Issue link: https://www.massageandbodyworkdigital.com/i/1471270
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 79 L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 79 openly advocated in fields from genomics to physiology and developmental biology. 3 Over the 20th century, these perspectives developed, and so did the supporting research. By the 1970s, research and training in what was then called psychosomatic medicine was just developing, but direct discussion of the impact of emotions and mental health on physical health was still met with skepticism and suspicion. 4 Yet, throughout the 1980s and 1990s, research continued, and findings ranging from the impact of group therapy on the symptom control and overall prognosis of breast cancer patients to cognitive behavioral therapy on viral load in HIV-positive men emerged, 5 alongside extensive research on the prevention and even improvement of heart disease progression and prostate cancer through lifestyle changes and stress management. 6 Research institutes at Harvard, Stanford, Columbia, and UCLA, among many other major universities, have all contributed to the growth of robust literature to the degree that there is no longer any question as to whether there is a clear connection between physical health and mental well-being. ough many questions remain open regarding mechanisms of action and other factors (such as outcome predictors or the relative effectiveness of these therapies), there is now a strong evidence base for the efficacy of combined multimodal body-mind therapies for multiple conditions ranging from cancer to chronic pain. And of course, rich research into pain science and the potential of pain education is an additional significant area demonstrating these connections. SO WHERE'S THE PROBLEM? In a major critical review from 2003, the author highlighted the positive progress made in this field of research, while quoting the (then) director of the Osher Institute at Harvard Medical School, explaining that "medicine has not moved much beyond the biomedical model" because "practitioners are not exposed to the evidence supporting the biopsychosocial model." 7 is has certainly changed in the 20 years that have elapsed, since person-centered and the biopsychosocial model are prioritized in both the British and American primary-care settings, the same is true in many other European countries as well as Australia, and efforts to integrate social prescribing and behavioral modifications into geriatric care are also under way. 8 It is worth highlighting that these practices have been central to naturopathic and osteopathic practice since their early beginnings, when lifestyle changes were at the very heart of natural health applications. e same review noted that the growth of the evidence base might help body-mind medicine to "escape its negative association with alternative medicine." Yet, although biomedical clinical practice has actively begun to adopt elements of holistic practice with solid evidence underpinning it, biomedical communities show little, if any, awareness of its long-standing use in the context of "alternative" disciplines. Similarly, in mainstream medical education the integration of holistic approaches into the curriculum is being presented as a new addition, without consideration of the principles, for example, of osteopathic education for which the holistic approach to health care is foundational. On the flip side, the (old) news of the integration of holistic thinking within biomedical practice does not seem to have reached many allied and integrative health practitioners or schools. As a result, holism and "alternative" practices are either defined in terms of their "negative associations" or upheld as a proud countercultural current holding out against the forces of allopathic approaches. In both cases, the language and concepts are divisive. Since their inception, "nature cure," "natural medicine," osteopathy, chiropractic, and other holistic approaches to health care defined themselves in contrast to mainstream "allopathic" medicine. Historically, there were good reasons for this, not least because, particularly in the US, funding, political support, and public opinion played a strong part in the shaping of these approaches. It is worth noting that from the earliest days, holistic health care incorporated a strong emphasis on self-care and grassroots campaigning closely connected with political and social views; these contrasted strongly with the more top-down hierarchical power structures in the biomedical fields as they were developing at the time, so the countercultural dynamic is well-earned. 9 Yet, in this age of taking such care over the connotations of language, this contrary negative definition (defining these therapies as not mainstream) has well and truly stuck. From outright accusations of quackery, to being considered "fringe" (1960s), "alternative" (1970s), "complementary" (1980s), then alternative again, then integrative, now, sometimes, "functional," in all cases, these therapeutic approaches are "other," a state oen emphasized more by their practitioners than their historical "opponents" (who might well think of them as little more than part of the broad field of "allied" health professions, at least in some locales). us, despite decades of work to professionalize and validate numerous aspects of integrative (complementary, alternative) therapies, the negative association remains; the mud has stuck. Even aer accounting for the many very real flaws in research, 10 TAKEAWAY: Many controversies among integrative health professions are outdated and a result of poor communication and negative habits. Examining evidence through interprofessional collaboration will benefit practitioners and patients alike.