What is alternative about alternative medicine? Increasingly we note that main stream pharmaceutical companies are mass producing and selling the most popular herbal remedies such as St. John’s Wort and echinacea-goldenseal. Acupuncture is now covered by some insurance companies for certain medical problems.

Recently, I was at an addictions conference and a former medical school dean spoke on alternative medicine. He said that the most meaningful distinction between alternative medicine and modern medicine, is not what the alternative is itself, but the relationship that surrounds its delivery.

Many herbal remedies are, for example, not really that alternative but traditional medicine. Pharmaceutical companies are out trekking through the rain forest and every other strange place on the planet to try to find species of plants that may have therapeutic value. What has in the past been alternative is the way in which certain medicines were dispensed, not by prescription but by advice from someone that this particular herb is what you ought to get. I guess in the old days one would go to a herbal medicine person and sit and talk about the medical problem and then receive directions on what herbs to obtain. Today one can skip that step and simply go to the local drug store and buy the herbal product off the shelf, just like one would acquire any over-the-counter drug without consultation. Or maybe the Internet is in part the modern version of the tribal healer, a place anyone can consult for anything. As alternative medical modalities become mainstream they are losing what has most distinguished them and that is the opportunity for the patient and the practitioner to establish an interpersonal relationship around the patient’s healing. In this sense the image of the old family doctor who made house calls and phoned to see how his patients were doing after his visit might also be viewed as an alternative medicine practitioner. Today this traditional form of medical practice has become alternative.

There are numerous schools of psychology, many of which approach problems in very different ways. Studies which have sought to determine what brings about the most efficacious result from different kinds of psychotherapy have determined that the most significant factor is not any particular school of psychology or psychological approach but the degree to which the clinician has been able to establish a meaningful interpersonal relationship with the patient.

Western medicine is very good at dealing with acute medical problems, such as setting broken bones or administering antibiotics to treat an infection. Western medicine is not as effective at dealing with certain chronic diseases particularly those involving chronic pain. Much of where alternative medicine has flourished in the past is in dealing with chronic diseases and it is with chronic diseases that relationships seem to be particularly important. Relationship is by definition something that happens over time.

Patients who have chronic illnesses and get to spend meaningful time with their physician or with others who support their healing do better. People in cancer support groups do better and live longer than those who do not have such support.

One aspect of a meaningful relationship is that it is not reductionistic. We value our friends because of their total personality, who they truly are, not because of one particular characteristic. My sister recently has had to deal with breast cancer, surgery and the process of recovery. She says, “that for me right now I have a primary care physician, a surgeon, an oncologist and a radiologist, and as far as I can tell they send reports back and forth to each other, but theres no one really looking at me as a whole person. You’d think it would be the primary care person, but he’s bowed out and turned me over to the “experts.” Alternative medicine, because it is more relationship focused, is more centered on addressing the entire person instead of just one symptom or one complication of a disease.

Addiction is a long term chronic disease. Those patients who suffer from addiction do better when they are in 12-step recovery groups. It seems to me that relationships also make the difference between healing and curing. An alcoholic knows that he is never cured. In fact, studies have shown that once there is the onset of the disease of alcoholism this disease continues to progress even while a person is not drinking. Many people in the recovery community have seen first hand how rapidly someone who is chemically addicted, and who may have been sober twenty or thirty years, may progress to his or her death upon starting to drink again. At the same time, many people in recovery have experienced healing around their disease. The compulsion to drink has been lifted and the hole of fear that seemed to drive the compulsion to drink has been filled with gratitude and a desire to serve others. Relationships may not cure, but they do lead to the possibility of healing. So what may be most important for anyone with a chronic illness is not whether the modality of treatment is mainstream or offbeat, but whether there is opportunity in the treatment modality for a meaningful relationship-centered experience to evolve. It may be this experience which allows healing to occur.

Another aspect of any relationship-centered approach to healing is that it usually focuses on empowering the patient to be active in his or her healing and recovery. Very specialized medical modalities provide no opportunity for a patient to become actively involved in understanding and participating in changes that may be needed for healing. This is why even if the magic bullet cure came along for alcoholism that reversed the brain neurochemistry that causes the addictive craving, there would still be many other aspects of the disease that needed treatment. This is understandable when one sees how disease family members of an alcoholic can suffer without even being aware of their own irrational behavior and depression. Because alcoholism has manifestations that are simultaneously biological, psychological, social and spiritual, only a comprehensive approach to treatment is efficacious. Not only must the patient be treated as a whole, but the patient must be empowered to become the active manager in being responsible for doing what is necessary to treat his or her condition and keep it in remission.

Managed care on the one hand, and the general pace of interaction in our culture even among people who would describe themselves as alternative healers such as nutritionists and acupuncturists, etc., on the other, have combined to make more medical treatment, whether it is mainstream or traditional, less relationship-centered. In the face of this is the paradox of our human condition, that it is other people who drive us crazy and also our interconnection with other people that heals. I love some of the old family stories about home remedies that a grandmother would make up and give to the sick child. Often, I suppose there was something healthy in the remedy, but surely there was a lot of love that worked positively in the immune system of the child who received it. If you are worried about the need for an alternative to treat a chronic ailment it may be important to remember the relationships that go with the kind of treatment you choose.

People with active alcoholism find that their relation with alcohol has replaced their relationship with other people. Family members of alcoholics often find themselves getting just as sick as the alcoholic because relationships don’t work.

– by Don Carroll

Campbell Law Observer, Vol. 20, No. 5, May 1999