Category Archives: instructor reflections

Week 8: The Development of Contemporary CAM

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We’ve made it halfway through the semester! Keep up the good work y’all! 

Last week our readings focused again on fleshing out Baer’s theory of understanding CAM modalities as sites of resistance (to biomedicine and general counter-culture protest movements) and accommodation (through the process of licensure). 

While Baer’s chapters and articles typically focus on the majority of CAM users (white, upper-middle class women), the supplemental chapters last week explored CAM use by cultural and ethnic minorities and what potential experiences might inform these decisions. As you could tell from the slightly different conclusions from these chapters (based on different communities), there is no clear-cut answer to this question. Cultural context and nuanced understandings are always important. That said, it does raise interesting points and I’d like you to keep those findings in the back of your mind as we continue exploring contemporary CAM modalities. 

A quick caution about the reading this week: it is a bit dull (sorry!). It’s filled with acronyms for different CAM associations, institutes and universities. I’m much less concerned about the specific dates and names, and more about the general process and dynamics each healing system has with biomedicine and licensing. I’d also like you to focus on how healing is approaches by each of these systems in a modern context (ex: early Chiropractic vs contemporary manifestations), as Baer gives quick overviews of the systems that many of you will be attending in the coming weeks. 

 

IMPORTANT DATES: 

Tuesday, March 3rd (tomorrow) is the last day to drop the course for a W (withdrawal). If you’re having issues keeping up with the course, please reach out to me tomorrow. I may be able to help you navigate the rest of the semester, but I also may suggest that you withdraw and try again next semester. 

 

CHOICE PROJECT: 

Tomorrow I expect to spend time working through your reflection journals and commenting on your Choice Projects. Make sure you’ve included as much information as possible, including:  issues that you’ve encountered, where you are in the process, what steps you plan on taking next and potential timelines for each step completion. 

Also something to contemplate: have you thought about how you’ll schedule work on your project given that it’s due right after spring break? Would you rather get it done so you can relax over break, or do you use Spring Break as a time to catch up on all your class work? No judgement here, I just want you to be honest with yourself and how you work as a student. 

 

READING PROMPTS:  

Toward an Integrative Medicine: Chapter 2: The Semi-Legitimation of Four Professional Heterodox Medical Systems (pg 25-56)

  • What does it mean to be “professional” in the context of CAM? To be “legitimate”? 
  • What does Baer mean by “semi-legitimation”? 
  • What is the stated purpose of licensure (according to biomedicine associations) and what are it’s unintended consequences?
  • Describe the differences of “mixers”, “specialists” and “drugless general practitioners” in the Chiropractic context. If you’ve seen a chiropractor for an adjustment before, which did they most resemble? How could you tell? 
  • Describe the process of emergence, decline, and rejuvenation of American naturopathy. Why was naturopathy so well suited for a revitalization starting in the late ‘70s ? 
  • Describe modern homeopathy. 

 

Toward an Integrative Medicine: Chapter 3: Partially Professionalized Therapeutic Systems: The Struggle for Legitimacy (pg 57-88)

  • What does Baer mean by “partially professionalized” CAM systems? By “lay heterodox”?
  • What are the general steps that each CAM system goes through in the process of professionalization? 
  • How do “Traditional Naturopaths” distinguish themselves from (and critique) other forms of naturopathic healing? 
  • Although there is little ethnographic research on herbalist healers, where do preliminary studies reveal they operate out of? (in other words: if you are going to see an herbalist, where do they work?)
  • Instead of medical jargon (such as patients, healer, treatment, etc), what kind of language do herbalists use in reference to the people they provide service to? Why is this? 
  • How is Ayurveda different from other forms of Asian medical transplants? 
  • Why is lay midwifery included in Baer’s discussion of alternative healing?

