Complementary Medicine and Alternative Medicine: An Integrative Health Approach By Dr. Lisa Smalheiser, Psy.D.

I truly believe that when it comes to defining health, in order to improve the well-being of each individual, we need to look at the whole person: mind, body, soul, and spirit. How we spend our mental and physical time and energy, and how we take care of our bodies is a huge part of my professional focus.

Psychology is defined as the study of the mind and behavior. This definition addresses the first piece of the puzzle, “our mental and physical time and energy,” but many mental health professions easily overlook the second part: “How we take care of our bodies.” When it comes to how I treat my clients, and people in general, I don’t follow a cookie cutter approach. What helps one person might not be what is best for the next. Everyone is unique, and should be treated as such. However, one thing that I do strongly advocate is the use of physical activity, most notably exercise, as a means to bolster any other forms of traditional therapy being provided. This article not only addresses the use of exercise and physical activity, but also other approaches that can add to the therapy an individual is receiving. In some cases, these other, less commonplace approaches, may act as a form of therapy in and of themselves.

With all of the emerging treatments for mental, physical, and emotional ailments available in today’s society, it can be difficult to tease out the good from the bad, the helpful versus the harmful, and what works from what doesn’t. The most recent surveys conducted report that 38 percent of Americans have started to incorporate mind/body practices and other natural products into their health care, and we are seeing a shift to less reliance solely on conventional medicine. While mainstream Western approaches may work for some, it is my belief that an integrative health approach, which can aid in overall well-being, may be the way to go.

You may be familiar with the concept of Complementary and Alternative Medicine, also known as CAM. The two terms, “complementary” and “alternative,” although sometimes used interchangeably, are varied with regard to their conceptual framework. One is not necessarily better than the other, and it is important for every person to find relief through an approach best suited for him or her individually. The term “complementary medicine” refers to the use of non-mainstream techniques and approaches that are used in combination with conventional medicine. The term “alternative medicine” refers to the use of non-mainstream techniques and approaches in place of conventional medicine. Take, for example, a patient diagnosed with cancer that would traditionally undergo some form of surgery in order to treat his or her condition. In order to be considered true alternative medicine, an approach would be utilized that would take the place of surgery, such as prescribing the patient a special diet to follow. Conversely, complementary medicine can be employed. This can be in the form of retaining the services of a qualified massage therapist to provide a comforting touch, providing instruction on how to use visual imagery for relaxation post-surgery, or through the use of aromatherapy during and after the surgery with the intention of reducing the discomfort a patient may feel surrounding the time of the procedure.

In 2007, a survey was conducted by the Centers for Disease control, known as the National Health Interview Survey (NHIS). The NHIS found that the most common mind and body practices included deep breathing, meditation, chiropractic and osteopathic manipulation, massage, yoga, progressive relaxation, and guided imagery. Other, less utilized but still valuable, approaches included acupuncture, tai chi and qi gong, yoga, hypnotherapy, and movement therapies, such as Pilates, Rolfing Structural Integration, and Trager psychophysical integration. In addition to mind and body practices, some people opt for the use of natural products, such as vitamins, minerals, probiotics, herbs, and botanicals, typically sold as dietary supplements.  The 2007 NHIS also found that the most common products being used as a form of complementary medicine (in those that utilized natural products) were omega 3 fish oils (37.4 percent in adults and 30.5 percent in children in past 30 days) and Echinacea (37.2 percent in children in past 30 days).

In the mental health field, mood disorders, such as depression and dysthymia, are among the most commonly reported. Not only are mood disorders widespread in the mental health field, but several studies have found that mood and anxiety disorders are found at higher percentages than any other chronic medical condition! Of course, there are countless psychotropic medications available, but it might be a mistake to not consider any other approaches. CAM techniques can be applied to a wide array of problems and disorders, including (but not limited to) psychotic disorders, mood disorders, anxiety disorders, PTSD, ADHD, conduct disorders, insomnia, cancer, chronic pain, obesity, etc. and improvements can be seen in the physical, mental, and emotional realms.

Studies show that most mood disorders go untreated, and the unmet need is greatest for highly vulnerable populations, including minority groups, low income individuals, individuals with less education, and those not covered by insurance. Since mood disorders not only affect our mental and emotional state, but also lead to decreases in everyday functioning and serious chronic physical illnesses, it is important that these ailments are addressed. As a result of medication-induced side effects, un-responsiveness to conventional treatment, inability to pay due to high cost or low income, and unavailability of conventional services, utilizing CAM practices may prove to be attainable, beneficial, cost-effective, but even more important, life-changing!

A fantastic body of research conducted by Jacobsen and colleagues in the early 1990’s on behavioral activation relates closely to this topic. They found that just doing activities can be very powerful in helping people who are depressed. Behavioral activation aims at helping depressed individuals to become reengaged in their lives by countering their typical patterns of avoidance and withdrawal. Individuals begin to find positive reinforcement through various means, and these activities then serve as a natural antidepressant. This idea relates closely to my thoughts on exercise as a powerful form of both alternative and complementary medicine. More on this topic will be addressed in upcoming posts.

There is an indisputable connection between your mind and body. Your physical health affects your psychological well-being, and your thoughts and emotions can, in turn, affect your physical health. What you choose to do or not do is up to you, and there is not one right solution for everyone. You have to decide what is best for you individually. With all of the different options out there, it may feel overwhelming to some, and at times may seem like a bit of trial and error. The take home message is: Do your research, but don’t be afraid to try something new.

 

References

Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. Retrieved from http://nccam.nih.gov/news/2008/nhsr12.pdf

Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255–270.

Kessler R.C., Demler O., & Frank R.G. et al. Prevalence and treatment of mental disorders, 1990–2003. N. Engl. J. Med. 352(24), 2515–2523 (2005).

Kessler R.C., Greenberg P.E., Mickelson K.D., Meneades L.M., & Wang P.S. The effects of chronic medical conditions on work loss and work cutback. J. Occup. Environ. Med. 43(Suppl. 3), 218–225 (2001).

National Center for Complementary and Alternative Medicine (NCCAM). (2011e). What is CAM? Retrieved from http://nccam.nih.gov/health/whatiscam/

The WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291(21), 2581–2590 (2004).