Alternative Medicine:
Science or Pseudoscience?

Sharrona Pearl and Sheryl Tayar
April 9, 1996

Although the alternative medicine movement tends to seem amorphous and ill defined, an attempt will be made to outline the major contributions to its thinking. The shared values, beliefs, and assumptions of holists exert an influence beyond the boundaries of the movement itself, and for this reason should be carefully scrutinized. Few people remain unexposed to holistic thought, even if it is not identified as such. Herein lies the potential peril of accepting as received wisdom that which may be flawed, even dangerous or unhealthy. Some of what comes from the movement has value; some does not. As there is a wide range of the application of holistic thought, only one of its applications will be dealt with in depth--Therapeutic Healing.

Many of the alternative therapies regard most if not all diseases as potentially curable. The body, given the right conditions, will always try to heal itself. In this account, all diseases have the same cause, namely the "accumulation in the system of waste materials and bodily refuse, which has been steadily piling up in the body of the individual concerned through wrong habits of living".[1] The cure consists in 'enabling' or 'empowering' the body to throw off this toxicity by a number of different measures.

Holistic healers draw attention to the interpersonal environment and its effects on healing and health. They say that holistic understanding of healing makes optimum use of "dynamic and therapeutic forces inherent in group interaction".[2] It is important to relate to individuals in ways that enhance the patient's self image and mobilize natural self-regenerative tendencies.

Recently, however, the holistic movement has become increasingly attractive for many reasons. Firstly, it provides a sense of control. Adherents are provided with a recipe for a state of well-being, be it therapies, behaviors, and attitudes that must inevitably contribute to a state of well being. Great satisfaction is taken in doing the right thing.

The movement is also popular because its scheme is purported to be both comprehensive and simple. It deals not only with health, but with the entire human condition. Simple answers are available, the holists suggest, to problems that have been regarded as overwhelmingly complex. It has answers to health problems, and also offers insights into philosophical problems, social dilemmas, environmental concerns, and spiritual issues.

Finally, alternative treatments focus on problems that have been ignored or handled badly within the conventional health-care system. The holists are keenly aware of the frustration with the limitations of that system. Holists claim that western medicine has tended to be dominated by a mechanistic concept of biology, believed to provide a superior understanding of man and his health.[3,4] Individuals have frequently come to be seen as a conglomeration of parts and processes, and 'illness' as any deviation from some predetermined pattern of chemical formulae or numerical values. In this "reductionist" perspective, holists feel that the patient tends to be thought of as a machine.

Contrarily, the holistic health care perspective maintains that the patient represents more than the sum of these parts alone. If the body can be helped on its way to true well-being, or real health, it will employ its own mechanisms of healing, either curing or fighting off even the most serious of the twentieth-century illness. "Every human being is a unique, holistic, interdependent relationship of mind and body, mind. emotions and spirit."[5]

This is, however, far from an innocuous truism. The introduction of the term spirit, alongside body, mind and emotions carries with it a bold metaphysical interpretation of reality. It entails commitment to a belief in the interpenetrating of reality. It entails commitment to the belief in the interpenetrating of physical and nonphysical spheres of causality to a degree that is inherently incompatible with the naturalistic framework of our modern scientific heritage.

However, holistic healing becomes most differentiated from orthodox medical practice in its insistence that the "larger environment" that humans inhabit includes an inner continuity with energies that are spiritual and divine. Most holistic healers set this claim rather cautiously. The term energy seems to creep up in all the alternative medicines in one guise or another. For example, both homeopathy and herbalism, which appear on the face of it to eschew the more esoteric mystical elements, include vital energies as explanations for the force of their cures. Homeopathic medicine for instance is made by the process of "potenciation," a curious activity, which increases the 'potency' of the medicine the more it is diluted. One homeopathic practitioner said that however much he disliked the mystical element of alternative medicines, he could think of no other explanation for this curiously unexpected phenomenon than some build up of neutral energies'[6] Herbal medicines, too, when pushed, sometimes accounts for the efficacy of medicines in terms of energy fields: "[Plants], in common with all living beings, have a non-physical energy field which may react directly on the 'energy field' of people they are used to treat."[7]

On the whole, ideas about life forces and energy fields are not just rather grudging elements, lurking at the bottom of these therapies. The idea of the fundamental energies of the body is explicit in most other 'alternative' ideas of illness and healing. The disruption of energies, their blocking and the resultant imbalance of the body are invariably blamed for illness or susceptibility to disease. Perhaps the prime example of "energy flow" manipulation as a health treatment is the practice of Therapeutic Touch. This treatment embodies all the elements of holistic medicine, including initiating the body's "own healing power" as a means of recuperation.

