Photos by Lucas Vasques & Christin Hume on Unsplash
Admittedly, I have been a bit critical of the complementary and integrative health profession as of the last year. With much research and a lot of inner deliberation and back and forth, I am now proposing a middle-ground that is both supportive of science and the therapies offered under the umbrella of complementary and integrative health (CIH).
Within the past couple of months, I have been in the midst of studying Buddhist teachings/philosophies in a lay ministry program. I know this sounds like a bit of a detour from my discussion of science and CIH but stay with me as this will all fit together in a moment.
One of the main messages of the Buddha’s teachings is finding the middle-way.
On his journey to reducing his own dissatisfaction, the Buddha practiced many common spiritual practices of his day including practices that were focused on indulging in sense pleasure and others focused on severely limiting sense pleasure through self-mortification.
As the Buddha found, neither of these extremes are useful or helpful in terms of our long-term health and well-being and they certainly were not going to help him awaken in any capacity. Gaining these insights from his personal experience, the Buddha proposed the middle-way.
The middle-way simply refers to finding a middle-ground or a balancing point. This concept can be applied in all realms of human endeavors and experience. Another way of stating this is, finding a balance between yin and yang.
In fact, yoga practice is the perfect example of this. In yoga, students work on finding a balance between strength and stillness, holding on and letting go; finding a balance between doing the posture and being the posture.
In thinking about the teaching of the middle-way, I have recently considered how this teaching might be applied in the realm of science and CIH.
One of the main reasons that my position on CIH has softened is directly attributable to the work that I have done with my yoga therapy clients (you know who you are).
The single common denominator that I have found with all of my clients is that every single one of them has a combination of complex co-occuring health conditions that have manifested in both physical and psychological diagnoses.
The second commonality between my clients is that all of them have followed all of the recommendations of their physicians/specialists to a T.
As I began to see these commonalities among my clients, I began acknowledging the fact that even though modern medicine has made tremendous advancements within the last 200+ years, people are still suffering.
Reflecting on this, I acknowledged the fact that modern medicine doesn’t have all the answers but neither does CIH—when working in combination with one another, better health and well-being is achieved even if one’s chronic health condition(s) cannot be cured.
In an article entitled, “Modern Medicine is Killing You, But It’s Also Saving Your Life,” Medical Doctor Lissa Rankin discusses the division and divisiveness between some scientists and the holistic health community. She notes that there are some scientists that absolutely rebuke all alternative therapies; on the flip-side, there are some in the holistic health community that entirely rebuke modern medicine.
Like our modern politics, there is an expectation of picking sides; one side fighting against the other.
How is this useful?
Dr. Rankin notes that she is not taking sides, she is neither going to renounce modern medicine nor renounce the therapies provided by CIH practitioners.
Alas, I have come to the same conclusion as Dr. Rankin; even though my previous blog posts may have seemed like I was siding more with science.
I can proudly say, like Dr. Rankin, I am not going to side with either, both are needed and have their place along the continuum of patient care.
Often times modern medicine is missing a key piece of the healing equation and that is heart—let me be clear, this is not to say that there are not healthcare practitioners that do not offer a deeply caring approach to patient care.
In the spirit of a more heartfelt medicine, Dr. Rankin states, “…we need not just drugs, but soul medicine as well.” She further states, “Thank God for the healers who play a role doctors are often too busy and traumatized by the system to play.”
This said, as a CIH practitioner myself, one thing that I have noticed is that some in the CIH/holistic health community make broad generalizations and claims about modern medicine. It seems to me that this is done with the intention of making modern medicine look bad and CIH look good.
These broad generalizations include:
“Doctors don’t care about preventing disease."
“Doctors don’t treat the whole-person."
“Doctors don’t get to the root cause.”
“Doctors are pill pushers.”
These statements are just that, generalizations. Again, I ask, how is this useful or helpful?
Rather than uniting, these statements divide.
The fact is, there are some incredibly caring healthcare practitioners who take time with patients and treat them from a whole-person perspective. So…why make these generalizations?
