed in India and literally means “the science of life.” Ayurvedic medicine is described as “knowledge of how to live.” Focus is on the innate harmony of the body, mind, and spirit. Therapies such as diet, meditation, herbs, yoga, exposure to sunlight, and controlled breathing are designed to restore balance, thus healing the individual.

Homeopathy is “a therapeutic method that uses natural substances in microdoses to relieve symptoms” (Boiron, 2007). It is based on the “principle of similars.” Its founder, German physician Samuel Hahnemann (1755–1843), developed treatments for his patients by choosing a very small portion of a substance that matched the patient’s symptoms. Only one substance at a time is used, and the effects are closely monitored. Although the NCCIH has found homeopathy to be unproven by scientific studies, there is anecdotal evidence as illustrated in the following Case Study.

Originating in Europe, naturopathy views disease as an alteration in the process by which the body heals itself. The term naturopathy means “nature disease.” Its focus is on the six principles described in Box 6.1. Practitioners use several therapies, including diet, herbs, nutritional supplements, hydrotherapy, massage, joint manipulation, and lifestyle counseling.

Traditional Chinese medicine (TCM) can trace its beginnings to 200 BCE. It is based on the view that the body is a delicate balance of opposing forces: yin and yang. Yin is cold, slow, and passive, whereas yang is hot, fast, and active. Health is a balance between these two energies. Mental or physical problems arise when an imbalance of these vital energies (qi) occurs. This leads to blockage of energy and blood along the energy pathways (meridians).

Treatments are chosen on the basis of individual diagnosis and include acupuncture, the use of herbs, food therapy, massage, and body manipulation. The Chinese Materia Medica is an extremely old reference book of herbs and other medicinal substances.

Certain scents evoke certain responses in people. Aromatherapy, which means treatment using scents, is the use of essential oils to promote health and well-being. Most essential oils are obtained from extracts or essences of flowers, herbs, trees, fruits, bark, grasses, and seeds. Each essential oil has distinct therapeutic, physical, and psychological properties. Certain aromas are said to prevent disease, whereas others produce a calming effect.

Aromatherapy has been practiced for more than 6000 years. Early Greeks, Romans, and Egyptians used fragrant oils for massage, bathing, healing the sick, and embalming the dead. “Hippocrates, the father of modern medicine, used aromatherapy and scented massage. He also used aromatic fumigations to rid Athens of the plague” (holisticonline.com, 2018).

Today aromatherapy is gaining greater acceptance because research is demonstrating that essential oils can exert specific effects on the individual. Lavender, for example, was found to promote relaxation and increase alpha brain waves, whereas jasmine increased alertness and beta brain waves. Further studies are being conducted.

In 1994, the US Congress passed the Dietary Supplement Health and Education Act (DSHEA), which defined a dietary supplement as a “dietary ingredient” supplemental to the diet. Ingredients in dietary supplements can include “vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites” (NCCIH, 2018). The Food and Drug Administration does not impose the same standards on dietary supplements as it does on prescription drugs. Care must be exercised when considering dietary supplements. Good nutrition, though, can help combat both mental and physical problems.

The relationship between body structure (the spine) and function is the subject of study for chiropractic care. Practitioners use a therapy called manipulations to help improve the relationship and help the body heal.

The chemical EDTA was synthesized in the 1930s by German scientists. Because of its ability to bind with heavy metals, proponents claim that EDTA chelation therapy is effective against atherosclerosis and many other serious health problems. However, there is little scientific evidence that this is so. Current international studies are being conducted to see whether chelation therapy is effective.

In 1987, Francine Shapiro, PhD, a practicing psychologist in Palo Alto, California, introduced a new therapy to treat posttraumatic stress disorder (PTSD). Eye Movement Desensitization and Reprocessing (EMDR) uses controlled eye movements to help reprocess traumatic memories. At first the scientific community dismissed this therapy, but published studies in more than 25 scientific journals are proving the value of EMDR. The therapy is gaining popularity. “It has been endorsed by government mental health agencies in the United Kingdom and Israel and is in wide use throughout the United States and Europe” (EMDRIA, 2018). EMDR has been used to help victims of 9/11, hurricanes, tsunamis and other traumatic experiences, and military personnel following active service.

Basically, the clients identify a problem, such as flashbacks or nightmares of the event. They also state what they would like to have happen instead. Then the therapist moves his or her hand, or a baton, in a certain pattern and clients follow the movement with their eyes while recalling the disturbing event. Each “set” lasts 15 to 20 seconds and ends with clients describing how their self-perceptions have changed. Some clients are helped with one treatment but others require several. Most experience fewer negative emotions associated with the event after treatment.

Many therapists think EMDR helps the rational left side of the brain to integrate a disturbing memory from the emotional right side. Often, therapists describe this as processing. EMDR is proving to be a useful tool for treating those who suffer from the effects of overwhelming trauma.

Massage is the manipulation of muscles and connective tissue to relax the body and enhance well-being. It is one of the oldest healing arts, with written records in China that date back 3000 years. Massage reduces stress, promotes relaxation, and improves circulation. It improves sleep, concentration, and energy. Many people with depression and anxiety are helped by the relaxing powers of massage.

The use of creative activities to decrease stress is not new. Drawing, painting, and sculpting may help release inner conflicts and repressed emotions. Some mental health providers use expressive therapy to help diagnose and treat people with depression, schizophrenia, and trauma related to abuse. Dance and music therapy are helpful for those who are recovering from abuse to gain a sense of ease with their own bodies. Listening to music stimulates the body’s neurotransmitter production (endogenous opioids such as endorphins), which results in “feeling good.” Music and sound therapy have successfully been used to treat stress, depression, grief, schizophrenia, and autism.