 

VOCABULARY: 

  • Semi-legitimate
  • Partially professionalized
  • Lay heterodox
  • Lay practitioner
  • Sanitaria
  • Chi / Qi
  • Midwifery
  • Hostile Licensure

I also wanted to take a moment to include the overlap that I see in my social media consumption (Instagram) and the content that we’re discussing in class. In a few sentences in this chapter, Baer briefly alludes to a dynamic (which can be applied in other instances we’ve discussed in this course) in which middle-class white women consume healing modalities as though it were either a novel and new development (or the opposite, that they’re tapping into an “ancient” universal practice”, that are common-place to peoples of color. His text reads: 

“Cobb delineates four types of birth attendants in the United States: (1) obstetricians; (2) nurse-midwives; (3) lay “granny” midwives, who historically were particularly predominate among African Americans in the South; (4) and “modern lay midwives,” who emerged out of the feminist and natural birthing movements of the late 1960s…As Cobb observes, “at precisely the time when members of low income and rural populations have been persuaded to give up home births, certain segments of white American middle-class are seeking birth at home…” (pg 78-79)

His commentary reminded me of an artist critique (and discussion by an anti-Racist activist / Public Academic) of this dynamic that came through my Instagram feed months ago. 

View this post on Instagram

This week was used widely to acknowledge black maternal health. • On medical racism: “Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data — a racial disparity that is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel. In one year, that racial gap adds up to more than 4,000 lost black babies. Education and income offer little protection. In fact, a black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education. This tragedy of black infant mortality is intimately intertwined with another tragedy: a crisis of death and near death in black mothers themselves. The United States is one of only 13 countries in the world where the rate of maternal mortality — the death of a woman related to pregnancy or childbirth up to a year after the end of pregnancy — is now worse than it was 25 years ago.” -via: @nytimes • On breastfeeding: “Black women were once considered property, very valuable property during chattel slavery. Not only were black women ripped apart from their families and sold on auction blocks, they were systematically “broken in” by their new slave owners by being raped, then forced to nurse the young babies of the master. They often watched their babies suffer and die of malnourishment as they generously fed the slave master’s babies. Black women were known to be exceptional feeders and breeders. There was an entire market created for “black milk” which sustained this nation. No one can imagine the trauma of what our ancestors must have experienced at the hands of slave masters. But what we do know is that post traumatic slave syndrome is real, and that our collective maternal line has gaping holes that need healing and reintegration when it comes to our bodies.The descendants of these ancestors who endured so much are now ready to heal.” – @glowmaven • First slide art by: @andrearoussos Second slide art by: @chelslarss

A post shared by Rachel Elizabeth Cargle (@rachel.cargle) on

While this post (and the subsequent commentary) isn’t directly related to our course topics, it’s still related to our broader conversations of healing, alternative medicine, and healthcare in America. Taking posts like this as jumping off point, or exploring the connection you see, is an excellent way to reflect on the course material. 

So I’ll also ask you: what kind of media are you consuming outside of institutional education? Is social media simply a platform for sharing beautiful pictures, funny memes and entertainment? Or have you curated a platform that encourages you to dig a little deeper? 

 

Meta-Reflection: A reflection on your reflections

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I spent the good part of three hours today reading through your first EduBlog reflections and the comments. While I spent a substantial amount of time making sure to comment on each of your reflections, I wanted to take a moment to reflect myself on what I saw in your responses as a whole. I won’t be able to do this every week, but its important to me that 1) you know that I’m reading and reflection on your thoughts and 2) that I can do a similar project that I’m asking you to do. 

So here we go! A few themes that I noticed while reading your reflections today, and my response…

(side note:  I’m now wishing I had started tracking the topics and main phrases y’all used to make a word cloud — oh well, next time)

 

A general distrust and distaste for modern medicine and big pharma

Over the course of the semester, this theme will arise again and again. The idea that modern Western medicine is missing the mark somehow – whether it be the lack of time spent with patients, the strong drugs with adverse side effects, the over prescription of said drugs, or a limited (rather than holistic) scope of practice that focuses only on the body and not the “whole person.”

What I hope you realize through the next weeks is that this dissatisfaction with heroic medicine / regular medicine / biomedicine (whichever medical system has the hegemonic power) has pervaded the American psyche. This is not a new phenomenon nor a return to past – it’s always been there. 

