The Synergy of Complaint: Birth of a Grievance

The Synergy of Complaint:
Birth of a Grievance

A time like our own, when intensive criticism of medicine has become widespread, offers the potential for even more fundamental critiques and proposals for change. It has not been lost on observers or practitioners that the longstanding critiques of Western medicine as mechanistic, reductionist, and technologically biased can be joined with the recent criticisms of high cost, limited access, inefficiency, and therapeutic ineffectiveness. Taken together, the impact of both sets of criticisms is more than the sum of the parts. If medicine is not only too costly, inaccessible, and ineffective but also fundamentally wrong in its most basic assumptions about the nature of illness and healing, significant improvement can only come through a major change in how we think about health and healing. The problems are so great that a solution will require the emergence of what some have termed a new "paradigm."

		The relatively common use of the terms "paradigm" and "paradigm shift" is traceable to Thomas Kuhn's The Structure of Scientific Revolutions. Kuhn used examples from physics to rebut the idea that scientific change came about through the consistent and gradual accretion of knowledge among experts. Rather, Kuhn asserted, change was generated in bursts—as the accumulation of facts or insights that disproved existing doctrines took hold among researchers who were outside the scientific mainstream. These outsiders focused their thoughts and theories on the inevitable gaps or lapses in what the dominant perspective could explain. A new paradigm was "revolutionary" in Kuhn's view because it aggressively pointed out the deficiencies of the old ways of seeing, and because it offered a new way of understanding in place of the old. The extent to which the new paradigm helped people understand something heretofore incomprehensible would determine its success. Kuhn himself was surprised, and eventually somewhat aghast, at the way his descriptions of changes in physics became used to describe changes (or proposed changes) in many arenas of intellectual and social life. It was far from clear to Kuhn that something as vast as "medicine" was very much like the small world of theoretical physics. Still, both advocates and observers of alternative medicine use Kuhn's terminology in describing the "paradigm shift" to a new "medical model." For example, Deepak Chopra writes, "Each assumption of the old paradigm can be replaced with a more complete and expanded version of the truth." In his call for ''a new medical model," Kenneth Pelletier asserts: Medicine, based upon Newtonian physics, has adhered for some time to one mode of scientific inquiry with inherent assets and often-unacknowledged limitations. . . . Holistic approaches to health parallel the insights of quantum physics in that both supplant the Newtonian reductionist view of the world with the quantum perspective of a dynamic universe. From this new paradigm derive the philosophical and scientific roots for the practice of holistic medicine. In using this language, these and many other alternative practitioners "suggest that a holistic approach to health care is so original that it qualifies as a paradigm shift, that is, an entirely new way of characterizing and approaching the problems of a given discipline." Whether or not alternative medicine does offer a truly new paradigm is open to question. In part the answer lies in specifying whether those who advocate an "alternative medicine" hold a common set of conceptual understandings. This is the subject of the next chapter. But, the answer depends as well on the ability of the new paradigm to successfully respond to the gaps or failures of the dominant biomedical paradigm. An "alternative" paradigm requires something to which it is an alternative. In this respect it differs from a paradigm that claims to be "holistic," "complementary," or "integrative." It is the very ability to point out, emphasize, and respond to the vari ous failures of something else that energizes and gives a raison d'etre to anything that is self-consciously "alternative." Alternative medicine does represent a new paradigm in that it provides a new framing of ideas about illness and the health care system. Situations and circumstances that were previously seen as uncomfortable or unfortunate now are conceptualized as being wrong or unjust. For example, the standard biomedical approaches for treatment of chronic illness and suffering arc not just perceived as inadequate but as grievously and unacceptably limited. Alternative medicine offers the sense that the current situation is riddled with contradictions and that something else, something better, is possible. The future of alternative medicine hinges on its ability to prove that such an approach to health and illness does exist. But, the opportunity for alternative medicine to make its case at this point in history derives from the extent, depth, and acceptance of the notion that existing forms of conventional medicine have come to place an unreasonable burden upon society and hinder our ability to respond to illness. The phenomena described in the following pages are called by many names: holistic medicine, mind-body medicine, East-West medicine, complementary medicine, integrative medicine, and more. The advocates of each term are cogent in offering reasons for why their particular choice best encapsulates the underlying principles of the techniques they use. Often, these advocates disdain the term "alternative medicine" because of its residual character. Alternative medicine is what conventional medicine is not. From a purely clinical perspective this reasoning may be sound, if not persuasive. But the phrase "alternative medicine" best captures the role and meaning of these techniques and approaches to healing in relation to the larger society.