WHEN YOU VENTURE out of the world of standard medicine to look for alternative treatments, it is even more important to be an informed consumer. Alternative medical practices range from those that are grounded in long traditions of careful work to those that are nonsensical. In general, alternative treatments are less risky than allopathic drugs and surgery, but they can be expensive and wasteful of time and effort. I have written at length elsewhere about the history and philosophy of major systems of alternative medicine; what I will do here is give capsule summaries of a number of popular therapies, along with indications for their use. You will find a guide to locating practitioners in the Appendix to this book.
Insertion of needles into particular points of the body is a unique therapeutic intervention of traditional Chinese medicine (TCM); Western doctors have taken the technique out of context, using it mostly to treat acute and chronic pain. As a symptomatic treatment for pain, acupuncture has the advantage of being free of the side effects of analgesic drugs, although relief is usually temporary, necessitating frequent visits to the therapist. I have known acupuncture to cure the pain, pressure, and congestion of acute sinus infections as well as to speed the healing of joint injuries. Some dentists use it as the sole form of anesthesia for dental work, including drilling and extraction of teeth. Another interesting use is in addiction treatment: placement of needles in points in the ear has helped some people quit smoking, withdraw from heroin and cocaine, and moderate addictive eating. In TCM acupuncture is used to manipulate energy flows around the body, not primarily to relieve pain or change behavior.
One of the oldest medical systems in the world, Ayurveda has only recently become widely available in the West. Practitioners diagnose by observing patients, questioning them, touching them, and taking pulses. With this information the practitioner is able to assign patients to one of three major constitutional types and then to various subtypes. This classification dictates dietary modifications and selection of remedies. Ayurvedic remedies are primarily herbal, drawing on the vast botanical wealth of the Indian subcontinent, but may include animal and mineral ingredients, even powdered gemstones. Other treatments include steam baths and oil massages.
Although Ayurvedic herbs are little known outside India and few have been studied by modern methods, many may have great therapeutic value. For example, guggul (Commiphora mukul), a plant indicated traditionally for control of obesity, has been shown to lower cholesterol in a manner similar to pharmaceutical drugs used for that purpose, but with much less risk. An extract of it called gugulipid is now available in health food stores. Another Ayurvedic preparation, called triphala, is the best bowel regulator I have come across, much better than Western herbal remedies for constipation. It is a mixture of three fruits and can be found in capsule form in health food stores.
Finding a good Ayurvedic doctor takes some effort. Many practitioners in the West are members of the international religious organization of Maharishi Mahesh Yogi, the Holland-based billionaire, whose promotion of Ayurveda is definitely a for-profit endeavor. (In India Ayurveda is medicine of the people, an inexpensive alternative to allopathic treatment. Maharishi Ayurveda is anything but inexpensive.) This group offers training programs for physicians that certify them to be Ayurvedic practitioners after minimal exposure to the philosophy and methods of the system. I recommend seeking out practitioners who are independent of this organization. One way to find them is by inquiring in Indian communities, even in Indian restaurants and grocery stores.
Training in biofeedback, a relaxation technique employing electronic equipment to amplify body responses until they become perceptible, is offered by certified therapists, many of them clinical psychologists. In the most common version, patients learn to raise the temperature of their hands and by so doing relax the whole sympathetic nervous system, which controls many involuntary functions. Biofeedback training is enjoyable, and almost everyone succeeds at it. It is especially useful for alleviating Raynaud’s disease (see this page), migraine, hypertension, bruxism (involuntary grinding of the teeth, especially during sleep), temporomandibular joint (TMJ) syndrome, and other ailments with a prominent stress component. Brainwave biofeedback, requiring more complex technology, may be helpful for people with seizure disorders, narcolepsy, and other central nervous system problems.
It is easy to find biofeedback therapists—they are usually listed in the yellow pages of the telephone book—but harder to find ones who are creative and do not use the technology in a mechanical fashion. A typical training program consists of ten one-hour sessions as well as daily practice on your own. Biofeedback teaches you what it feels like to be relaxed internally. It is then up to you to recreate the feeling and make it part of your way of being.
In addition to prescribing massage therapy as a form of stress reduction, I often recommend specific kinds of body work. Here are the four I most prefer:
• Feldenkrais work is a system of movements, floor exercises, and body work designed to retrain the central nervous system, particularly to help it find new pathways around any areas of blockage or damage. Feldenkrais work is innovative, gentle, and often strikingly effective at rehabilitating victims of trauma, cerebral palsy, stroke, and other serious disabilities. I find it to be much more useful than standard physical therapy.
• Rolfing, a more invasive form of body work, aims at restructuring the musculoskeletal system by working on patterns of tension held in deep tissue. The therapist applies firm pressure to different areas of the body, which can be painful while it is administered. “Getting Rolfed” means going through a basic series of ten sessions, each focusing on a different part of the body. Rolfing can release repressed emotions as well as dissipate habitual muscle tension.