Why let the actions of some in the medical world undermine the caring approach of others?
After all, the keyword in CIH is integrative--thus the best of what modern medicine has to offer and the best of what ancient healing modalities have to offer. It's a team approach, not a 'one is better than the other approach,' as I said, they both have their place along the continuum of patient care.
My sincere hope in starting this conversation is that we can have a more nuanced and balanced discussion on the integration of modern medicine and alternative therapies rather than sitting in our separate camps and spewing insults at one another.
In the book, Buddhism Without Beliefs, secular Buddhist teacher Stephen Batchelor advises that when it comes to conversations between science and spirituality it is worthwhile to approach both of these areas with a bit of agnosticism, with a bit of, 'I don't know.'
The fact remains, there are questions in life that neither science nor spirituality can answer, one of the main questions being, does god exist? Well, I don’t know…none of us will know until the day we die.
As Batchelor contends, why argue about things that can neither be proven nor disproven?
Batchelor also points to something that Dr. Rankin notes in her article...
We as human beings seek belonging through shared beliefs and ideas no matter how radical these ideas may be—this is where confirmation bias comes into play which I have written about in one of the blog posts above.
There is a tendency on both sides whether from the scientific side or the alternative health side to take extreme positions.
The fact remains...
When scientists begin believing that only science can solve our greatest problems at the expense of other philosophical and intellectual disciplines then this is when science becomes scientism in the same way that religious/spiritual literalism can easily cross the line into fundamentalism.
This is the exact reason why Batchelor supports an agnostic approach—this isn’t to discount science, it is just an acknowledgement of, “I don’t know…and we will probably never know.”
These ideas are further articulated in an article entitled, The Blind Spot of Science is the Neglect of Lived Experience in Aeon. In this, the authors express the fact that in the pursuit of science, "...physical reality has absolute primacy in human knowledge;" this is the tendency for scientists to take a reductionist view of the world thus breaking things down into their component parts and not considering the experiential nature of the human experience. The authors further state, "We erect a false idol of science as something that bestows absolute knowledge." They further note, "The contention that science reveals a perfectly objective 'reality' is more theological than scientific." As a side note, two of the authors of this article are physicists and one is a philosopher.
Given this, I come back to Batchelor's question...
How is it useful to be arguing about things that can neither be proven nor disproven?
”Can we find a middle-way?”
As the Buddha teaches, finding a middle-way IS possible with a little effort and awareness.
To exist in the middle, there are a few things that are noteworthy to consider in terms of CIH.
In modern healthcare, all patients have to be given informed consent so they are aware of the potential risks of any given treatment or procedure. In the same spirit of informed consent, it is tremendously important that you thoroughly research any alternative therapies that you are interested in receiving.
As you research, look for the middle way.
What does the science say about the particular alternative therapy?
What are the claims that the CIH practitioner is making about the therapy?
Do these claims seem reasonable?
Has any harm been done by a particular alternative therapy?
Two excellent sources for guidance in this area is the National Center for Complementary and Integrative Health (NCCIH) which operates within the National Institute of Health (NIH) and Cochrane Complementary Medicine who works in partnership with the NIH/NCCIH and the University of Maryland School of Medicine Center for Integrative Medicine.
One of my areas of concern in the realm of CIH is the supplement industry. Currently, the supplement industry is vastly unregulated. Whereas pharmaceutical drugs are regulated, it is also the case that there have been numerous cases of negligence and harm done by the pharmaceutical industry. Our existing opioid crisis is one prime example of this. My point is, some amount of regulation is better than no amount of regulation as there have been a plethora of cases where supplements have caused severe harm or even death--cases of this can be found in reputable sources with a simple Google search. Again, it's not to say that the pharmaceutical industry is perfect but again, it's important to take a balanced approach when considering these intersecting issues.
An example of this includes:
Endocrine disrupting chemicals being found in essential oils as is reported in the article, "Are Essential Oils Endocrine Disruptors?" found in Endocrine News by the Endocrine Society.
This is just the tip of the iceberg, so the message here is: Just because it’s natural, does not mean that it is safe.
