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C H A P T E R 8
Considering Alternative Approaches
Lecture Outline
I. Alternative Medical Systems
Both the biomedical and biopsychosocial models of medicine arose within Western
medicine, but other cultures hold different views of health and disease and use alternative
treatments. Alternative medicine may come from other cultures or from practices that are not
well accepted by conventional practitioners. When people combine these alternative treatments
with conventional approaches, the term complementary medicine is appropriate. Treatments
that are alternative may become part of conventional medicine over time with evidence of their
effectiveness. The U.S. National Center for Complementary and Alternative Medicine is an
agency created to prompt evaluation of alternative treatments.
A. Traditional Chinese Medicine
Traditional Chinese medicine (TCM) originated in China over 2,000 years ago and
B. Ayurvedic Medicine
Ayurveda, or Ayurvedic medicine, originated in India more than 2,000 years ago. Its
goal is to integrate and balance the body, soul, and mind. When events disrupt this balance,
health is endangered and can be restored through changes to diet and exercise, which
includes yoga. Massage and preparations with herbs, oils, minerals, and spices are also
included in treatments, as are recommendations to reduce worry and increase harmony in
relationships.
Other alternative medical systems include naturopathy and homeopathy, systems of
medicine that arose in 19th century Europe and hold the view that bodies have the power to
maintain and return to a state of health.
II. Alternative Practices and Products
Alternative practices and products include chiropractic treatments, massage, diets,
supplements, and dietary supplements.
A. Chiropractic Treatment
Chiropractic treatment was founded in 1895 by Daniel David Palmer, who believed that
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B. Massage
Massage manipulates soft tissue to produce health benefits. Several different types of
massage exist, including Swedish massage, acupressure (and its Japanese counterpart
Shiatsu), tui na, and Ayruvedic massage. Many share the underlying premise that this type of
manipulation helps the body to heal itself.
C. Diets, Supplements, and Natural Products
Another common procedure is following a specialized diet. Many diets are oriented to
III. Mind—Body Medicine
Mind–body medicine is the term applied to a variety of techniques that are based on the
notion that the brain, mind, body, and behavior interact in complex ways and that emotional,
mental, social, and behavioral factors exert important effects on health. People use these
techniques to improve their health or treat health problems, including meditation, guided
imagery, yoga, qi gong, tai chi, biofeedback, and hypnosis.
A. Meditation and Yoga
Transcendental meditation directs people to focus on a single thought or sound to achieve
relaxation, whereas mindfulness meditation encourages practitioners to focus on the moment,
B. Qi Gong and Tai Chi
The movement-based practices of qi gong and tai chi originated in traditional Chinese
medicine. Qi gong and tai chi involve postures and movements that are intended to balance
the body’s energy and restore health. Both promote relaxation, flexibility, and balance.
C. Energy Healing
The view that energy can heal the body or that the body contains vital, healing energy is
D. Biofeedback
Biofeedback is the process of providing feedback information about the status of
biological systems. Biofeedback techniques involve the electronic measurement of various
biological responses and the immediate relaying of that information to the person being
tested. This immediate feedback permits the person to alter physiological responses that
could not have been voluntarily controlled without the feedback. The two most frequently
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used biofeedback procedures are the electromyograph (EMG), which measures electrical
discharge in muscle fibers, and thermal (temperature) biofeedback, which uses a
thermister to measure skin temperature.
E. Hypnotic Treatment
Hypnotic treatment can be traced almost to the beginning of human history, but modern
hypnosis is usually traced to Franz Mesmer during the last part of the 18th century.
all hypnosis is self-hypnosis.
IV. Who Uses Complementary and Alternative Medicine?
The prevalence of CAM varies, depending on what is included in the definition. Most
people use these techniques as complementary and not as alternative medicine.
A. Culture, Ethnicity, and Gender
Well-educated Whites are most likely to be users, but some immigrants who hold to the
traditions of their native culture continue with these approaches. People in Australia and
B. Motivations for Seeking Alternative Treatment
People are motivated to use CAM if their worldviews are compatible with the
philosophies that underlie CAM. Those who accept a biopsychosocial view of health are
more likely to seek CAM than those who endorse the biomedical view. Health status is also a
motivation for seeking CAM; people who have health problems that have not responded to
conventional treatments are motivated to seek CAM.
V. How Effective Are Alternative Treatments?
For alternative treatments to be accepted by conventional medicine, research evidence must
confirm their effectiveness. The standard for this evidence is controversial. Should CAM be held
to the standard of effectiveness as demonstrated by randomized, controlled trials? Some in
conventional medicine say so, but some in alternative medicine argue that most treatments in
conventional medicine fail to meet this criterion. Nonetheless, evidence is accruing concerning
effectiveness for CAM.
A. Alternative Treatments for Anxiety, Stress, and Depression
Both transcendental meditation and mindfulness meditation have demonstrated
effectiveness for managing anxiety, and mindfulness-based stress reduction is effective in
managing stress. The movement-based practices of qi gong and tai chi are also effective in
helping to manage stress. Acupuncture and yoga show some promise of reducing depression,
and the herbal remedy Saint-John’s Wort has also been found to reduce depression.
B. Alternative Treatments for Pain
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Guided imagery seems to be an effective intervention in helping people manage several
types of pain. Techniques from traditional Chinese medicine have been successful in pain
C. Alternative Treatments for Other Conditions
Techniques from CAM are also effective for a variety of other conditions, including
speeding burn healing (aloe vera), treating insomnia (acupuncture), controlling nausea and
vomiting (hypnosis and acupuncture), managing Raynaud’s disease (thermal biofeedback),
and lowering risk for cardiovascular disease (meditation) and diabetes (qi gong). Research
has indicated that the practice of qi gong and tai chi can alter the immune system in
beneficial ways, and tai chi decreases fear of falling and improves balance and flexibility in
older adults.
D. Limitations of Alternative Therapies
Like all treatments, CAM has limitations and even dangers. Some herbal remedies and
E. Integrative Medicine
The movement toward integrative medicine comes from practitioners in both
conventional and alternative medicine, who propose that an integration of these two
treatment approaches would be beneficial to patients. This type of integration faces the
challenge of melding very different philosophies of treatment but offers the promise of
benefits from both approaches. Two areas in which integrative medicine is advancing most
rapidly are pain management and cancer treatment.
Exploring Health on the Web
Internet sources abound offering advice and resources to help people manage stress and pain,
including alternative and complementary medicine. Some of those sites are commercial sites that
offer products or services, and others are organization or government sites that provide
information.
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HealthWorld Online is a large website devoted to alternative and integrative medicine,
with topics, papers, products, and links to other sites.
Suggested Activities
Personal Health Profile
The Personal Health Profile for Chapter 6 asked students to keep a stress diary and the
activity for Chapter 7 required students to keep a record of their pain. Those diary entries provide
the information for additional analysis. Students should evaluate the situations that provoked their
stress and pain and what types of coping strategies they used. Then, they should consider the
alternative approaches detailed in Chapter 8 in order to formulate more effective ways for
managing their stress and pain. Did they use alternative approaches such as massage or
chiropractic? Or mind-body techniques such as meditation, yoga, or biofeedback? What are their
attitudes about such approaches? Would they feel comfortable in pursuing an alternative approach
for stress or pain management? Which are more appealing and which are less so?
Seeing Alternative Treatments
Invite several alternative medicine practitioners to class to inform your students about the
philosophy and practice of alternative treatments. This presentation should include as wide a
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variety of practitioners as possible, but be sure to include a massage therapist, chiropractor, and
someone who can present traditional Chinese medicine. Hearing from an advocate for each of the
alternative medicine systems would be interesting, and demonstrations of qi gong and tai chi,
biofeedback, meditation, yoga, and Reiki would allow your students to see these techniques in
action.
Seeking Alternative Treatments
Many students have sought alternative healthcare options, without realizing that going to
the chiropractor, taking a yoga class, or taking supplements are considered complementary and
alternative medicines and treatments. Have students share their experiences (or their families’)
experiences with CAMs and talk about which treatments they would seek out in the future now
that they have heard about them.
Seeking Specific CAM Treatments vs. Traditional Treatments
Ask students to generate ideas for why someone might seek CAM vs. traditional
medicine options. For example, why might people prefer a CAM treatment for mild high blood
pressure instead of medicine? What are the possible negatives of using CAM instead of medicine
for high blood pressure?
Improving Health Literacy
Many people – including students in health psychology courses – fall prey to the allure of
anecdotal evidence. That is, they believe that if some treatment, pill, or supplement seemed to
work for one person then it is necessarily an effective treatment for everybody. This fallacy can
be challenged by having students look on the internet for false health claims. The links below
can be a good place to start, as they provide general information on how to tell if a product or
Students may be able to identify widely false health claims but may not be as quick to
identify health claims they see every day, such as ergogenic aids in drinks (e.g., energy drinks or
vitamin-enhanced waters).
Video Recommendations
From Films for the Humanities & Sciences:
Alternative Medicine (2002) provides a critical review of healing techniques such as
acupuncture, therapeutic touch, and other alternative approaches to healing.
Alternative Therapies: A Scientific Exploration (2008) includes three 60-minute programs:
hypnotherapy, meditation, and reflexology and massage. Each program evaluates its subject
critically, examining the scientific research on the technique.
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Chinese Medicine (2007) explores the philosophy and techniques of Traditional Chinese
Medicine, including acupuncture, qi gong, and herbal remedies.
From Fanlight Productions:
No Fears, No Tears shows the experience of children with cancer who learn to use behavioral
techniques to control the pain of their treatment and manage the stressful experience of medical
testing. A follow-up, No Fears, No Tears—13 Years Later, presents some of these children as
adults and their description of recollections of their childhood experiences.
Videos from the Web:
http://www.youtube.com/user/NCCAMgov – The National Center for Complementary and
Alternative Medicine makes available a number of videos describing CAM practices such as
yoga, meditation, acupuncture, Qi Chong, and Tai Chi.
Multiple Choice Questions
1. The National Center for Complementary and Alternative Medicine
a. sponsors research on complementary and alternative medicine.
Considering Alternative Approaches
b. promotes the use of complementary and alternative medicine through lobbying
efforts.
c. evaluates the safety of products and devices.
d. reviews treatment programs for the National Institutes of Health on
complementary and alternative practices.
2. Alternative medicine is an alternative to what?
a. complementary medicine
b. conventional medicine
c. Chinese medicine
d. Western medicine
3. The commonality among all the systems, practices, and products that are considered
alternative is
a. that they are ineffective except for the placebo response.
b. their derivation from Chinese medicine.
c. that they are not accepted within conventional medicine.
d. their higher degree of effectiveness compared to conventional techniques.
4. When people combine conventional treatments such as analgesic drugs with alternative
approaches such as massage,
a. they are using complementary medicine.
b. the diverse treatment approaches will be ineffective.
c. their conventional medicine practitioners often force them to make a choice
between approaches.
d. the combination of approaches will probably cancel each other out.
5. According to traditional Chinese medicine, when the qi is blocked or becomes stagnant,
a. health impairment occurs.
b. people lose weight.
c. an increase in creativity occurs.
d. lung capacity increases but digestive capacity decreases.
6. One of the goals of treatment in traditional Chinese medicine is to
a. reduce the amount of qi that flows through the body.
b. increase the amount of qi that flows through the body.
c. bring yin and yang into balance.
d. increase yin forces and decrease yang forces.
Considering Alternative Approaches
7. The technique that involves inserting needles into specific points on the body and
stimulating those points is
a. qi gong.
b. acupuncture.
c. ayurveda.
d. pressure point therapy.
8. Ayurvedic medicine originated in
a. India.
b. China.
c. Europe in the 19th century.
d. Japan.
9. The goal of Ayurvedic medicine is to integrate and balance
a. the body, space, and time.
b. the body, mind, and spirit.
c. the yin and yang.
10. The exercise that originated with Ayurvedic medicine is
a. qi gong.
b. tai chi.
c. yoga.
d. rhythmic meridian movement.
11. What do all alternative medical systems have in common? The systems
a. are holistic, considering psychological factors as well as physical factors in
health.
b. arose long ago and are now accepted by very few people.
c. accept the importance of manipulation of the skin and organs in the healing
process.
d. emphasize physical factors and minimize psychological and emotional factors.
12. The main limitation on the use of CAM is
a. the body of research that indicates no real effects for these techniques.
b. the widespread lack of acceptance by the public.
c. the lack of research on these techniques.
d. the campaign by conventional medicine to prevent people from using CAM.
Considering Alternative Approaches
13. Therapeutic manipulation of the spine is the basis for
a. TENS.
b. allostasis.
c. qi gong.
d. chiropractic treatment.
14. Chiropractic practitioners
a. earn doctoral degrees and are licensed to practice.
b. attend college for about four years but receive no degree.
c. may earn a doctoral degree or not, which affects the extent of their practice.
d. train through an apprentice program rather than through colleges.
15. Chiropractic treatment was the subject of a bitter fight during the middle of the 20th
century. What group tried to keep chiropractors from practicing?
a. The American Psychological Association
b. The American Psychiatric Association
c. The American Medical Association
d. The National Institutes of Health
16. Which alternative treatment is most likely to be covered by insurance plans in the United
States?
a. chiropractic
b. dietary supplements
c. hypnotherapy
d. tai chi classes
17. Which of the following manipulative techniques originated in traditional Chinese
medicine?
a. acupressure and tui na
b. acupuncture and Reiki
c. Shiatsu massage and counterpressure
d. Shiatsu massage and Reiki
18. The group of diverse medical and health care systems that are not considered part of
conventional medicine are _____________.
a. biopsychosocial medicines
b. bio-medicines
c. alternative medicines
d. complementary medicines
Considering Alternative Approaches
19. Acupuncture, acupressure, and tui nai are techniques or practices that stem from
_________.
a. traditional Chinese medicine
b. Ayurvedic medicine
c. energy healing
d. homeopathy
20. _________is a technique of inserting needles into specific points of the skin that is meant
to unblock the flow of qi and restore health.
a. Acupuncture
b. Acupressure
c. Tui na
d. Reiki
21. Two of the more common alternative treatments in the United States are
a. chiropractic treatment and energy healing
b. chiropractic treatment and massage
c. massage and meditation
d. energy healing and massage
22. Vegetarian and vegan diets are helpful in promoting good health, as they are beneficial in
helping to _______________.
a. reduce high cholesterol
b. reduce the risk of cold and flu
c. reduce the risk for osteoarthritis
d. all of the above
23. Almost _______ of adults in the US supplement their diet with vitamins, minerals or
natural products to improve their health.
a. 7%
b. 18%
c. 24%
d. 62%
24. The notion that the mind and body form a holistic system of dynamic interaction
characterizes which approach?
a. mind-body medicine
b. traditional Chinese medicine
c. Ayurvedic medicine
d. all of these
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25. Who was important in formulating the view that the mind and the body work according
to different principles?
a. Norman Cousins
b. Benedict Lust
c. Daniel David Palmer
d. René Descartes
26. The meditation technique that involves sitting relaxed with eyes closed, focusing on
breathing, and repeating a single word or sound is called
a. mindfulness meditation.
b. transcendental meditation.
c. yogic meditation.
d. repetitive meditation.
27. With the technique known as mindfulness meditation, people
a. receive spiritual advice from their therapist.
b. receive information on their internal biological functioning.
c. focus nonjudgmentally on any thoughts or sensations as they occur.
d. attempt to discover their irrational cognitions.
28. Snyder is in therapy with a health psychologist for relief from panic attacks. The
psychologist uses a technique in which Snyder is asked to imagine a peaceful pastoral
scene and then concentrate on that scene during any anxiety-provoking situation. From
this description it appears that Snyder’s psychologist is using
a. hypnosis.
b. progressive muscle relaxation.
c. meditative relaxation.
d. guided imagery.
29. The practice of yoga includes many postures that are intended to ___________ and
controlled breathing that is intended to ____________.
a. relieve pressure on the spine . . . reframe their problems
b. concentrate energy in the body . . . concentrate attention
c. induce a trance . . . energize the body
d. concentrate muscle tension . . . remove muscle tension
30. Qi gong is
a. a series of movements that offer therapeutic benefits.