The traditional definition of hypnosis is the induction of a relaxed, trancelike state in which the individual is receptive to appropriate suggestions. Brain scans of hypnotized persons document different patterns than those who are merely dozing. A typical hypnotherapy session lasts an hour; the therapist speaks softly and helps the client become deeply relaxed and tuned out to outside distractions. Once the client reaches “a state of hyperconcentration, the therapist makes suggestions” (Glower, 2005) that can alter the way one thinks and behaves. For example, smokers who use hypnosis are more likely to quit successfully. Hypnotherapy is being used to treat gastrointestinal problems, irritable bowel syndrome, pain, headaches, addictions, phobias, and anxiety. Self-induced hypnotic therapies are relaxation and visualization.

Hypnosis has everyday practical uses also. Bierman (a full-time emergency department physician) focuses on the concepts of human patterns and consciousness. He believes that hypnosis is just ideas and responses. His work with acutely traumatized clients demonstrates the power of the health care providers’ words and actions (Bierman, 1995). The accompanying Case Study illustrates the use of Bierman’s response-evoking hypnosis.

Meditation has been used in Eastern religions for more than 2500 years and has gained popularity in the West as a tool for combating stress. Many therapists who recommend meditation for their clients meditate daily themselves. There are many techniques for meditation, but all share four common elements: concentration, retraining the attention to one item while excluding all other thoughts, mindfulness, and an altered state of consciousness (Fig. 6.2). The physical effects of twice-daily meditation include “slower heart rate, decreased blood pressure, lower oxygen consumption, and increased alpha brain wave production” (Moore, 2010). Meditation techniques have been used successfully in the fields of education, business, medicine, and mental health care.

Prayer is the most commonly used CAM therapy in the United States. NCCAM (2007) defines prayer as “an active process of appealing to a higher spiritual power, specifically for health reasons.” Spirituality has a broader meaning that includes an individual’s sense of meaning and purpose in life. Several studies are now being conducted to look at how prayer affects immune system functions and emotional well-being.

Acupuncture. For more than 2000 years, a treatment in Oriental medicine has cured disease and alleviated suffering. Acupuncture is defined as the inserting of fine needles into the skin along specific sites on the body. These sites travel along energy channels called meridians. Stimulating these points is thought to restore the energy or qi balance within the body. More Western explanations of acupuncture relate to the release and movement of neurotransmitters, neuropeptides, and hormones. Acupuncture has been successfully used for the treatment of drug addictions and is proving to be a cost-effective and safe form of therapy.

Biofeedback. Biofeedback teaches clients to control their physical responses by providing visual or auditory information about autonomic body functions. Body functions, such as respiration, pulse, or skin responses, are monitored by machines while clients practice relaxation techniques and change the monitored data. For example, changes in respiratory or pulse rates that can be seen on a graph provide clients with objective feedback and encouragement. Biofeedback has proven useful in treating anxiety, hypertension, insomnia, headaches, and attention-deficit disorders.

Qi Gong. Qi is the Chinese name for vital energy. Qi Gong and Tai Chi are systems of movement, regulation of breathing, and meditation designed to enhance the flow of qi throughout the body.

Reiki. The word reiki comes from the Japanese words rei, meaning “God’s Wisdom” or “Higher Power,” and the word ki, which means “life force energy.” Reiki is a life force energy that flows through one’s body. When it is low, we are stressed or sick. When it is in abundance, we feel healthy and happy. Practitioners of reiki use a “laying on of the hands” to promote relaxation and healing.

Therapeutic Touch. Therapeutic touch is based on the practice of laying on of the hands. The healing energies of the therapist encourage the body’s energies to return to a balanced state. Healers pass their hands over the body to identify the blockages or energy imbalances. The therapist then strengthens and reorients the body energies, thus restoring the biofield. Therapeutic touch is effective in stress-related conditions, such as migraine headaches and anxiety. Caution should be exercised, however, because mental health problems such as paranoia, hallucinations, or delusions are associated with an impaired sense of touch.

Color Therapy. High-intensity light has been used to successfully treat SAD. Color therapy is still being studied, but practitioners believe that the energy fields that surround each of us, called auras, are filled with constantly changing energies of color. When one is sick, the aura is discolored. Color therapists scan the energy centers (chakras) for imbalances and expose the body to the appropriate healing color to help heal the physical problem and rebalance energies.

Standard medicine has used electromagnetic field (EMF) energy for years in magnetic resonance imaging (MRI), radiation therapy, cardiac pacemakers, and more. However, the use of that energy to treat illness is still under study.

Magnetic therapy uses magnets placed over painful areas to relieve pain. Repetitive transcranial magnetic stimulation (rTMS) has been successfully used to treat severe depression. Pulsating electromagnetic therapy enhances bone healing and is claimed to be effective with sleep disorders and headaches. Millimeter wave therapy has been used in Russia and other Eastern European countries to treat both physical and psychiatric illnesses. Exposure to low-power millimeter waves is thought to increase immunity and improve well-being. The main courses of action for these therapies are not well understood; further investigations are being conducted.

People with related problems find great support and understanding with others with similar experiences. Those who “have been there” are invaluable resources for empowering others toward recovery. Box 6.2 describes the characteristics of self-help groups.