Strengths and weaknesses of integration.

Nickolaev N. – Prof., M.D., Ph.D.

„For Integrative Medicine to develop in the World, there is a necessity for education of both the general public and of health care providers, and for greater communications between the medical practitioners and patients” (Anderson, 2009).

The above rallying-cry is heard again and again in the quest for integration. Yet it is curious that in the same paragraph of her article Dr. Anderson also counsels the reader: „Limit the amount of times you spend on Chinese medicine theories to explain illness, and how acupuncture works… Western medicine audience responds better to scientific information”….

Integration is neither an arbitary concept, nor is it a mixing together of various disparate approaches in health careas prevailing thought would have us believe. Rather, integration is a discernable conceptual and clinical model of medical practice.

„It is a comparative way that one can learn from another tradition to see an aspect of one,s own that one had not been paying attention to, and a kind of illumination goes up” (Campbell, 1977).

Here I will venture to suggest that what people are calling integrative medicine is actually holistic medicine! It is holistic medicine which inherently contains a focus on prevention and the promotion of wellness, and which inherently acknowledges the role of invironmental factors, life-style design and psycho-emotional and social factors in health and illness.

When I speak to medical bureaucrats about what I do, the question I feld seem motivated by their Western training, which compels them to organize the reality of health and illness along certain distinguishing and definable lines.

Once I was asked „What is holism?”. At first, that question brought me up short. Yet upon reflection, this question is as predictable as it is legitimate, given the grounding of Western thought in reductionism.

Though it may come as a real surprise to many, holism is based on holistic science and is thus utterly evidence-based…

This is more significant, that it might first appear.

Integration is not the wholesale dismissal of reductionism and its subsequent replacement by holism. It is rather, the correct combining of holism with reductionism in a judicious, prudent, circumspect manner, which maximizes the strengths and minimizes the weaknesses of each system.

Once one understands the basic epistemological and ontological tenets of holism vis a vis reductionism, combining the best of both is actually not all that difficult, and the inherently complimentary nature of these two systems of cognition will become self-evident.

It is important for us to realize that the metaphors, or cognitive system, employed by conventional, reductionist medicinedefine what Western physicians acknowledge ass real, just as the metaphors of Chinese medicine define reality for us.

Objectivity in science is not so much a fallacy as a paradox. Quantitative date are objective only insofar as they remain within the realm of the physical.

The objectification of nature was a critical step in the development of conventional medicine. No one can deny the tremendous advances that have been realized as a result. Howether, that success may be the greatest challenge to the reductionist cognitive system in medicine.

Chronic disease inevitably involves some subjective interpretation and awareness by patients with regard to haw to alter their life paths in such a way as to intercede in the illness process, e.g., by practicing wellness. In holism the seminal influence of subjective reality is impossible to ignore.

Here,s the trick: subjective reality can also be verified…

When a patient cannot stop thinking or worrying , the subjective report does not exist in isolation from other symptoms or signs.

Holkistic medicine recognizes, that symptoms and signs of a disease does nor exist in singular isolation, but as patterns of imbalance in which one sign or symptom will help to corroborate a given constellation or picture of the disharmony. Being able to see this picture does not cause one to fall into the void, into the haos of absolute relativism and subjectivity…

Perhaps, the greatest test of a practitioner,s ability to conceive of any model of integration lies in his or her ability to understand that epistemology varies from culture to culture. More specifically, the epistemology of conven-tional medicine is only one approach, and a new and somewhat limiting one at that.

Medical science is not a science at all: it is too a large extent based on science – but it has yet to become a Science…

Western medicine, like Chinese medicine, developed empirically. Unlike Chinese medicine, however, it developed without beeing guided by a fundamental-ly stable theoretical framework.

The fundamental bedrock of holistic reality is that the inner, psychic world of thoughts and emotions is inextricably linked to and influential of, as well as influenced physical material reality. That is to say, material reality (body and also the environment at large) is in a bi-directional relationship with the inner, invisible, non-physical world of thoughts and feelings. That, it. That,s Holism!

This point is exasperatingly important when dealing with chronic disease.

Chronic diseas is, by definition, disease for which no cure yet exists! Chronic disease inevitably involves issues of life-style and psycho-social factors.

In 2005, the WHO published their report on chronic disease, stating that, in all countries, 8 out of 10 people will dieprematurely of chronic diseases in the 21 century (WHO, 2005).

If Holism is inherently suited to the management of chronic diseases, then clearly, good-quality holistic practice is something desperately needed in this epoch.

It is subjective meaning that is missing from a heavily quantitative approach. It is synchronicity that imbues experience with meaning. It is CAM modalities and qualitative methodologies, of which n-of-1 is the epitome, that imbue treatment and research with meaning. It is meaning that empowers patients to manage their chronic illness. It is meaning that is the common thread…