Therapeutic touch was developed in 1972 by Dolores Kreiger, RN, Ph.D. and her mentor, Dora Kunz. Although it is derived from ancient healing practices, including laying on of hands, therapeutic touch (TT) is not performed in a religious context. Rather, it involves manipulation of a patient's "energy flow" to accelerate healing and stimulate the immune system. Thus, it is not required for the patient to believe in TT for it to be helpful, as "energy flow" acts independently of the one's faith in its existence.

Due to the fact that the method was developed by nurses, there is a strong affiliation between the nursing profession and the practice of TT. However, one need not be a licensed professional to practice this treatment. In fact, all that is required for a practitioner is compassion and a commitment to helping others. Given these qualities, TT can be learned at the beginner's level in one day! It is contended that this accessibility has been an obstacle in the acceptance of TT as a valid practice; nevertheless, the medical world is slowly beginning to accept TT as a complement to traditional medicine.

The first formal TT training was introduced in 1975 as a graduate nursing course at New York University. Today, TT training is offered at 80 universities world-wide, as well as at various weekend seminars and programs. Many hospitals encourage their nurses to practice TT in conjunction with other healing techniques.

There is a strong Canadian connection to TT, as TT has been incorporated into the College of Nurses in Ontario 1990 Standard of Practice. Moreover, TT is a technique outlined in the Nursing Policies and Practices of Toronto East General Hospital, Sunnybrook Hospital, and St. Joseph's Hospital. In addition, Ontario is a strong chapter of the non-profit Therapeutic Touch Network, whose membership numbers over 700 world-wide. This network, founded in 1986, promotes the practice and acceptance of TT while encouraging a high level of practice of its techniques according to established guidelines. In 1994, the network succeeded in procuring a research grant from the United States National Institute of Health to study TT.

Clearly, TT is gradually gaining credibility even among the traditional medical community. Nevertheless, the technique must be viewed with careful skepticism. Any practice which claims that its "underlying principles include the acceptance of the Einstein paradigm of a complex, energetic field-like universe (i.e. the existence of a Life energy flowing through and around all of us)"[8] must be challenged from a scientific point of view.

In order to examine TT more deeply, one must examine the principles of energy flow. According to TT enthusiasts, there is a field of human energy that goes beyond the skin that is visible only through Kirlian photography. The Indian word for this field is prana. TT contends that a healthy person has an equilibrium between inward and outward energy flow, and thus an abundance of prana. By contrast, an illness indicates an imbalance in the energy field, causing a disruption of the energy flow. This ultimately leads to a prana deficiency. Often, the imbalance is due to an obstruction that blocks the energy interchange. TT is the use of hands to consciously direct the energy flow and rebalance the field, bringing about pain relief and feelings of peace and tranquility.

Prana is quite reminiscent of the Middle Ages medical belief of four humours. It was thought that individuals have four humours that are in balance in a healthy individual. Illness was due to an imbalance of the humours, and was treated by bleeding. This was thought to restore the balance of humours. but more often than not, brought about infection and death. Many medical advances have been made since this practice; it is ironic that a similar phenomenon is gaining popularity today.

There are four basic steps to TT: centering, assessment, treatment, and evaluation. Centering is viewed as the most fundamental aspect to therapeutic touch, as it is this step that causes the practitioner to focus on the patient. Centering is a form of meditation that helps one to block out competing thoughts, allowing oneself to become a conduit through which a healing universal energy is directed toward the recipient.

It is only through faulty centering that TT can be draining to the practitioner. In fact, if the practitioner fails to remain centered, s/he can actually absorb some of the patient's negative energy. This can result in headaches and increased tension levels, particularly in novice practitioners. However, post-treatment negative effects are rare, as the practitioner is not "using up" his/her own energy. In fact, when done properly, TT can be energizing, and actually increase the practitioner's feeling of wellness as well as the patient's.

The next step to TT is assessment. It is during this stage that the practitioner places her/his hands two to six inches above the patient's body. The hands scan the body, searching for differences in the energy flow. The hands must not linger in any one area; if there is doubt as to energy congestion, the area in question may be checked after the initial scan. A balanced energy flow is smooth and flowing in texture, whereas energy fluctuations and texture changes indicate an unhealthy energy exchange.

At this point, the effectiveness of TT becomes more dependent on the skill of the practitioner, as there is no distinct indication of an energy imbalance. To one practitioner, an affected area may feel cold. To another, it may feel empty and bare. This ambiguity throws the consistency of the practice into doubt; there should be a definitive sign of an afflicted area. Moreover, the sensing of such a cue is entirely subjective, indicating a lack of scientific basis.

In addition, congested areas may not be the site of the actual injury. In fact, it is often the case that an energy block occurs in an entirely different area! This convenient contingency allows practitioners a great deal of freedom, as they do not have to worry about testable accuracy of their assessment. Again, this principle of TT lacks a basic component of science - testability. It would seem that TT is very carefully designed to be unfalsifiable.

Congested areas are cleared by an "unruffling" sweeping hand motion that releases the bound energy, enhancing the energy transfer that occurs during the upcoming treatment phase. It is during this treatment that balance is restored to the patient's energy field. Healing energy is redirected towards lacking areas through the practitioner's "intentionality" or will to heal based on the assessment cues. The redirection is guided by the "law of opposites" (a hitherto unscientific and basically invalid "law"), that is, cool areas are warmed, empty areas are filled, etc. Again, this is entirely subjective to the given practitioner. The balancing of an energy field allows the patient's own healing powers to be recovered and stimulated. The rate of stimulation is dependent on both the practitioner and the patient, and thus there are few criteria for gauging success or failure.

Finally, the practitioner embarks on the last phase of TT, evaluation. Here, the energy field is assessed (again with a hand scan) for balance and restoration. When the cues that had originally been sensed have vanished, the treatment is complete. The entire process usually takes less than 25 minutes. Indeed, a treatment can take too long - an abundance of energy can cause irritability and discomfort for the patient. One would think that any extended treatment would cause discomfort for one who is ill, so this claim is hardly surprising.

Nevertheless, there are numerous cases of TT accelerating the healing process and producing nothing less than miraculous results. In fact, studies have been done using patients who have the same affliction. One group was treated with TT, one with pain killers, and one with a placebo TT (an untrained practitioner mimicked the motions of TT.) The results showed that the TT group lasted without asking for pain killers far longer than the placebo group. However, one should be careful in accepting these results, as the details of the experiment are quite sketchy, and the reported results are quite ambiguous. (i.e. most TT patients seemed to experience less pain etc.)

Yet despite the ambiguity of many of the "experiments," there are indeed many cases of TT producing wonderful results. Indeed, doctors are gradually becoming more accepting of TT as a useful medical tool. Aside from the placebo effect, which can certainly account for some of TT's success, TT assists the healing process in another very important manner. The TT process is very relaxing and soothing. "During treatment, my patients often ask if I'm trying to put them to sleep. Others have remarked on the sense of peace, tranquillity, and trust they feel.''[9] This relaxation alone can account for a decrease of pain and accelerated healing. Tension increases pressure on the muscles, preventing pain killers and medicine from having a full effect. A relaxed body and mind is far more conducive to healing than a tense body and mind-set. Thus, it would be naive and arrogant to dismiss TT's claims of success as false; however, it is key to recognize the reasons behind the results.

TT is not the only holistic practice to manipulate relaxation principles and "energy flow" to achieve success. Indeed, notion of balance and energy link up the more widely accepted alternative therapies such as homeopathy, naturopathy, and acupuncture with those which are more easily dismissed as fringe. The largely mainstream British Holistic Medicine Association explicitly seeks to collaborate with orthodox medicine. However, even within this organization, there are calls to recognize these views of vital bodily energies as fundamental to new conceptions of medicine.

Holistic health still receives most of its criticism from physicians. One may argue, however that their criticism is motivated by their loss in the movement's success by a change in the status quo of health care. The threatening feeling can be seen in the hyperbole used by a physician who likened the proliferation of holistic practices to "an uncontrolled nuclear reaction."[10]

Despite this claim against doctors, many legitimate issues about holistic health have been raised. Almost all the therapies believe in the involvement of the patient's whole personality to save her/himself. This might appear contradictory due to the importance of the mediator or healer in the alternative health movement. One may fairly ask if the mediator is necessary in many cases, or is his/her presence merely a money-making ploy?

Furthermore, it is not unusual to find 'modern physics' quoted as an unexpected but welcome ally of the esoteric views. The theory of relativity in modern physics has suggested that matter and energy are interchangeable. In particular, modern physics has suggested that it is not valid to describe matter in isolation from those things interacting with it (hence the idea of relativity). Instead, any description must refer to all that matter interacts with, including the presence of an observer.

The insistence on interacting energy fields has been taken up by the alternative therapies movement in a highly selective manner. For example, many of the therapies have appropriated the idea that all matter is energy but they have grafted other meanings on to this proposal. What is most striking is the way in which these ideas of interacting energy have been given a more religious slant, pushing an abstract scientific concept of energy towards the idea of the world made up of positive and negative energies. There is a whole world of a difference, for example, between saying that 'matter is relative to energy', and 'health is positive energy' or 'disease is negative energy'. The implications of modern physics are that nothing can be assumed to have fixed identity. Everything is process and transformation. Yet the appropriation of this idea of energy have exactly the opposite implication.

Some also suggest that unorthodox practices and unlicensed clinicians make the public vulnerable to charlatans and quackery. In a practitioner's eagerness to identify the mental and emotional components of the illness, some holists may overlook significant physical problems. A serious concern among many doctors is that practitioners who embrace a holistic philosophy will tum away from the most helpful contribution of conventional medicine.[11] Others such as Chinn, a nurse, suggest that the concept of holistic healing needs further development: "Much of the literature focusing on holistic health appears superficial, vague, inexact, subjective and generally inconsistent with traditional values upon which science is based."[12]

The holistic movement has a wide variety of supporters ranging from individual to scientifically legitimate institutions. The institute for the Study of Humanistic Medicine in San Francisco published a volume intended to introduce medical staff to the fundamental postulates of the holistic approach to medicine. The institute's central message is that all interaction between a physician and a patient should be based upon the premise that "a person is more than his body."[13] To activate the therapeutic properties of the "more than body" aspects of a patient, the institute advises physicians to utilize empathic listening, massage and guided daydreaming.

The holistic movement also has supporters among fringe groups, cultists, and mystics as well as among the lay public and health professionals. Organizations such as the American Holistic Nurses Association, and Holistic Dental Association International have been established.[14]

It is important for recipients of TT and other holistic health practices to be educated about the treatment, and to understand its limits. However, for example, TT is generally introduced to patients in hospitals and medical clinics, making them less hesitant to be skeptical of its claims. After all, it is endorsed by doctors! Yet "energy flow" is a currently unproven, and even largely untested, phenomenon. Moreover, the assertion that TT is supported by Einsteinian theories is both an abuse of science and a ridiculous claim. Here, science is used to mislead and confuse the scientifically illiterate general public. Yet if the "literate" doctors and nurses are readily accept these claims, it is difficult to expect the public to be more discriminating. Medical professionals hold a position of great trust in the community; it is their responsibility to uphold this trust by educating their patients.

Nevertheless, TT and other holistic health practices can be a useful tool in conjunction with traditional medicine. At the very least, they cannot cause harm, so long as they are used only to complement accepted scientific methods. Therein lies the danger of TT and other holistic health practices and alternative medicines similar to it: that patients will use it as a replacement to traditional medicine. Thus, a patient is deprived from getting helpful treatment, and receives only unproven and untestable therapy. Moreover, when the effects of TT and other holistic health practices wear off, the patient may feel guilty, and place the blame on him/herself rather than the treatment. This can have a very adverse effect on a patient's mental state, thereby impeding the healing process. If abused, TT and other holistic health practices can have the opposite effect than intended.

Given these facts, it is clear that therapeutic touch and holistic treatments are pseudosciences. They are a series of unfalsifiable claims and unscientific principles. There is a great deal of ambiguity and lack of definition about its practice. Perhaps most importantly, there is no "correct" method. There is no "right" answer. Thus, holistic medicine is NOT science. However, despite the fact that TT and other holistic health practices are pseudoscientific, they do have their merits. They can be helpful therapy when used alongside traditional medicine so long as both practitioners and patients are aware of the limitations and the reasons for their success.

[1] Coward, Rosaline. The Whole Truth: The Myth of Alternative Health. p 23.
[2] Fuller, Robert C. Alternative Medicine and Religious Life. p. 84
[3] Alster, K.B. The Holistic Health Movement. p.1
[4] LeShan, L. Holistic Health. Turnerstone Press, London, 1884 p 3
[5] ibid.
[6] Fuller, Robert C. p. 129.
[7] Salmon, WalTen J. (Editor). Alternative Medicines: Popular and Policy Perspective. p. 129.
[8] Mackey, Rochelle, B. American Journal of Nursing Co. 1995, USA: http://www.ajn/15.4/
[9] ibid.
[10] Salmon, Warren J. (Editor). p. 85.
[11] Alster, K.B.
[12] Chinn, P.L. Advance in Nursing Science. p. xii.
[13] The holistic Health Handbook. p. l3.
[14] Alster. p. 1.


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