• Shiatsu, a traditional healing art from Japan, makes use of firm finger pressure applied to specified points on the body and is intended to increase the circulation of vital energy. The client lies on the floor with the therapist seated alongside. Japanese practitioners use much firmer pressure than many Westerners find comfortable, but it is worth tolerating because shiatsu can be remarkably effective at dissipating muscle tension and recharging the body. Western practitioners generally use a lighter touch.
• Trager work is one of the least invasive forms of body work, using gentle rocking and bouncing motions to induce states of deep, pleasant relaxation. In addition to its relaxing effects, Trager work can also help facilitate the nervous system’s communication with muscles, so that it can be helpful as a rehabilitation method, especially for people suffering from traumatic injuries, disabilities, post-polio syndrome, and other chronic neuromuscular problems.
Traditional Chinese medicine is a comprehensive system of diagnosis and treatment that has now established itself throughout the world. Practitioners include Chinese immigrants and Westerners trained in China or in numerous schools in other countries. Diagnosis in TCM is based on history, on observation of the body (especially the tongue), on palpation, and on pulse diagnosis, an elaborate procedure requiring considerable skill and experience. Treatment involves dietary change, massage, medicinal teas and other preparations made primarily from herbs but also including animal ingredients, and acupuncture. The Chinese herbal pharmacopeia is vast, with many plants now under serious scrutiny by Western pharmacologists. Many Chinese remedies appear to have significant therapeutic value, and some work on conditions for which Western doctors have no pharmaceutical drugs.
In my experience, TCM is worth trying for a wide range of allergic, autoimmune, infectious, and chronic degenerative conditions, including asthma, ulcerative colitis, Crohn’s disease, chronic bronchitis, chronic sinusitis, osteoarthritis, chronic fatigue syndrome, HIV infection and other states of immune deficiency, sexual deficiency, and general debility.
Chiropractic has come a long way since the days of its invention a century ago. Today’s chiropractors have had basic scientific education and are not likely to claim that spinal adjustment alone can cure cancer, diabetes, or any other serious disease. In my experience chiropractors still take too many X-rays and are too likely to have patients commit to long and costly treatment packages. (Some people see their chiropractors once or twice a week just to get adjusted, whether or not they have anything wrong with them.) Chiropractic treatment can be helpful in cases of acute musculoskeletal pain, tension headaches, and recovery from trauma; it is less effective with chronic pain syndromes.
At several points in this book (see this page–this page and this page–this page) I have indicated my enthusiasm for these methods of employing the mind/body connection to modify illness. Here I will simply repeat my assertion that no disease process is beyond the reach of these therapies and that it is best to work with a trained professional, at least initially, to ensure you are using them correctly. Guided imagery and visualization can enhance the effectiveness of other treatments, including allopathic drugs and surgery. Certainly try them for all autoimmune disorders and for any illness in which healing seems blocked or stalled.
As a physician with botanical training, I recommend herbal treatments for a wide range of diseases. Unfortunately, few allopathic physicians have the knowledge or experience to do this. You are more likely to find knowledgeable practitioners in the fields of Ayurvedic medicine, traditional Chinese medicine, and naturopathy. There are also professional herbalists, persons who do not have degrees in any of the major systems of medicine but who have studied on their own or with experienced preceptors.
To be a wise consumer of the great variety of herbal remedies available in health food stores, you must buy reliable preparations and brands. Tinctures (alcoholic extracts), freeze-dried extracts, and standardized extracts are recommended. Herbal medicines tend to be milder than chemical drugs and produce their effects more slowly; they are also much less likely to cause toxicity, because they are dilute forms of drugs rather than concentrated ones.
Holistic doctors subscribe to the principles that human beings are more than their physical bodies and that good medicine should embrace the whole spectrum of available treatments, not just the drugs and surgery of conventional medicine. Although holistic doctors share a common general philosophy, there is little uniformity of practice from one to the next, nor is there any assurance that a doctor is good just because he or she is a member of a holistic medical association.
Homeopathic medicine, a system of diagnosis and treatment based on the use of highly diluted remedies made from natural substances, has a distinguished two-hundred-year history and is now enjoying new popularity. Its main virtue is that it cannot possibly cause harm, because the medicines it employs are so diluted. Homeopaths say that the diluted substances work on the body’s energy field, catalyzing natural healing responses; critics charge that homeopathic remedies are nothing but placebos.
It is confusing to seek homeopathic treatment today, because it is practiced in many different forms by people with very different training. Classical homeopathy—the kind taught by the founder of the system—specifies the administration of one dose of one remedy selected on the basis of information gained during a lengthy interview with the patient. Nonclassical homeopathy prescribes multiple or regular doses of formulas combining several remedies. Homeopathic practitioners may be M.D.’s, osteopaths, naturopaths, chiropractors, or lay persons without formal training as health professionals. My own preference would be to seek out classical homeopathy from an M.D., but I have met a few highly accomplished lay homeopaths. Homeopathic remedies are now widely sold in both drugstores and health food stores, another deviation from the classical system, which requires the expertise of a doctor to pick the proper remedy for each individual.
Although I cannot explain how homeopathy works in scientific terms, I have known it to be effective for a diversity of health problems, including allergies, skin and digestive ailments, rheumatoid arthritis, ear and upper respiratory infections in children, gynecological problems, and headaches. Homeopaths often object to combining their treatment with other types of treatment, especially allopathic drugs, herbal medicines, and vitamins and supplements. They also believe that coffee, camphor, mint, and a few other substances act as antidotes to the remedies and must be avoided once you begin treatment with this system.
Hypnotherapy takes advantage of the mind/body connection by encouraging patients to enter a trance, a state of heightened suggestibility. In this state, verbal suggestions are often able to pass from the mind to the nervous system, influencing the body in ways that seem impossible in ordinary states of awareness. I frequently refer patients to hypnotherapists because I have seen it produce excellent results in many illnesses that are managed poorly by conventional medicine, among them a wide range of skin and gastrointestinal ailments, allergy and autoimmune disease, and chronic pain. Some people fear hypnotherapy, seeing it as mind control; but, in fact, hypnotherapists simply arrange circumstances to allow patients to move on their own into natural states of focused concentration, similar to daydreaming or watching a movie. Patients then learn to recreate the experience on their own. It is important to shop around for a therapist you trust and feel comfortable with. One problem I encounter as a referring physician is that many hypnotherapists lack imagination and limit their work to relaxation, pain control, and overcoming bad habits. If I send them patients with challenging physical diseases like multiple sclerosis or ulcerative colitis, they are likely to regard these problems as beyond their expertise and are reluctant to take them on. So as well as being someone you can trust, a good hypnotherapist should be inventive and willing to try new strategies to access spontaneous healing.
Many people think of naturopathic physicians as being “New Age.” In fact, naturopathy comes from the old tradition of European health spas with their emphasis on hydrotherapy, massage, and nutritional and herbal treatment. Older naturopaths may actually be chiropractors with mail-order degrees in naturopathy. Younger naturopaths are well trained in basic sciences and have had exposure to subjects omitted from the conventional medical curriculum, such as nutritional and herbal medicine. Except for their adherence to a general philosophy of taking advantage of the body’s natural healing capacity and avoiding the drugs and surgery of conventional medicine, naturopaths show a great deal of individuality in their styles of practice. Some use acupuncture, some use body work, some practice herbalism, others practice homeopathy.
As a profession, naturopathy is smaller than the other major systems of alternative medicine, licensed in only a few states in the United States, mostly in the West. Good naturopaths are worth consulting for childhood illnesses, recurrent upper respiratory infections and sinusitis, gynecological problems, and all ailments for which conventional doctors have only suppressive treatments. Naturopaths can be valuable as advisors to help people design healthy lifestyles.
Most osteopaths (D.O.’s) today are indistinguishable from M.D.’s in their reliance on drugs and surgery; only a small percentage of them still use manipulation as a primary therapeutic modality. Unlike chiropractic, osteopathic manipulation does not focus solely on the spine but works on all parts of the body, often with gentler techniques than the high-velocity adjustments favored by chiropractors. Since osteopaths have the same educational background as M.D.’s, they are much more competent than chiropractors in assessing general health problems. Skilled practitioners of OMT can relieve a variety of acute and chronic musculoskeletal problems, undo effects of past traumas (like automobile accidents), and help treat headaches and TMJ syndrome. Cranial therapy, a specialized form of OMT, may benefit asthma, recurrent ear infections in children, sleep disorders, and other conditions rooted in nervous system imbalances. I frequently refer patients to D.O.’s for OMT and often encourage medical students to learn the technique, because I have found it to be safe and highly effective.
A considerable body of research data supports the beneficial effects of prayer on health. Good documentation also exists for the efficacy of Christian Science healing. It is reasonable to think that belief on the part of patients is the crucial factor here; however, some research shows prayer to be effective even when sick people are unaware that they are the objects of prayer, suggesting that unknown mechanisms might also be at work. Since religious practices can clearly activate healing responses and cannot cause direct harm, there is no reason not to use them as adjunctive or primary treatments in cases of medically hopeless disease.
Therapeutic touch, a form of energy healing taught and practiced mostly by nurses, is a learnable skill of great utility. It can relieve pain without the side effects of drugs, can speed healing from injury, and can identify and dissipate energy blockages that may be impeding the healing system. As with prayer, therapeutic touch cannot harm, so there is no reason not to try it. Many healers outside the therapeutic touch movement also work by the laying on of hands and achieve good results. In addition, you can learn to use this therapy on yourself. Put yourself in a relaxed state and begin by trying to sense and transmit energy with the palms of the hands; then direct it to a part of the body that is hurting.