Complementary treatments for chronic disease


Following on from my blog about complementary treatments and cancer, I came across this video about a shamanic treatment for depression, by Andrew Solomon  It includes comments about how western style talking therapies didn’t seem to work so well in Rwanda, better to drum and get out in the sun surrounded by one’s community than sit in a dark room reliving the bad things. He also describes the ritual in detail which I found very interesting. It was his comments on treatments for depression that got me thinking.

When treating diseases like depression, somethings will work for people whilst others don’t.  There is evidence to support interventions such as drugs and talking therapies, but it seems to me that the outcome is generally an improvement in symptoms rather than a cure.  When talking about cancer, the evidence outcome used is normally death.  This means information on numbers needed to treat to live 5 years is a precise outcome.  When talking about chronic diseases and / or mental health diseases the evidence outcomes are normally in the form of improved symptoms. This improvement can be measured objectively through observing changes in surveys like SF36 which is a general patient health survey. By the nature of calling them chronic diseases it is clear that western medicine is not currently able to cure them.

To me, this is a different group of diseases which can be approached differently.  It is different for the patient since the how they feel is often an important factor in deciding whether there has been a clinical improvement. Working with the benchmark of how the patient feels enables different interventions to be used and compared by the patient.  This enables the patient to make their own choice on what works for them. At the individual level it is easy to include complementary treatments and measure their impact for oneself.  There is still a role for providing objective population information.  It helps to inform the decision making for the individual. I do think that building objective data for complementary therapies will help to empower people so they can make their own decisions.

When someone is declining western medicine, with a chronic disease, I feel they are exploring what is out there. They are empowering themselves to seek their own solution and healing. The consequences of not following the western path are generally not so severe. Medication stopped  can always be reinstated (the doctor part of me is saying do check how to stop medication first to avoid side effects and problems). There is an element of trial and error for the individual.  This can be informed by evidence so that things that are more likely to work are tried first.  It can also easily involve multiple treatments so complementary therapies are a key part of the picture.

A personal question I have is whether my views are based on a fear of death / fear of doing harm? Is it because there is in my view less risk of harm that I think it is acceptable to take risks and try things? The answer is yes it is based partly on fear. It is also based on wanting to be honest with people who are wanting to explore spiritual healing.  I want to be coming from a place of safety and security for that individual.  I feel, for me as a trained doctor, I would not be honest if I was pushing a alternative rather than a complimentary approach.  In my time as a medic I have seen the limits of medicine.  In seeking the shamanic path I am looking for a path of healing. Over time I am coming to recognise that, for me, shamanic healing is different to the absence of disease.  It brings me back to the WHO definition of health as taught to me in public health.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO 1948

The final aspect I’m going to touch on is recognition that we don’t really take rational decisions. Any advertiser / marketer plays on our emotions to affect different decision making. The same is true for us when it comes to health.  We live in a society that holds up rational decisions as the best, indeed my whole argument about evidence base medicine is part of this ethos. Yet I am struck by how many “successful” people seem to use gut feelings.  As I deepen my shamanic practice I increasingly deepened on my inner knowledge and feelings.  In the ideal world, every patient would be so in tune with themselves and Spirit that they would be able to divine for themselves what they should do, and be released from fear in the decision making, including fear of death.  We don’t live in that world yet, so I will continue to work at enabling people to get to that point.

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