Furthermore, there have been many cases of people unintentionally mixing certain herbal remedies/supplements with various pharmaceutical drugs that have resulted in organ failure, evidence of this can be found online or by talking with any medical professional.
Given the lack of regulation in the supplement industry, it is imperative that you discuss any potential for harm/interaction with a medical professional.
There is another important message here, too:
Alternative therapies are meant to complement modern medicine, not replace it.
Science vs. Evidence
Additionally, I would like to discuss the differences between science and evidence. To the naked eye (so-to-speak), these two words are often used interchangeably but there are a couple key differences that are worth noting.
In the Aeon article mentioned above, the authors give a pretty outstanding definition of science and the scientific method:
"In general terms, here’s how the scientific method works. First, we set aside aspects of human experience on which we can’t always agree, such as how things look or taste or feel. Second, using mathematics and logic, we construct abstract, formal models that we treat as stable objects of public consensus. Third, we intervene in the course of events by isolating and controlling things that we can perceive and manipulate. Fourth, we use these abstract models and concrete interventions to calculate future events. Fifth, we check these predicted events against our perceptions. An essential ingredient of this whole process is technology: machines – our equipment – that standardize these procedures, amplify our powers of perception, and allow us to control phenomena to our own ends."
By this definition, science includes the process of discovery; thus, uncovering new truths about the natural world. Interwoven through this process, scientists consider how these new discoveries fit within the framework of already existing scientific knowledge--thus science takes both a micro view of the world and a macro view. Therefore, scientists don’t make conclusions based on evidence found in a single research study or even a couple research studies—there is massive energy that goes into replicating studies to verify results. Only after a considerable amount of research has been done and studies have been replicated many times, can conclusions be made. Even then, scientists don't like making definitive conclusions because science is always changing/evolving and new things are being discovered constantly.
Herein lies the difference between science (a method of inquiry) and evidence (the result of scientific inquiry). As I said, science takes both a micro and macro view; evidence primarily takes a micro view. When people talk about evidence from one particular research study or even a combination of studies, you’ll often here the phrase, “Evidence suggests that…” It should be noted that this phrase doesn't mean that there is conclusive evidence, it just means that there is some research that shows some evidence of a particular effect.
Getting back to the subject at hand, this conversation relates to CIH because of the fact that there is evidence to suggest that many of the alternative therapies (yoga, acupuncture, reiki, supplements, etc.) offer therapeutic value and may indeed produce some physiological benefit. This said, I have seen many scientists argue that the vitalistic philosophy (the belief in a universal healing energy) behind many of the alternative therapies makes them incompatible with existing scientific knowledge, i.e., the widely accepted laws of physics, chemistry, biology, and other areas of scientific inquiry. However, this argument is entirely predicated on the fact that science (as the authors of the Aeon article note) and thus objective reality is absolute knowledge at the expense of lived experience (or subjective reality) and other forms of knowledge/inquiry.
The question now becomes...
Can we find a middle-ground between the objective experience that science values and subjective/lived experience that spirituality values?
All of these questions and insights aside, I hope that I have laid the ground work for finding a middle-way between medicine/science and healing/spirituality.
Moving forward, it is important for each of us to reflect upon how we can both be supportive of science and scientific progress while at the same time not discounting the nourishment and support that individuals receive from CIH practitioners.
As Dr. Rankin writes, “…I am also grateful for the alternative medicine healers who save patients in their own way. They are serving a need doctors aren’t serving adequately. They are spending time sitting at the bedside, holding a scared hand, giving a much needed hug, and helping patients reduce stress responses and relax their nervous system so the patient’s natural self-repair mechanisms can activate.”
She concludes by saying, “We need not choose camps. I’d like to invite you to join me here…in this middle place, where there’s no camp, where we just appreciate that we all have tools in our toolbox and the more tools we have available to us as patients, the more healing is possible.”
To this end, if any of you would like to reach out to me prior to receiving services from a CIH practitioner, I would be happy to help you research and discuss the extensive amount of research that I have done to help you make an informed decision. You can e-mail me at: