TOWARDS AN INTEGRATED MEDICINE
by Theodore E. TePas, MD, Medical Director, Comprehensive Mental Health Center, Saint Francis Hospital, Evanston, Illinois, Psychiatric Consultant at the Foster Care Services of Catholic Charities of Chicago, and member of the Association of Christian Therapists and of NOHA’s Professional Advisory Board
When I was asked to writer the "Doctor’s" column for the NOHA newsletter this year, the thought came to me that I wanted to diverge from my usual review and update on hyperactivity and the role played by nutrition and dietary factors. All of the things that I have mentioned in the two previous "Doctor’s" reports are still as true today as they were almost 20 years ago, including the continuing denial among most authorities that there is any nutrition issue involved in ADHD (Attention Deficit Hyperactivity Disorder). There has been research showing that both the manipulation of fats and the use of certain phytonutrients (plant-derived nutrients) demonstrate benefits of statistical significance. Continuing on the cutting edge of clinical and nutritional research, the Pfeiffer Treatment Center, as well as our own center and that of Paul J. Dunn, MD, have shown the value of treatment programs based on diet and nutritional supplements.
As useful as this is, my interest in integrative medicine, which had its beginnings with our founder Barbara Sachsel and NOHA over some 25 years ago, now has expanded into what is being called Mind/Body medicine involving such mind-bending and tongue-twisting words as Psychoneuroimmunology. One of the major pioneers in the field is Herbert Benson, MD, of the Mind-Body Medical Institute at Boston’s New Deaconess Hospital and Harvard Medical School and author of the ground breaking book, Beyond the Relaxation Response, in 1984. We all know of the well worn, "It must be a placebo response," when we try to explain cures that make no sense. Dr. Benson and others have shown that what we believe and have faith in can have rather strong effects on our health, both negative as well as positive. Another area, which is represented by Larry Dossey, MD, in his book, Reinventing Medicine: Beyond Mind-Body to a New Era of Healing, challenges us to consider looking deeper into human nature and wrestling with the possibilities that, if indeed we are creatures with a fundamental part of ourselves called spirit, there are implications for our lives. And, in the same vein, Harold G. Koenig, MD, Director of Duke University Center for the Study of Religion/Spirituality and Health, tracks with his research team the influence of religious beliefs, practices, and lifestyle on physical and mental health.
As I have been involved in all three areas in my own practice, it has been an education to observe how this evolution has come about and the conflicting responses generated. The earlier part of my premedical life was spent in learning the best that science could offer with its solid facts built on scientific empiricism. I recall when I was a chemistry and premed student that DNA was unknown in chemistry and lobotomies were being done in our state institutions. Nutrition was not considered part of a medical school curriculum, there were no lectures in preventive medicine, and faith healing was for Sunday entertainment.
At this point in time, we continue to have the marvelous and at times astounding advance of the medical and biological sciences as the mainstay of traditional medicine. Added to this, and not yet altogether integrated with traditional medicine, are the research and clinical findings in the field of nutrition, which have richly contributed to both treatment and prevention of illness. In this NOHA has been a leader in promulgating and supporting such efforts.
Beginning in mid-century the term psychosomatic was developed—arising from the observation that attitudes, thoughts, and emotions could have profound effects on our physical well-being. It turned out that these effects could be both positive and negative. There has followed considerable work on what has come to be known as the placebo response, as well as the effects of biofeedback, meditation, hypnotherapy, and other relaxation techniques, as well as other energy strategies, such as Reiki, homeopathy, and acupuncture. While all this has been developing, efforts to broaden health care have ushered in alternative or integrative medicine in attempts to bring into the healing circle more of those modalities that contribute to health. Slowly medical establishment doors are opening: for example, Rush-Prudential’s recent move to include some of these modalities in partial insurance reimbursement. (Chicago Tribune, September 23, 1999, page 1)
More recently, although the roots are centuries old, we are faced with the challenge, according to Dr. Dossey, that we are not all just body and brain/mind, but that being human entails a fundamental property traditionally called spirit. It is considered fundamental because it does not break down into anything, it stands on its own, it does not come from something else, nor does it have more basic parts of which it is made. When I recently read Dr. Dossey’s book, I thought, why is he trying to reinvent the soul or spirit, which I have accepted as an article of my own faith since childhood. On the other hand, I am only too aware of how many members of my own religion, when pressed, will admit to serious doubts about the actual existence of their own spirit. So I can admire Dr. Dossey’s attempts to put some understandable dimensions onto spirit. The main phrase he uses is "nonlocal," which translates out to the freedom of the spirit not to be limited by space or time. It is not what we call ego or self in current psychological paradigms.
What has this got, if anything, to do with the healing arts? In large measure, it means being open to the possibilities of the power of prayer in the treatment formula. It does not mean to use only prayer or even worse to use prayer where common sense would advise surgery, medicine, or diet. It does not advocate an "either-or" or a competitive position, e.g., "My prayer is better than your SAMe [a commonly advertised nutritional supplement for depression]." It is a "both-and" proposition. It also means learning to honor and respect all forms of proven healing and not just those of our own expertise or even familiarity. It means, in developmental psychological terms, moving from a familial (local) stage of human development to a more communitarian (all inclusive or in Dossey’s words nonlocal) one. The reality is that families have prayed for and over one another for centuries. And in medicine itself prayer has been done for years, usually quietly and without fanfare by families, nurses, mental health personnel, and physicians. In recent years, there have been many studies, some even using the medical gold standard of placebo-controlled, double-blind studies, that have demonstrated a positive effect of prayer on healing. Prayer, by the way, is not confined to our more formal understanding of it. It involves intention for the good of another (not necessarily spelled out), love, compassion, empathy, unity, caring, and connectedness. The beauty of this is that all members of the health family, including nations, can have a part to play for the enriched health of everyone else, making medicine and the healing arts truly integrative and holistic.
Article from NOHA NEWS, Vol. XXV, No. 1, Winter 2000, pages 4-5.