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 Naturopathic Authenticity: The Importance of Distinguishing Paradigms From Treatments
When the fourth conversation recently brought up this same topic and its importance, I knew the time had arrived for me to hone these amorphous images into an essay that might simultaneously provide form, as well as a continuum for this discussion that should not be taken lightly. The first time this distinction appeared on my horizon was in conversation with Pamela Snider, ND, who was explaining to me, as a first-year naturopathic medical student, an important aspect of the naturopathic profession – namely that the profession had defined itself chiefly by its philosophy rather than by its interventions. This distinction had immediate appeal to me because I had seen how the chiropractic profession had been defined by, and then limited to, spinal manipulation by external allopathic forces1 as well as by powerful internal factions.2 The second time this conversation alighted near me was in a grassy field aside the Kenmore campus of Bastyr University. The year was probably 1999, and the late Bill Mitchell, ND, was holding class outside, with a hill as his podium and the nearby trees as his blackboard. While the notes I took during that class are still buried among mountains of other books and articles I've amassed over the years, one comment from that day's lecture rang in my ears so resoundingly that I still hear it even today. Dr. Mitchell had strayed briefly onto a tangent that included the phrase "green medicine" and he ended his sentence by saying, in essence, "if we ever go that way, our profession is doomed." I remember feeling uneasy from and indeed averse to what he said, and while I had some idea what he meant at the time, it took years of replaying those words for me to fully crack the code. At that time, as a fledgling naturopath, I still had not completely bridged the chasm between philosophy and intervention. Fittingly, Jared Zeff, ND, provided the third occasion for me to reconsider this distinction and its relevance for naturopathic practice and the profession as a whole. It happened just last year when Jared and I were at the Northwest Naturopathic Physicians Convention in Tacoma, Wash. My interpretation from what I remember him saying was, in essence, that people confuse "naturopathic medicine" with "natural medicines." This again is similar to what Bill Mitchell had tried to communicate to us in class, and so I began to mix and simmer these ingredients, knowing that in due time they would fortify me with a clearer, deeper articulation and understanding of this multifaceted phenomenon we call naturopathic medicine. Naturopathic medicine is unique not only because of its philosophy, which is powerfully different from the chiropractic, osteopathic and allopathic philosophies (if indeed the latter does exist), but also because of the relationship the schools and the profession have with naturopathic philosophy. We could describe these philosophical characteristics as declarative (the articulation of naturopathic philosophy) and dynamic (the interaction of our philosophy with our paradigms and practices). Of the four main primary contact health care professions in the U.S., the naturopathic profession is tied more to its philosophy than any of the others. The allopathic profession, for example, declares patient beneficence as its guiding light, but with its exorbitant expenses that are among the leading causes of personal bankruptcies3 and the well-documented iatrogenic catastrophe that occurs perpetually in this country,4,5 it is clear that the profession does not wholly act in accord with its declared goal. Related, an osteopathic medical student with whom I talked last week lamented that his osteopathic school seems to have confused its use of manipulative medicine as a sign that the school's curriculum is "holistic." Failure to maintain clear distinction between interventions and authentic philosophy is abundant in the research literature, and this "mistake" probably is not entirely accidental. The vast majority of studies attempting to validate, or more often subvert, natural treatments are not performed in accord with naturopathic philosophy; rather, these studies are performed in accord with the drug-based, double-blind, placebo-controlled model, which has merits as well as deficits (more of the latter). The inherent risk to the naturopathic profession from this problem is that when naturopathic treatments are studied out of context and in isolation, the effectiveness of naturopathic medicine is tremendously underestimated. This is why naturopathic research should be performed, or at least supervised, by naturopathic physicians, rather than by non-clinicians or non-naturopathic physicians whose training in natural medicine amounts to attendance at a few weekend seminars. When researchers who are untrained in natural therapeutics (in general) and naturopathic therapeutics (in particular) dissect these interventions, their research and conclusions generally are not representative of authentic naturopathic practice. This is a major problem because this bogus research will then be cited to discredit naturopathic medicine and naturopathic physicians, when it is neither reflective of naturopathic medicine nor representative of authentic naturopathic practice. Solutions to this problem include: Defend your territory. Individual NDs must assume greater personal responsibility for protecting the image of the profession and for authentically representing the profession in scientific publications. Do not tolerate your image and your profession being lambasted by "researchers" with ulterior motives or whose ignorance invalidates their findings; this is especially important when their inaccurate conclusions6 create the false impression that natural therapeutics are dangerous or inefficacious.7 Major journals frequently publish bogus and defaming research that you can easily deflate with a published letter to the editor.8,9 Publish your success. The second part to individual action is the proactive publication of your successful cases. The more you can back these case reports with long-term, follow-up and/or objective data, such as lab tests and biopsy results, the better and stronger will be your evidence of success. Naturopathic colleges and professors must publish. This appears obvious, but rarely is enacted, let alone enforced. One publication or letter to the editor per year is not too much to ask for, especially if it is a group effort involving two or three authors. If our profession fails to articulate and document our perspectives and experiences, then by default we will have allowed other, often adversarial, groups to define our reality for us. At that point, like a puppet on a string, our profession will continue to be restricted by groups and policies led by self-advocacy and falsity, rather than an objective appraisal of naturopathic medicine and its merits. Authentic naturopathic medicine often employs the use of "natural medicines," such as nutrients and botanical medicines, but the use of such natural medicines is not synonymous with the practice of naturopathic medicine. Alternative medicine includes switching a patient from Lipitor to policosanol or from Prozac to Hypericum, and while such substitutions may be used within naturopathic medicine, they are not fully representative of naturopathic practice. Naturopathic medicine is a philosophy of life, grounded upon respect and love for nature and the multifaceted life process we seek to support. Naturopathic medicine does not exist in capsule or liquid form, and it cannot be picked up from the pharmacy or administered in a double-blind manner. It cannot be conveyed or mastered in a weekend seminar. Naturopathic medicine is a dynamic state of being that is moving in the direction of optimal vitality, conveyed clinically from one who is more healed or skillful in health matters to one in need of healing or treatment. Our interventions are our means, not our identities. Naturopathic medicine cannot be "learned" or "administered"; it must be incorporated (brought into the body) and, ultimately, lived. References
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All Rights Reserved, Naturopathy Digest, 2011.
Date Last Modified - Friday, 17-Oct-2008 12:11:06 PDT
By Alex Vasquez, ND, DC, Editor, Naturopathy Digest