 

Issues with accessibility to regular / biomedicine — 

Connected to the distrust of regular / heterodox medicine is the general sense that it’s inaccessible, not just to patients, but also the process of “legitimation” made it an inaccessible profession to any person that wasn’t white and male. While I didn’t assign the chapter this time around, Baer has an excellent discussion of the role of corporate capitalism in the rise of biomedicine. He pays special attention to the Flexner Report. It’s stated intent was to ensure that medical practitioners were held to a high standard for the protection of patients, but a (unintended?) consequence was the closure of many medical schools that allowed women and Black doctors.

A related issue is the prohibitive cost of healthcare from regular physicians. As we’ll see a bit in this week’s readings (Week 3), regular medicine was typically more expensive than alternative modalities — it most definitely is now. In terms of Thomsonian medicine, he imagined the ultimate democratization of healing — “every (hu)man (their) own doctor” — (but I’d also push back on the idea that these early healers were completely altruistic and “good hearted” as some of you mentioned in your reflections; they were still making good money selling the rights to their approach).

The conversation of accessibility healthcare will become more complex as we work through the syllabus: first with conversations about the Holistic Health Movement and New Age healing (usually upper- or middle-class white women who have disposable income), but then broadening our conversations to different types of CAM that may (or may not) appeal to other communities, especially Black, Indigenous, and immigrant communities that face discrimination and trauma by the biomedical community. 

My questions for you here are: Throughout these different historical periods, what are some of the barriers of access to regular / biomedical care? And what happens when biomedical care doesn’t “work” / cure (in the case of chronic illness)? How do you imagine some of these issues relate to who practices / is a patient of alternative medicine? What about biomedical care seems insufficient, and how are the values of alternative medicine filling those gaps? 

 

A desire for “natural” and “holistic” — 

Time and again in your posts I read comments about how y’all (or your families) were much more receptive to healing modalities that were “natural” – whether that meant an avoidance of prescription meds because of their side effects, or because “clean living” and healthier lifestyles lead to less disease in the first place, or that modern medicine is limited in effectiveness and needs to “integrate” with alternatives… These are also not new or modern concepts. As we’ll see in this week chapters, but especially in the Holistic Health movement, these values are consistently part of American’s views on healing. 

A few more questions to keep in mind as we continue to read: How do all of these communities define “natural”? What does “holistic medicine” mean, especially in the context of the Holistic Health movement? Despite alternative medicine’s attention to “holism” , how does it continue to be “limited” (per Baer)? 

 

Personal and familiar use of a variety of “alternative healing” practices

Thank you all for sharing your personal and familiar / community experiences of CAM healing! Some of the practices that y’all mentioned included:  folk and ethno- medicine (teas, herbs, tinctures, oils), parochial medicine (incense, prayer for healing), and some New Age healing (crystals, energy healing).

I’d love to know more about all of these practices, especially the folk medical traditions used in your family – to the extend that you’re willing to share. Some of the most powerful reflections and connections to material happen when we talk about things related to your life, your family, your community… One student even mentioned calling their mom to share that a leader from their religious communities was mentioned in the one of the chapters — that made my day! And while that won’t happen every week, hopefully once or twice throughout the semester we’ll touch on something that resonates with your experience. 

Another great source of content for your reflections would be the integration of how you see CAM pop up in your daily life. Snap pictures while you’re at the grocery store waiting in line (so many health magazines draw on CAM and holistic health movement ideals), at the esoteric shop (New Age healing), the tea that your grandma make when you’re sick or the tonic that a friend sends from abroad (folk medicine, herbal remedies, “Eastern” healing). Once you start looking, you might see it everywhere! 

On a personal note, as a child of California hippies (my mom was at UC Berkeley in the late 60’s and my dad considers himself a (neo)shaman (yes, in all the very problematic ways) — most of the content we’ll cover this semester (at least the modalities that are marketed to middle-class while folks) is familiar to me and feels a bit like “home” — and I find it really fascinating (and an opportunity of growth to encounter all the problematic ways I was raised) to explore the history of practices that were just a part of my background growing up.

Welcome to the RELS3700: CAM Course Blog!

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I won’t ask my students to do something I can’t do myself; so, I’ve created a blog for our Spring 2020 course, RELS3700: Complementary and Alternative Medicine. 

This will be a space where I post course announcements, assignment details, general musings on the readings and my own reflections on my own developments as an instructor. Please bear with me as I get the hang of it. 

Well, here goes nothing…